1 Respiratory drugs and epidemiology

Question 1

How are respiratory drugs administered

Answer 1

• inhalation
• oral
• IV

Question 2

What are the drugs which are used to improve ventilation

Answer 2

Brochodilators

• Beta2 agonist
• anticholinergic

Anti-inflammatory
- corticosteroid

Question 3

What do the drugs which are used to improve ventilation do

Answer 3

improve airway patency (keeping it open)

prevent mast cell degranulation

Question 4

What are drugs which impair ventilation

Answer 4

• beta-blockers

- respiratory depressants e.g. benzodiazepines, opioids

Question 5

What drugs are used to improve gas exchange

Answer 5

• respiratory stimulants (e.g. theophyllines)

- oxygen

Question 6

What are used to deliver inhaled drug delivery

Answer 6

• Meter dose inhaler (MDI)

- breath activated device (spinhaler, turbohaler)

Question 7

What is the problem with an inhaler compared to a spinhaler/turbohaler?

Answer 7

high velocity suspension in inhaler can mean a lot of powder ends up in the mouth rather than in the lungs

Question 8

What can be used for young children instead of an inhaler

Answer 8

nebuliser

Question 9

What are the actions of beta agonists

Answer 9

• stimulate beta2 receptors
• lungs dilate
• airways wider

Question 10

What different types of beta agonists do you get

Answer 10

Short acting

• salbutamol
• terbutaline

Long acting
- salmeterol

Question 11

What is in a blue inhaler

Answer 11

Short acting beta2 agonists:

• salbutamol
• terbutaline

Question 12

What is the onset of short acting beta agonists

Answer 12

2-3 minutes

Question 13

how long do the effects of short acting beta agonists last

Answer 13

4-6 hours

Question 14

What are short acting beta agonists used for

Answer 14

used treat acute bronchial constriction

Question 15

what is the onset time for long acting beta agonists

Answer 15

1-2 hours

Question 16

how long do the effects of long acting beta agoinsts last for?

Answer 16

12-15 hours

Question 17

what are long acting beta agonists used for

Answer 17

used to prevent acute bronchial constriction

Question 18

What are long acting beta agonists always used with? why is this important?

Answer 18

an inhaled steroid, to prevent cardiac arrest

Question 19

what do anticholinergics do (Ipratropium = grey inhaler)

Answer 19

• inhibit muscarinic nerve transmission in autonomic nerves

- additive effect in bronchial dilation and reducing mucus secretion

Question 20

What are the effects of corticosteroids

Answer 20

reduce inflammation in the bronchial walls

Question 21

What corticosteroids have brown, orange and pink inhalers

Answer 21

Beclomethasone (brown)
Budesonide (brown)
Fluticosone (orange)
Mometasone (pink)

Question 22

What are inside compound preparations (purple)

Answer 22

inhaled steroid with long acting beta agonist (mixture of green and brown as lots of patients will ignore brown one cause they don’t feel it makes much difference)

Question 23

What does chromoglycate do

Answer 23

stops mast cells degranulating (‘like tasting sand’)

Question 24

What do leukotriene inhibitors do

Answer 24

monotelukast

- inhibits one of the key inflammatory mediators