pharmacology

Question 1

bronchodilator mechanism

Answer 1

stimulate bronchial smooth muscle B2 ADR

- inc cAMP, inc PKA = relax

Question 2

what does one use for nocturnal asthma

Answer 2

LABA

Question 3

bronchodilator side effect

Answer 3

fine tremor, tachycardia, arrhythmias, hypokalaemia

Question 4

bronchodilator contraindications

Answer 4

use with cautioning hyperthyroidism, CVS disease, arrhythmias and hypertension

Question 5

CysLt receptor antagonist examples

Answer 5

montelukast, zafirlukast

Question 6

CysLt receptor antagonist mechanism

Answer 6

CysLTs (LTD4, LTC4) derived from inflammatory cells cause contraction of airway SM, oedema inc in mucus and eosinophils
they block these

Question 7

what is the therapeutic ratio like for oral steroids

Answer 7

low

Question 8

oral steroid mechanism

Answer 8

signal via nuclear receptors

bind to GRE

Question 9

oral steroid AE oral

Answer 9

oral candidiasis

Question 10

oral steroid AE GI

Answer 10

peptic ulcer

Question 11

oral steroid AE MSK

Answer 11

myopathy

Question 12

oral steroid AE endocrine

Answer 12

cushing

Question 13

NOTE: what is cushings

Answer 13

excess corticosteroids (causes hypertension)

Question 14

name an inhaled steroid

Answer 14

beclomethasone

Question 15

inhaled steroid AE

Answer 15

fever systemic effects than oral steroids

Question 16

anti inflammatory anti-IgE monoclonal antibody

Answer 16

omalizumab

expensive

Question 17

omalizumab administration

Answer 17

injection every 2 weeks

Question 18

omalizumab use

Answer 18

prophylaxis in asthma

when raised IgE and severe persistent allergic asthma despite max therapy

Question 19

omalizumab AE

Answer 19

abdominal pain
headache
pyrexia

Question 20

omalizumab contraindications

Answer 20

caution in autoimmune disease

Question 21

methylxanthine example

Answer 21

theophylline

Question 22

methylxanthine mechanism

Answer 22

non selective inhibitor of PDE

- inc cAMP and relaxes ASM

Question 23

theophylline route

Answer 23

oral

Question 24

aminophylline route

Answer 24

IV

Question 25

methylxanthine AE

Answer 25

narrow therapeutic ration | arrhythmias, seizures, hypotension

Question 26

SAMA

Answer 26

ipratropium and oxitroprium

Question 27

SAMA mechanism

Answer 27

non selectively block M 123

Question 28

LAMA

Answer 28

tiotropium and aclindium

Question 29

tiotropium mechanism

Answer 29

selectively blocks M3 | longer half life than ipatropium

Question 30

PDE4 inhibitor

Answer 30

rofimulast

Question 31

PDE4 inhibitor use

Answer 31

to reduce COPD exacerbations

Question 32

PDE4 inhibitor AE

Answer 32

nausea, diarrhoea, headache, weight loss

Question 33

Mucolytics

Answer 33

oral carbocisteine and oral erdosteine

Question 34

carbocisteine mechanisms

Answer 34

reduce sputum viscosity

Question 35

carbocisteine AE

Answer 35

rarely GI bleeding

Question 36

Mucolytics contraindications

Answer 36

caution with those with history of peptic ulcer

Question 37

erdosteine mechanism

Answer 37

symptomatic treatment of acute exacerbation chronic bronchitis

Question 38

erdosteine AE

Answer 38

nausea, vomiting, diarrhoea and abomdinal pain

Question 39

what do M1 ACH receptors do

Answer 39

facilitate fast neurotransmission by Ach acting on nicotinic receptors

Question 40

what do M2 ACH receptors do

Answer 40

inhibit Ach release

Question 41

what do M3 ACH receptors do

Answer 41

mediate SM contraction and inc mucus secretion

Question 42

what is indacaterol

Answer 42

ultra LABA - rapid onset of action and only daily dose required

Question 43

what is the best combination for reducing FEV1

Answer 43

LAMA + LABA

Question 44

what are the effects of antihistamines

Answer 44

antagonists of H1 receptors - dec vasodilatation and inc capillary permeability - dec activation of sensory nerves - dec mucus secretion from submucosal glands

Question 45

what is used for aspirin induced asthma

Answer 45

CYsLt antagonist

Question 46

what is symbicort

Answer 46

budesonide and formoterol

Question 47

what is seretide

Answer 47

fluticasone and salmeterol