Inhalation Therapies Flashcards
(29 cards)
SABA
- example
- duration of action
Salbutamol And Terbutaline
- 4 hours (short term reliever to expand airways)
Max dose SABA
1-2 puffs up to 4 times per day (max 8 puffs daily)
LABA
- example
- duration of action
Salmeterol, formoterol
- 12 hours
Caution of SABA/ LAMA in diabetics
- what can it cause?
DKA
- Especially after IV administration
What electrolyte imbalance can beta-2 agonists cause?
- what can this cause?
HyPOkalaemia
- QT prolongation and arrhythmias
Side effects of SABA/LAMA
- fine tremor
- headaches
- palpitations
Interaction between digoxin and SABA/LAMA?
- Why is this caused?
Increase risk of digoxin toxicity
- due to hyPOkalameia
Example of SAMA
Ipratropium
Example of LAMA
Tiotropium, Glycopyrronium, Umeclidium
What are the side effects of SAMA/LAMA
Anti-muscarinic
- blurred vision
- urinary retention
- constipation
- dry mouth
examples of ICS
Budesonide, Beclometasone, fluticasone. Mometasone
which ICS should be prescribed by brand?
Beclometasone
what can steroid used in children do?
Slow down growth (growth retardation)
- monitor height and weight
What are the main side effects of ICS?
Thrush in mouth (candidiasis)
- reduce by using spacer and rinsing mouth with water after use
Paradoxical bronchospasms
- reduced by using SABA
example of LTRA
Montelukast
what is the MHRA warning for montelukast
Risk of neuropsychiatric reactions
- such as sleep disorders, hallucinations, anxiety and depression, and changes in behaviour and mood.
what is Churn-Strauss syndrome?
Inflammation of blood vessels
- can restrict flow to organs
Characterised by
- Vasulitic rash
- pulmonary/ cardiac symtoms
- elevated eosinophils
What are the interactions of LTRA?
CYP450 substrate
- meaning its metabolism can be induced and inhibited
what is the therapeutic range for theophylline?
10-20mg/L
- same as phenytoin (PHy = 10-20)
When and what time should blood levels of theophylline be checked?
4-6 hours after dose
- 5 days after starting treatment
- 3 days after changing dose
Brands of theophylline do not have the same bioavailability, this means that they must be…
Prescribed by brand and maintained on the same one
Side effects of theophylline
- SICK AND FAST
- Vomiting
- Palpitations and tachycardia
- Arrhythmias
- Tremor
- HyPERglycaemia
What are the main interactions of theophylline?
- Smoking- INCREASES clearance
- Fevers- REDUCE
- CYP enzyme
- Drugs that cause hypokalaemia- diuretics, corticosteroids
What can REDUCE the clearance of theophylline?
- what does this mean for the therapeutic range?
Having a FEVER
- these decrease the rate at which theophylline is cleared so INCREASES levels
- This means it can exceed therapeutic levels and cause TOXICITY
