Respiratory Pharmacology Flashcards

1
Q

What are the aims for asthma control?

A
Minimal symptoms during day + night 
Minimal need for reliever medication 
No exacerbations
No limitation of physical activity 
Peak flow >80% predicted
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2
Q

What is the stepwise management for asthma in adults?

A

Low dose ICS

SABA + low dose ICS

LABA + low dose ICS

Increase ICS dose OR add LTRA

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3
Q

What is the stepwise management for asthma in children?

A

Very low dose ICS

SABA + very low dose ICS

Very low dose ICS + (>5) LABA/LTRA OR (<5) LTRA

Low dose ICS + LABA/LTRA

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4
Q

What are the commonly used SABAs?

A

Salbutamol

Terbutaline

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5
Q

What is the mechanism of SABAs?

A

Cause bronchodilation by agonising B2 receptors in the lungs

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6
Q

What are examples of LABAs?

A

Salmeterol

Formoterol

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7
Q

What are the side effects of B agonists?

A

Tachycardia
Palpitations
Tremor

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8
Q

What are examples of ICSs?

A

Beclomethasone
Budesonide
Fluticasone

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9
Q

What is the mechanism of ICSs?

A

Prevent IL-1 + IL-6 production by macrophages

Reduce inflammation

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10
Q

What are the side effects of ICSs?

A

Dry mouth
Nausea (if swallowed)
Headache
Oral candidiasis

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11
Q

What should you check before you add a new drug?

A

Re-check compliance
Check inhaler technique
Eliminate trigger factors

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12
Q

What are examples of LTRAs?

A

Montelukast

Zafirlukast

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13
Q

What is the mechanism of LTRAs?

A

Block effect of cysteinyl leukotrienes in the airways at CysLT1 receptor

Prevents LTC4 release by mast cells and eosinophils

Prevents

  • Bronchoconstriction
  • Mucus secretion
  • Mucosal oedema
  • Inflammatory cell recruitment
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14
Q

What are the side effects of LTRAs?

A
Angioedema
Dry mouth 
Anaphylaxis
Arthralgia
Fever
GI disturbances
Nightmares
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15
Q

What are the drugs can be used for asthma?

A
Methylxanthines 
LAMAs (long acting anticholinergics)
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16
Q

What are examples of Methylxanthines?

A

Theophylline

Aminophylline

17
Q

What is the mechanism of Methylxanthines?

A

Antagonise adenosine receptors

Inhibit phosphodiesterase - increase cAMP

18
Q

What are the side effects of Methylxanthines?

A

Nausea
Headache
Reflux

19
Q

Wat is an example of a LAMA?

A

Tiotropium bromide

20
Q

What is the mechanism of tiotropium bromide?

A

M3 receptor antagonist

21
Q

What are side effects of tiotropium bromide?

A

Dry mouth
Urinary retention
Glaucoma