Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase II - Pharmacology > 29. Respiratory > Flashcards

29. Respiratory Flashcards

1
Q

What is asthma?

A

Chronic inflammatory disease of the airways characterised by episodes of acute bronchoconstriction causing shortness of breath, cough, chest infection, wheezing, and rapid respiration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the airflow obstruction in asthma due to?

A

Bronchoconstriction resulting from contraction of bronchial smooth muscle, inflammation of the bronchial wall, and increased secretion of mucus. Inflammation leads to airway hyperresponsiveness, airflow limitation, respiratory symptoms, and disease chronicity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What may trigger asthma attacks?

A

Allergens, exercise, stress, and respiratory infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the goals of asthma therapy?

A

Decrease intensity and frequency of asthma symptoms and the impact they have on day to day life of the patient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Give an example of a short acting B2 agonist and the indication for use.

A

Salbutamol - asthma or COPD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give an example of a long acting B agonist with its indication for use.

A

Salmeterol, terbutaline, formoterol - asthma or COPD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the naming rule for inhaled corticosteroids? Give an example.

A

-one. Prednisolone, beclomethasone dipropionate, budenoside, fluticasone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give an example of a short acting anticholinergic with its indication for use.

A

Ipratropium - COPD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give an example of a long acting anticholinergic with its indication for use.

A

Tiotropium - COPD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give an example of a leukotriene receptor antagonist with its indication for use.

A

Montelukast - asthma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the purpose of B2 agonists in asthma?

A

Quick relief and adjunctive therapy for long-term control.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the onset of action of SABAs?

A

5-30 minutes to provide relief for 4-6 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When is SABA as a monotherapy suitable in asthma management?

A

If it’s intermittent, e.g. exercise induced.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the ADRs of SABAs?

A

Tachycardia, hyperglycaemia, hypokalaemia, hypomagnesaemia, B2-mediated skeletal muscle tremors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the duration of action of LABAs?

A

At least 12 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When should LABAs be considered in asthma management?

A

As an adjunctive therapy alongside SABAs and ICS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the ADRs of LABAs?

A

Same as SABAs - tachycardia, hypokalaemia, hypomagnesaemia, hyperglycaemia, skeletal muscle tremor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the mechanism of action of ICS?

A

Inhibit arachidonic acid release through phospholipase A2 inhibition –> direct anti-inflammatory effects.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When should ICS be used in asthma management?

A

Long term control of asthma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the effect of ICS on the airways are several months of regular use?

A

Reduced hyperresponsiveness of airway smooth muscle to bronchoconstrictor stimuli (allergens, cold air, irritants, exercise).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which patients with asthma may be considered for oral or IV corticosteroids?

A

Those with a severe exacerbation or those not controlled on ICS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the ADRs of ICS?

A

Oropharyngeal candidiasis, hoarseness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How can candidiasis be prevented with regular ICS use?

A

Swish-and-spit method with water after using ICS.

24
Q

What is the action of leukotriene receptor antagonists?

A

Prevents the actions of leukotrienes - constriction of bronchiolar smooth muscle, increased endothelial permeability, mucus secretion promotion.

25
Q

What are the ADRs of LRAs?

A

Elevated LFTs, headaches, dyspepsia.

26
Q

What is the mechanism of action of cholinergic antagonists?

A

Block vagally mediated contraction of airway smooth muscle and mucus secretion.

27
Q

What are the ADRs of cholinergic antagonists?

A

Xerostomia, bitter taste.

28
Q

What is the mechanism of action of theophylline?

A

Bronchodilator that relieves airways obstruction, also anti-inflammatory.

29
Q

Why is theophylline not first line in asthma management?

A

Narrow therapeutic window, ADRs, DDIs.

30
Q

What are the effects of overdose of theophylline?

A

Seizures, potentially fatal arrhythmias.

31
Q

What is omalizumab?

A

A recombinant DNA-derived monoclonal antibody that selectivity binds to human immunoglobulin E.

32
Q

What is the mechanism of action of omalizumab?

A

Binds to IgE on mast cells and basophils so limits the release of mediators of the allergic response.

33
Q

Who is omalizumab indicated for in patients with asthma?

A

Moderate to severe persistent asthma who are poorly controlled with conventional therapy.

34
Q

What are the ADRs of omalizumab?

A

Rare anaphylactic reaction, arthralgias, fever, rash.

35
Q

What is COPD?

A

Chronic, irreversible obstruction of airflow that is progressive.

36
Q

What are the symptoms of COPD?

A

Cough, excess mucus production, chest tightness, breathlessness, difficulty sleeping, fatigue.

37
Q

What is the main risk factor for COPD?

A

Smoking.

38
Q

What is the goal of pharmacology in COPD management?

A

Relief of symptoms and prevention of disease progression.

39
Q

What is the action of bronchodilators in COPD?

A

Increase airflow, alleviate symptoms, decrease exacerbations.

40
Q

What is first line for COPD treatment?

A

LABAs and tiotropium.

41
Q

What are the reasons for and against ICS use in COPD?

A

For: improve symptoms, lung function, and quality of life if FEV1 <60% predicted.
Against: increased risk of pneumonia.

42
Q

What is Roflumilast?

A

Oral phosphodiesterase-4 inhibitor.

43
Q

What is the action of roflumilast in COPD?

A

Reduces exacerbations in patients with severe chronic bronchitis.

44
Q

What is the mechanism of action of roflumilast in COPD?

A

Reduce inflammation by increasing levels of cAMP in lung cells. It’s a bronchodilator.

45
Q

What are the ADRs of roflumilast?

A

Nausea, vomiting, diarrhoea, headache.

46
Q

Describe the proper inhaler technique for asthma and COPD patients.

A

Patient should exhale fully then coordinate pushing on the pump with a big breath in. They should hold their breathe for 10 seconds if possible then breathe normally. If administering multiple puffs, they should repeat this process separately, i.e. don’t double press on inhaler.

47
Q

What is rhinitis?

A

Inflammation of the mucous membranes of the nose with sneezing, itchy nose/eyes, watery rhinorrhoea, nasal congestion, and a nonproductive cough.

48
Q

Why are antihistamines helpful in managing allergic rhinitis?

A

Prevents histamine effects - sneezing, watery rhinorrhoea, itchy eyes/nose.

49
Q

How should allergic rhinitis be managed?

A

Antihistamines, inhaled CS, a-agonists (only short term).

50
Q

How should a cough be managed?

A

Opioids and benzonatate.

51
Q 
What is the most appropriate drug to rapidly reverse bronchoconstriction in severe symptoms of asthma?
A. inhaled fluticasone
B. inhaled beclomethasone
C. inhaled salbutamol
D. IV propranolol
E. oral theophylline.
A

C. inhaled salbutamol - immediate bronchodilation.

52
Q 
A 9yo patient has gone from 3 hospital admissions due to asthma attacks/year to none, which drug is most likely responsible for the improvement?
A. inhaled salbutamol
B. inhaled ipratropium
C. inhaled fluticasone
D. oral theophylline
E. oral zafirlukast
A

C. inhaled fluticasone - ICS reduce severe asthma attacks.

53
Q 
68yo male with COPD has moderate airway obstruction. He uses salmeterol twice/day but has continued SOB on mild exertion. Which would be an appropriate addition to therapy?
A. systemic CS
B. salbutamol
C. tiotropium
D. roflumilast
E. theophylline
A

C. tiotropium - anticholinergic bronchodilator addition would be appropriate to add to a LABA.

54
Q

58yo female has had a recent COPD exacerbation, this is the third exacerbation in the year although she only has mild symptoms between exacerbations. She currently takes salmeterol twice daily and tiotropium inhalation once daily. Her FEV1 <60% predicted. What should be changed about her medication regimen?
A. chronic systemic CS
B. stop tiotropium
C. stop salmeterol
D. change salmeterol to combination of LABA and ICS
E. theophylline

A

D. ICS and LABA combination - frequent exacerbations need more prevention, i.e. ICS.

55
Q 
Which of the following medications requires regular administration for asthma treatment?
A. tiotropium
B. salmeterol
C. mometasone
D. salbutamol
A

C. mometasone - they have anti-inflammatory properties with regular dosing.

56
Q 
Which of the following medications inhibits leukotriene?
A. cromolyn
B. zafirlukast
C. zileuton
D. montelukast
E. theopyhlline
A

C. zileuton - inhibits leukotrienes.

Phase II - Pharmacology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions