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Top 100 Drugs > Respiratory system > Flashcards

Respiratory system Flashcards

1
Q

list antihistamines (H1- receptor antagonists) (4)

A

chlorphenamine

certirizine

loratidine

fexofenadine

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2
Q

common indications for antihistamines (3)?

A
  1. first line for allergies (particularly hay fever)
  2. aid relief of pruritus (itchiness) and urticaria (hives)
  3. adjunctive Tx in anaphylaxis following adrenaline
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3
Q

MOA of antihistamines?

A

antagonists of the H1 receptor blocking effects of excess histamine

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4
Q

what is the difference between first and second generation antihistamines?

A

first generation- cause sedation

(chlorphenamine)

second generation- non sedative

(loratidine, cetirizine, fexofenadine)

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5
Q

why do newer second generation antihistamines not exert a sedative effect?

A

they do not cross the BBB

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6
Q

sedating antihistamines (chlorphenamine) should be avoided in which pt group?

A

severe liver disease as may precipitate hepatic encephalopathy

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7
Q

list drugs belonging to the antimuscarinic class (bronhcodilators) (4)?

A

ipatropium

tiotropium

glycopyrronium

aclidinium

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8
Q

common indications for antimuscarinics (2)?

A
  1. COPD
  2. Asthma
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9
Q

MOA of antimuscarinics?

A

bind to muscarinic receptors competitively inhibiting acetylcholine

blocks parasympathetic effect- reduce smooth muscle tone and reeduce secretions in the RT

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10
Q

common adverse effects (respiratory) of antimuscarinics (3)?

A

nasopharyngitis

sinusitis

cough

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11
Q

antimuscarinics should be used with caution in which pt groups (3)?

A

angle-closure glaucoma (can precipitate rise in IOP)

those with or at risk of arrhythmias

urinary retention

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12
Q

how can you communicate antimuscarinics to the pt?

A

Tx to open up the airways and improve their breathing

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13
Q

monitoring of antimuscarinics (resp)?

A

ask patients about their symtpoms and review peak flow

should check their inhaler technique

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14
Q

list common B2-agonists (5)

A

salbutamol

terbutaline

salmeterol

formoterol

indacaterol

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15
Q

common indications for B2-agonists (3)?

A
  1. asthma
  2. COPD
  3. hyperkalaemia
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16
Q

where are B2-receptors found?

A

smooth muscle of the bronchi gut, uterus and blood vessels

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17
Q

stimulation of B2-receptors has what effect on smooth muscle?

A

smooth muscle relaxation

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18
Q

like insulin what effect do B2-agonists have on potassium?

A

stimulate Na+/K+ (ATPase) pumps causing shift of K+ from the extracellular to intracellular compartment

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19
Q

long acting B2 agonists can have what side effect due to a rise in serum lactate levels?

A

muscle cramps

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20
Q

LABAs should lonly be used in asthma if what other drug is also being prescribed?

A

Inhaled Corticosteroid (ICS)

(without LABAs are assoc with inc in asthma deaths)

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21
Q

B2 agonists should be prescribed with care in which pt group due to risk of angina or arrhythmias?

A

cardiovascular disease

Tachycardia may provoke angina/arrhythmia

22
Q

give the common preparation of B2 agonists prescribed for the following indications 1) as reuired for asthma

2) asthma/COPD exacerbation
3) maintainence of asthma

A

1) SABA- inhaled
2) nebulised therapy
3) combi inhaler to ensure co-admin with steroid

23
Q

what does MDI stand for when refering to drugs delivered in aerosol such as B2 agonists?

A

MDI- metered dose inhaler

24
Q

how could you communicate the action of B2 agonists to the patient?

A

treatment is to help their airways relax and improve their breathing

*treats their symtpoms not the disease

25
Q

how should pts taking B2 agonists be monitored?

A

symtpom severity/ exacerbations

26
Q

when prescribing nebuliser therapy which of air or oxygen should be used in 1) asthma and 2) COPD?

A

1) oxygen in asthma
2) medical air in COPD (risk of CO2 retention)

27
Q

name corticosteroids (inhaled) (3)

A

beclometasone

budesonide

fluticasone

28
Q

common indications for inhaled corticosteroids (2)?

A

1) asthma
2) COPD

29
Q

MOA of inhaled corticosteroids?

A

reduces mucosal inflammation, widens the airways and reduces mucous secretion by modififying gene transcription:

pro-inflammatory/ cytokines are downregulated

antiinflammatory proteins are upregulated

30
Q

common adverse effects of inhlaed corticosteroids? (3)

A

oral candidiasis (thrush)

hoarse voice

v little absorbed into blood so few systmeic adverse effects unless taken at very high dose

31
Q

high dose inhaled corticosteroids should be used with caution in which pt groups? (2)

A

1) COPD pts with history of pneumonia
2) children where there is potential fro growth suppression

32
Q

how could you communicate the action of inhaled corticosteroids to the pt?

A

offering a steroid inhaler to ‘dampen down’ inflammation in the lung

(advise them to rinse mouth/gargle after taking it to help prevent sore mouth/ hoarse voice)

33
Q

how should inhaled corticosteroids be monitored?

A

symptom severity

review after 3-6months to see if therapy should be maintained/ reduced/ intensified

34
Q

which of asthma/COPD is more responsive to inhaled corticosteroids and why?

A

Asthma- poorly controlled airway inflammation can lead to remodelling and fixed airflow obstruction, as inflammation is generally steroid responsive pts should be encouraged to take steroid to prevent disease progression

35
Q

montelukast is what kind of drug?

A

leukotriene receptor antagonist

36
Q

common indications for montelukast by pt age group (3)?

A

1) adults add on for asthma when ICS/LABA not adequate
2) 5-12yr olds- alternative to LABAs as add on therapy where ICS in insufficeint
3) <5yrs first line preventative when unable to take ICS

37
Q

MOA of montelukast?

A

leukotrienes (produced by mast cells and eosinophils) activate G protein coupled leukotriene receptor CysLT1 activating pathwasy in inflammation and bronchiconstriction

Montelukast blocks CysLT1 receptor reducing inflammation and bronchoconstriction in asthma dampening down inflammatory cascade

38
Q

common adverse effects of montelukast?

A

headache

abdo pain

URTI

39
Q

when should montelukast be prescribed?

A

only when asthma is incompletely controlled with ICS and LABAs

40
Q

who can prescribe montelukast?

A

those with the appropriate knwoledge in the management of asthma as they are a third line therapy

41
Q

how is montelukast taken?

A

orally as a tablet, chewable tablet or granule form

42
Q

how could you communicate the action of montelukast to the pt?

A

helps to reduce inflammation and relax their airways to hopefullt improve their symptoms and control their disease

43
Q

common indications for oxygen therapy (3)?

A

1) to increase tissue oxygen delivery in acute hypoxaemia
2) accelerate reabsorption of pleural gas in pneumothorax
3) reduce carboxyhaemoglobin half-life in CO poisoning

44
Q

oxygen should be given with care in which pt group?

A

chronic type 2 resp failure (severe COPD)

can results in rise in PaCO2 leading to resp acidosis, depressed consciousness and worsened tissue hypoxia

45
Q

what is the target SpO2 in 1) most pts 2) those with Type 2 resp failure?

A

1) 94-98%
2) 88-92%

46
Q

what should the conc and flow of oxygen be in venturi and in nasal cannulae?

A

Venturi: 60-80%, high flow 15L/m

Nasal cannulae: 24-50% 2-6L/m

47
Q

common indications for sildenafil?

A
  1. erectile dysfunction
  2. Primary pulmonary hypertension
48
Q

what typ of drug is sildenafil?

A

phosphodiesterase (type 5) inhibitor

49
Q

what type of drug is sildenafil?

A

Phosphodiesterase (type 5) inhibitor

50
Q

finish PDE-5 pg 190

A

Top 100 Drugs (13 decks)

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