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Exam 1- respiratory conditions and infections > Drugs used in Asthma and COPD > Flashcards

Drugs used in Asthma and COPD Flashcards

1
Q

What is Clenil?

A

Beclametasone- ICS

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2
Q

What is salbutamol?

A

SABA

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3
Q

What is salmeterol?

A

LABA

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4
Q

What is montelukast?

A

LTRA

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5
Q

What is Tiotropium?

A

LAMA

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6
Q

What is ipatropium?

A

SAMA

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7
Q

What is a budesonide turbohaler?

A

ICS

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8
Q

What is Qvar?

A

Beclametasone- ICS

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9
Q

What is terbutaline?

A

SABA

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10
Q

What is formoterol?

A

LABA

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11
Q

What is glycopronium?

A

LAMA

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12
Q

What is indacaterol?

A

LABA- COPD only

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13
Q

What is Ventolin?

A

Salbutamol- SABA

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14
Q

What is Fostair?

A

Beclometasone + Formoterol (ICS + LABA)

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15
Q

What is a secretive evohaler?

A

Fluticasone and salmeterol (ICS + LABA)

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16
Q

What does Uniphyllin continue contain?

A

Theophyline (xanthine)

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17
Q

What should a healthy patients respiratory rate be?

A

12-18 bpm

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18
Q

What does PEFR stand for?

A

Peak expiratory flow rate- measures the volume of air forcefully expelled in one exhalation.

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19
Q

what should a patients PEFR be?

A

The ideal PEFR value will depend on the patient but their reading should be at least 80% of of the patients best (calculate)

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20
Q

What should a patients O2 saturation be?

A

At least 96%

21
Q

What could a patient taking hay fever medication signify

A

Hayfever can worsen symptoms of asthma as pollen can be a trigger and would cause further inflammation of the airways.

22
Q

Can people with asthma take Ibuprofen?

A

People with asthma should take care when taking NSAIDs and should speak to a doctor first (e.g. in a patient records scenario, if you collect it from them but it isn’t stated in their records, bring it up) as it can cause a bronchospasm.

23
Q

If on a patients record, ‘Beclametasone’ inhaler is written down, what must you do?

A

Clarify the brand- is it Qvar or clonal?
As they have different particle sizes and so are not interchangeable- Qvar has smaller particles and is also not licensed for use in children under 12

24
Q

If on a patients record, ‘Beclametasone’ inhaler is written down, what must you do?

A

Clarify the brand- is it Qvar or clonal?
As they have different particle sizes and so are not interchangeable- Qvar has smaller particles and is also not licensed for use in children under 12

25
Q

Can you give 2 topical corticosteroid products (e.g. inhaler and nasal spray) at once?

A

Yes- it would increase the likelihood of systemic effects but this combination os very common and suitable.
- if on a high dose of lots of steroids it can cause suppression of natural steroids so would need to stop taking slowly.

26
Q

What would you give if a patient goes into hospital with an acute asthma exacerbation in an emergency situation?

A

Give IV hydrocortisone 100mg every 6 hours until can be converted to oral prednisolone.
Also give a salbutamol via a nebuliser in an emergency situation to act as a bronchodilator
May also be given oxygen

27
Q

If you are adding a LABA to a patient already on an ICS, what might you do?

A

Give it as a MART therapy which contains an ICS + LABA so usually Budesonide and Formoterol ( has both long and short acting bronchodilator effects) e.g. Symbicort turbohaler
or Fostair- contains beclometasone and formoterol

28
Q

What does MART therapy stand for?

A

Maintenance and relieve therapy

29
Q

How do you use MART therapy?

A

Patients on MART therapy only need one inhaler that they take morning and evening (1-2 puffs)
- This same inhaler is also used as a reliever if needed

30
Q

What can a too high does of theophylline cause?

A
  • Can cause symptoms such as nausea, vomiting and a tremor. It has such a narrow therapeutic window that these symptoms are a sign of toxicity.
31
Q

What is the therapeutic and optimal range for theophylline?

A

Therapeutic window is 10-20 mg/L, however the optimal range is just 10-12 mg/L

32
Q

What might a serum theophylline level of >20 cause?

A

Nausea and vomitting

33
Q

What might a serum theophylline level of >25 cause?

A

cardiac arrhythmia

34
Q

What might a serum theophylline level of >30 cause?

A

seizures

35
Q

What therapeutic drug monitoring should be taken when taking theophylline?

A
  • l would need to observe plasma and potassium levels. plasma levels should be taken every 6 months
    can cause hypokalaemia if used alongside a B2 agonist
  • Also need to take blood tests 5 days after starting treatment- should be 4-6 hours after taking medication if it is a MR tablet or IV aminophylline.
36
Q

What is important when giving out prescriptions of theophylline?

A

Must be given the same brand each time, they are not interchangeable.

37
Q

What is the dose of theophylline?

A

MR BD

38
Q

Who would need a higher dose of theophylline?

A
  • People who smoke heavily as chemicals in the nicotine smoke induces the CYPIA2 responsible for the breakdown of theophylline. if the patient quits, the dose must be adjusted.
39
Q

What does theophylline interact with?

A

Many antibiotics- mainly macrocodes e.g. clarithromycin.
This is because theophylline is metabolised by CYP450 enzyme- broken down, however, clarithromycin inhibits the CYP450 enzyme so causes theophylline to not be broken down hence the side effects.
would swap clarithromycin for doxycycline

40
Q

What does the ultibro breezehaler contain?

A

indaceterol (LABA) + Glycopyrronium (LAMA)

41
Q

What could you give to a COPD patient with a chest infection that is not improving with antibiotics and has chronic sputum production?

A

A mucolytic agent e.g. carbocisteine that will reduce suit viscosity to make it easier to clear from the airways.

42
Q

What class of drugs can cause urine retention?

A

LAMA

43
Q

What is the recommended inspiratory flow rate for a pMDI?

A

20-60 L/min
if were too inhale at a high rate e.g. 90- it would hit the back of the throat and be swallowed- won’t relieve eh symptoms as there would be no localised effect

44
Q

How can using a spacer help patients using a pMDI?

A
  • don’t have to coordinate the breathing and pressing of the device
  • prevents deposition of drug in the upper airways that can lead to oral thrush
45
Q

What are some therapeutic monitoring parameters for salbutamol?

A
  • less wheezing and coughing
  • less night time waking
  • lower peak flow and spirometry readings
  • less breathlessness
46
Q

What are some toxic monitoring parameters for salbutamol?

A
  • tachycardia
  • tremors
  • nervous tension
  • headache
  • decrease in potassium levels- hypokalaemia
47
Q

What do LTRAs do?

A

block the effects of cytseinyl leukotrienes in the airways (LTC4, LTD4, LTE3)
- receptors for cysteinyl leukotrienes are present on airway smooth muscle cells and infiltrating immune cells
- By blocking leukotriene 1 receptor, they can decrease both early and late response to allergens in asthma
- Blocking it van slide prevent smooth muscle contraction and migration of eosinophils to the airways

HAS BOTH BRONCHODILATORY AND ANTI-INFLAMMATORY EFFECTS.

48
Q

Are LTRA’s used in asthma?

A

no, copd only

Exam 1- respiratory conditions and infections (11 decks)

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