Asthma drugs

Question 1

salbutamol and terbutaline are selective for what receptors

Answer 1

beta 2 agonists

Question 2

why is epherdine not a great SABA for asthma

Answer 2

not selective for beta 2 therefore more likely to produce side-effects and arrhythmias

Question 3

you can inhale SABA before exercise but

Answer 3

if you are having exacerbations in exercise your asthma is probably not well controlled

Question 4

what drug is formeterol

Answer 4

LABA

Question 5

what drug is salmeterol

Answer 5

LABA

Question 6

what is the point in combination inhalers

Answer 6

to ensure people arent missing the ICS and just taking LABA

Question 7

what LABAs are only licsensed for COPD

Answer 7

indacaterol and olodaterol

Question 8

what long acting oral beta agonist is used for noctornal asthma

Answer 8

bambuterol

Question 9

what class of drug is ipatropium

Answer 9

SAMA

Question 10

when is ipratropium used in copd

Answer 10

for patients not on an LAMA

Question 11

what is the only inhaled antimuscurinic suitable for acute bronchospasm

Answer 11

ipratropium - as short acting

Question 12

what type of drug is theophylline

Answer 12

xanthene

Question 13

how often is ipratropium given for maintanace treatmetn

Answer 13

tds

Question 14

what is in spiriva? how often is it given

Answer 14

tiotropium

OD

Question 15

what electrolyte imbalance might result from thophylline and bta ag together

Answer 15

hypokalaemia

Question 16

how much more potent is aminophyline than theophylline

Answer 16

20 x

Question 17

how does ICS help asthma

Answer 17

reduces airway inflammation

Question 18

how does smoking affect ICS

Answer 18

current or previous smoking reduces the effect of ICS and higher doses may be needed

Question 19

how long does improvement happen with ICS

Answer 19

3-7 days

Question 20

what 3 inhalers can be used for SMART and what is in them

Answer 20

symbicort
duoresp
(both budesonide and formeterol)
Forstair
(beclometasone and formeterol)

Question 21

when changing to SMART what should you do with the dose of ICS

Answer 21

keep the same

Question 22

what age can you used smart

Answer 22

adults

or children 12-18 with symbicort

Question 23

you can usually abruptly stop pred for exacerbation of asthma unless

Answer 23

over three weeks

on step 5

Question 24

what is the role of ICS in COPD

Answer 24

reduction of exacerbations

Question 25

do COPD patients ever take pred regularly long term

Answer 25

not recommended, limited benifit | also pneumonia is a side-effect for ICS in COPD

Question 26

how to reduce ICS thrush (2)

Answer 26

rinse mouth | use spacer

Question 27

how to prevent the paradoxical bronchospasm side-effect of ICS

Answer 27

SABA before ICS

Question 28

whats the crack with QVAR what other inhaler is troublesome like this

Answer 28

its a ball ache extra fine particles, approx 2x as potent as clenil FORSTAIR (beclometasone/formeterol) is also like this

Question 29

who are leukotriene antagonists mores effective in

Answer 29

excercise induced asthma and those with rhinitis

Question 30

when in montelukast given

Answer 30

in the evening

Question 31

cautions with leukotrine receptor antags, what should prescribers look out for

Answer 31

churg-strauss syndrome - look out for eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications or peripheral neuropathy

Question 32

caution with zafirlukast

Answer 32

hepatic disorder

Question 33

how long does it take for chromoglycate or nedocromil therapy to take effect

Answer 33

4-6 weeks

Question 34

who is chromoglycate or nedocromil most effective in

Answer 34

allergic asthma - but its difficult to predict who will respond

Question 35

chromoglycate or nedocromil side-effect to watch out for

Answer 35

paradoxical bronchospasm

Question 36

how are chromoglycate or nedocromil adminstered

Answer 36

inhalation

Question 37

how should chromoglycate or nedocromil be withdrawn

Answer 37

gradually over a week incase asthma worsens

Question 38

what is oral sodium chromoglicate used for

Answer 38

food allergy

Question 39

how often is omalizumab given

Answer 39

4 weeks

Question 40

cautions with omalizumab (2)

Answer 40

churg-strauss syndrome - look out for eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications or peripheral neuropathy hypersensitivity

Question 41

apparet from asthma omalizumab is also used for

Answer 41

spontaneous urticaria

Question 42

what age is omalizumab for

Answer 42

over 6

Question 43

when is omalizumab indicated

Answer 43

patients with asthma who need frequent or continous treatment with PO steroids (4 or more courses in the previous year) and in whom manufacturers make available via patient access scheme

Question 44

what is the mode of action or roflumilast and what disease is it for

Answer 44

phosphodiesterase 4 inhibitor for COPD | by mouth

Question 45

aminophylline is a stable mixture of

Answer 45

theophylline and ethylendiamine

Question 46

what conditions affect plasma theophylline concentration

Answer 46

heart failure hepatic impairment viral infection

Question 47

what durgs need adjusting in smoking and alcohol consumption

Answer 47

theophylline and aminophylline

Question 48

what weight to dose aminophylline

Answer 48

ideal body weigt

Question 49

what electrolyte imbalance can be caused by aminophylline or theophylline

Answer 49

hypokalaemia

Question 50

what are the symptoms of theorphylline overdose

Answer 50

vomiting, agitation, restlessness, dilated pupils, sinus tachycardia, hyperglycemia more serious haematoemisis convulstions arrythnmia

Question 51

what perameters are measured in aminophylline therapy

Answer 51

theophylline levels

Question 52

what are the levels of theophylline thought to be effective

Answer 52

10-20 toxicity can occur at these levels

Question 53

should theophylline and aminophylline be prescribed by brand

Answer 53

yes - and contact the prescriber to agree on a brand if it's not stated on the prescription