T4 - Respiratory pharmacology

Question 1

Give three examples of adrenergic agonists

Answer 1

Salbutamol, salmeterol, formeterol

Question 2

give two examples of anticholinergics

Answer 2

tiotropium and ipatropium

Question 3

give two examples of anti-inflammatories/steroids

Answer 3

prednisolone and beclamethasone

Question 4

name three inhaled drug devices

Answer 4

pressured metered dose inhalers (MDIs), dry powder inhalers and nebulisers

Question 5

give three adverse effects of bronchodilators and what are these side effects controlled by?

Answer 5

tachycardia, tremor and irritation - usually dose dependent

Question 6

which administration of bronchodilators gives the most side effects

Answer 6

IV

Question 7

how quick does a SABA work and how long does it last?

Answer 7

works immediately and works for 3-5 hours

Question 8

what Is the mechanism of action of a SABA?

Answer 8

binds B2 receptors in the lungs and relaxes bronchial smooth muscle

Question 9

give two examples of a LABA and what is it used for?

Answer 9

salmeterol/formeterol used in asthma and COPD

Question 10

what should a LABA always be given alongside in asthma?

Answer 10

inhaled corticosteroid

Question 11

how long does a LABA take to work and how long does it last for?

Answer 11

takes 2-30 mins to work and lasts for 10-12 hours

Question 12

what enzyme do LABAs work on?

Answer 12

adenylate cyclase to increase cAMP

Question 13

what is the onset time of formeterol?

Answer 13

immediately (same as salbutamol but longer action)

Question 14

what conditions would tiotropium be administered in?

Answer 14

stable COPD and asthma (if symptomatic despite SABAs)

Question 15

how long does tiotropium work for?

Answer 15

24 hours (LAMA - long acting muscarinic agonist)

Question 16

what is the mechanism of action of tiotropium?

Answer 16

inhibits M3 receptors in smooth muscle causing bronchodilator

Question 17

what does theophylline inhibit and what circumstance is it used in?

Answer 17

inhibits phosphodiesterase and is used when patient is very sick with persistent asthma or COPD

Question 18

what are zero order kinetics?

Answer 18

a small change in dose has a big change in levels/therapeutics of the drug

Question 19

give an example of an IV/oral glucocorticoid

Answer 19

prednisolone

Question 20

give an example of an inhaled glucocorticoid

Answer 20

beclametasone/furasone

Question 21

what is the mechanism of action of inhaled glucocorticoids?

Answer 21

decrease release of inflammatory mediators, decreased WBC action, decreased airway oedema, decreased mucus production

Question 22

what effect to glucocorticoids have on B2 receptors?

Answer 22

increase their numbers/sensitivity to cause bronchodilation

Question 23

what are the two main side effects of inhaled GCs?

Answer 23

oral candidasis, dysphonia (hard to speak)

Question 24

what effect can increased steroid use have on the immune system?

Answer 24

can suppress it causing increased risk of infections

Question 25

what are three treatments for allergic rhinitis?

Answer 25

H1 antagonists, intranasal glucocorticoids and leukotriene inhibitors/decongestants

Question 26

how can controlled oxygen be administered and what condition would this be relevant in?

Answer 26

venturi mask in COPD

Question 27

what can giving COPD patients too much oxygen cause?

Answer 27

a decrease in their respiratory effort which can increase CO2 and result in a respiratory acidosis

Question 28

give two scenarios where LMW would be used

Answer 28

1) decreasing risk of thrombosis (PE/DVT) if immobile | 2) VTE prophylaxis

Question 29

what class of antibiotics are given for respiratory infections?

Answer 29

penicillins

Question 30

give three scenarios where amoxicillin would be given ins respiratory infection

Answer 30

CAP, COPD exacerbation and bronchitis

Question 31

give two scenarios where doxycycline would be given

Answer 31

COPD exacerbation or atypical pneumonia

Question 32

how does doxycycline work?

Answer 32

by inhibiting protein synthesis

Question 33

what are the side effects of doxycycline?

Answer 33

GI upset, stained teeth, lipid, allergy and photosensitivity

Question 34

give two examples of macrolides and when would they be given?

Answer 34

erythromycin and clarithromycin - given in penicillin allergy

Question 35

what type of bacteria do macrolides work against?

Answer 35

gram positive