Respiratory Flashcards
(26 cards)
How does salbutamol work ?
Stimulate B2 receptors in airways (sympathetic stimulation) promoting bronchodilation
- also inhibits uterine smooth muscle contraction in premature labour
Indictations for salbutamol
- asthma
- chronic bronchitis
- Premature labour
- severe bronchospasm
Contraindications and cautions of salbutamol
- Tachyarrhythmias
- hypersensitivity
Caution in:
- CV disease
- hyperthyroidism
- long QT
- diabetes
What are the side effects of beta 2 agonists?
- fine tremor (usually in hands)
- nervous tension
- headache
- muscle cramps
- palpitations
- Hypokalaemia (rare)
What is the main route of elimination of salbutamol ?
Hepatic
Under what conditions is salbutamol more likely to cause hypokalaemia ?
If delivered by nebuliser or parenterally
What drug class is ipratropium bromide ?
Anticholinergic, antimuscarinic bronchodilator
Indications for ipratropium bromide
- reversible airways obstruction
- COPD
- rhinitis
How does ipratropium bromide work ?
- Inhibit parasympathetic impulses (from CNS and PNS) by competitively blocking acetylcholine therefore preventing contraction of smooth muscle (specifically lungs)
- also inhibits muscarinic ACh receptors, inhibiting mucous secretion in the bronchi
In which patients should antimuscarinics be used with caution ?
- benign prostatic hyperplasia
- bladder outflow obstruction
- those at risk of closed angle glaucoma
What are the side effects of antimuscarinic bronchodilators ?
- dry mouth (most common)
- nausea
- headache
What are the possible interactions of ipratropium bromide ?
- Clarithromycin and erythromycin
- Increased side effects with antidepressants
What class of drug is prednisolone ?
Corticosteroid
How does prednisolone work ?
- Inhibits Phospholipase A2 activity = decreased arachidonic acid production (precursor for prostaglandin and leukotriene synthesis)
- therefore less inflammatory mediators produced= anti inflammatory effect
- immunosupressive effect (decreased B and T lymphocyte response)
Indications for prednisolone:
Suppression of inflammatory and allergic disorders:
- IBD
- asthma
- croup
- immunosupression (leukaemia, transplant)
- rheumatic diseases
Contraindications of prednisolone
- adrenal suppression
- systemic infection
- osteoporosis
Side effects of corticosteroids
- more susceptible to infections (severe with atypical presentation)
- bruising
- hirsutism (abn. Female hair growth)
- moon face
Interactions of prednisolone
Phenytoin and rifampicin cause decreased effects of prednisolone
Elimination of prednisolone
Renal
Why can’t prednisolone treatment be stopped abruptly ?
Adrenal crisis
What drug class is oxygen ?
Therapeutic gas
Indications for oxygen therapy?
- resuscitation (100%)
- acute hypoxic events e.g. MI, asthma, PE, sepsis (60%)
- risk of hypercapnic respiratory failure e.g. COPD
What oxygen saturation should be aimed for in those at risk of hypercapnic respiratory failure (COPD) ?
88-92%
Which drug is in the brown inhaler (disease controller)?
Inhaled corticosteroid e.g. Beclometasone , budesonide, fluticasone
