Brainscape's Knowledge GenomeTM

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


See full index

Pharmacology > Resp > Flashcards

Resp Flashcards

1
Q

What sort of drugs are salbutamol, salmeterol, formoterol, terbutaline?

A

Beta2 agonists

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

What are the indications for prescribing a beta2 agonist?

A

Asthma (short acting for relief, long acting preventative (step 3) and must always be given with inhaled steroid)
COPD (short acting for relief, long acting as second line therapy)
Hyperkalaemia (nebulised salbutamol for urgent treatment alongside insulin, glucose and calcium gluconate)

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

What is the mechanism of action of beta2 agonists?

A

Stimulation of beta 2 receptors on bronchial, GI, uterus and blood vessel smooth muscle activates a signalling cascade that leads to smooth muscle relaxation.
Beta 2 agonists also stimulate sodium potassium ATPase pumps, causing a shift of potassium into cells, useful for treating hyperkalaemia, especially if IV access is difficult, although generally used when other options are incompatible or alongside other therapies.

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

What type of medication is salbutamol and terbutaline?

A

SHORT ACTING Beta 2 Agonist

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

What type of medication is salmeterol and formoterol?

A

LONG ACTING Beta 2 Agonist

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

What are the side effects of beta 2 agonists?

A

As a result of activation of beta 2 receptor activation in other tissue
Tachycardia, palpitations, anxiety, tremor, muscle cramps (LABA)
Highs serum glucose as promote glucogenolysis.

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

What are the contraindications for beta 2 agonists?

A

Long acting Beta 2 agonists should only be used in asthma along with an inhaled corticosteroid, otherwise increased mortality.
Care should be taken in patients who also have cardiovascular disease, in which tachycardia may provoke arrhythmias or angina

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

What type of medications are ipratropium bromide, tiotropium?

A

Antimuscarinincs, bronchodilators

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

What are the indications for ipratropium bromide or tiotropium?

A

COPD, asthma
Short term for treatment to relieve breathlessness during exacerbations
Long term used to prevent excacerbations (in asthma must be added to corticosteroid and LABA, step 4)

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

What is the mechanism of action of antimuscarinic bronchodilators?

A

Bind to muscarinic receptor, acting as a competitive inhibitor of acetylcholine. Inhibiting this receptor causes relaxation of smooth muscle, reduced secretions from glands, pupillary dilation, increase HR. Decreased parasympathetic rest and digest effects.

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

What sort of drug is ipratropium bromide?

A

Short acting antimuscarinic bronchodilator

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

Wha type of drugs are tiotropium, glycopyrronium?

A

Long acting antimuscarinic bronchodilators

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

What sort of medications are theophylline, aminophylline?

A

Methylxanthines

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

What are the indications for theophylline?

A

COPD, asthma, emphysema, chronic bronchitis

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

What is the mechanism of methlxanthine bronchodilators such as theophylline?

A

Relax bronchial smooth muscle via cAMP-PKA pathway

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

What class of medication do beclomethasone dipropionate, budenoside, fluticasone, belong to?

A

Corticosteroids (glucocorticoids), inhaled

17
Q

What are the indications for inhaled corticosteroids?

A

Asthma - in step 2 therapy in asthma not controlled by SABA alone
COPD - to control symptoms and prevent exacerbations in patients with severe airflow obstruction or repeated exacerbations

18
Q

What are inhaled corticosteroids usually prescribed along with?

A

LABA Long acting beta2 agonist

And or long acting anti muscarinic bronchodilator

19
Q

What is the mechanism of action of inhaled corticosteroids?

A

Enter cytoplasm and act on receptors which modify expression of genes in nucleus. Down regulation of proinflammatory interleukins, cytokines and chemokines. Upregulation of anti inflammatory proteins. This reduces mucosal inflammation, widening airways, and reduces mucus secretion.

20
Q

What type of medications are prednisolone, hydrocortisone, dexamethasone?

A

Corticosteroisd (glucocorticoids), systemic

21
Q

What are the indications for systemic corticosteroids (glucocorticoids)?

A

To treat allergic or inflammatory diseases
Suppression of autoimmune disease
As part of chemotherapy
Hormonal replacement in adrenal insufficiency or hypopituitarism

22
Q

What is the mechanism of action of systemic corticosteroids (glucocorticoid)?

A

Bind to cytoplasmic receptors which alter gene expression in nucleus. Upregulats antiinflammatory genes and downregulate proinflammatory genes (e.g. cytokines, TNF alpha). Decreased circulating monocytes and eosinophils. Increased metabolic gluconeogenesis, catabolism of muscle and fat. Na and water retention, K excretion

23
Q

What are the side effects of systemic glucocorticoid corticosteroids?

A

Immunosuppression, diabetes mellitus, proximal muscle weakness, skin thinning, easy bruising, gastritis, mood and behavioural changes, insomnia, confusion, psychosis, hypertension, hypokalaemia, oedema, adrenal atrophy, addisonian crisis (potentially with cardiovascular collapse)

24
Q

What sort of medication is montelukast?

A

Leukotriene receptor antagonist

25
Q

What are the indications for montelukast (leukotriene receptor antagonist)

A

Asthma

Allergies

26
Q

What is the mechanism of action of leukotriene receptor antaonists such as montelukast?

A

Blocks action of leukotriene D4 in lungs and bronchial tubes by binding to it. This reduces inflammation otherwise caused by such.

27
Q

What are the indications for prescribing oxygen?

A

Hypoxaemia
Pneumothorax
CO poisoning

28
Q

What is the mechanism of supplementary oxygen?

A

Raises alveolar pO2, and therefore helps raise arterial pO2, increasing delivery of O2 to tissues, whilst underlying disease is cured.
In pneumothorax, helps reduce nitrogen content in lungs and therefore speed up recovery (pleural air is mostly nitrogen)
In CO poisoning competes with CO for Hb

29
Q

What is the criteria for a mild asthma attack?

A

No features of severe asthma

PEFR greater than 75% best or predicted

30
Q

What are the criteria for a moderate asthma attack?

A

No features of severe asthma

PEFR 50-75% best or predicted

31
Q

What are the criteria for a severe asthma attack?

A

PEFR 33-50% of best or predicted
Cannot complete sentences in one breath
Respiratory rate over 25
Heart rate over 110

32
Q

What are the criteria for a life threatening asthma attack?

A

PEFR less than 33% predicted
Data less than 92%
ABG pO2 less than 8kPa
Cyanosis, poor respiratory effort, near or fully silent chest
Exhaustion, confusion, hypotension, arrhythmias
Normal pCO2

33
Q

What is the criteria for a near fatal asthma attack?

A

Raised pCO2

34
Q

What is the emergency treatment of anaphylaxis? (Drugs and doses)

A 
Remove trigger
Maintain airway (100% O2)
IM adrenaline 0.5mg
IV hydrocortisone 200mg
IV chlorpheniramine 10mg
If hypotensive fluid resuscitate
35
Q

Which way does the trachea deviate in tension pneumothorax?

A

Away from the side of the pneumothorax

36
Q

List some common infective organisms in patients with bronchectasis

A 
Haemophilus influenzae
Pseudomonas aeruginosa
Moraxella catarrhalis
Stenotrophomonas maltophilia
Fungi (aspergillus, Candida)
Nontuberculosis mycobacteria
Less common - Staphylococcus aureus (more common in CF)

Pharmacology (9 decks)

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