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Year 3 - Drug Profiles > Respiratory > Flashcards

Respiratory Flashcards

1
Q

name 2 short acting and 2 long acting Beta 2 agonsists

A

short: salbutamol, terbutaline
long: salmeterol, formoterol

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2
Q

how do B2 agonists work?

A

Stimulates beta-2 receptors causing smooth muscles of airways (and other) to relax
can also shift K+ intracellularly to treat hyperkalaemia

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3
Q

what are the indications to take B2 agonsists?

A

Asthma
COPD
uncomplicated premature labour
(hyperkalaemia rarely)

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4
Q

what are the contraindications of taking B2 agonists?

A

only use long acting alongside inhaled corticosteroids

CV disease - tachycardia leading to angina or arrhythmia

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5
Q

what are the side effects of B2 agonists?

A

tachycardia, palpitations, arrhythmia, anxiety, fine tremor, muscle craps, hyperglycaemia, headache, hypotension

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6
Q

what are the interactions with B2 agonists?

A

Beta blockers reduce efficacy of B2 agonists

theophylline and corticosteroids - can lead to hypokalaemia

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7
Q

Name 2 long acting and one short acting anticholinergic drugs

A

Long: Tiotrpium, Glycopyrronium
short: ipratropium

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8
Q

how do anticholinergic/antimuscarinic drugs work?

A

bind to muscarinic receptors and competitively inhibit Ach. this acts as a bronchodilator and also increases HR

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9
Q

what are the indications to take Anticholinergics?

A
  1. COPD - short acting relieve exacerbation. long acting help prevent breathlessness
  2. Asthma - same as above
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10
Q

what are the contraindications to taking anticholinergics?

A

angle closure glaucoma - causes raised IOP

arrhythmia or MI

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11
Q

what are the side-effects of anticholinergics?

A

dry mouth, cough, headache

GI motility disorder

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12
Q

what are the interactions with anticholinergics?

A

very few important ones

possibly DOPA drugs (possibly reduce absorption); tricyclic antidepressants, antihistamines, clozapine, codeine, disopyramide, MAOIs, nefopam (increased anti-muscarinic side effects)

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13
Q

Name 3 inhaled corticosteroids.

A

Beclometasone, budesonide, fluticasone

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14
Q

how do inhaled corticosteroids work?

A

down regulate inflammatory cytokines eg ILs and up regulate anti inflammatory production. This helps reduce mucosal inflammation, widen airways and reduce secretions

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15
Q

what are the indications for inhaled corticosteroids?

A

Asthma - only if not contolled by B2 agonists

COPD - only used in severe cases

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16
Q

what are the contraindications of inhaled corticosteroids?

A

history of pneumonia

children

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17
Q

what are the side effects of inhaled corticosteroids?

A

local immunosuppressive effects - can lead to thrush and increase chance of pneumonia

hoarse voice

18
Q

what are the interactions of inhaled corticosteroids?

A

very few - no systemic absorption

19
Q

which responds better to inhaled corticosteroids asthma or COPD?

A

Asthma

does not stop progression of disease in COPD

20
Q

name 3 oral corticosteroids.

A

prednisolone, hydrocortisone, dexamethasone

21
Q

how do corticosteroids work?

A

down regulate inflammatory cytokines eg ILs and up regulate anti inflammatory production. This helps reduce mucosal inflammation, widen airways and reduce secretions

22
Q

what are the indications to take corticosteroids?

A

allergic or inflammatory diseases eg asthma

23
Q

what are the side effects of corticosteroids?

A

immunosuppression (more common infections) Adrenal suppression, withdrawal, psychiatric reactions ( insomnia, confi=usion, psychosis), diabetes, osteoporosis

24
Q

what are the contraindications to taking corticosteroids?

A

infection

children - suppress growth

25
Q

what are the interactions with corticosteroids?

A

NSAIDs - increase risk of ulceration
enhance hypokalaemia in B2 agonists, theophylline, loop/thiazide diuretics
efficacy reduced with P450 inducers eg phenytoin, carbamazapine
reduce response to vaccines

26
Q

what class of drug is carbocysteine?

A

mucolytic

27
Q

how does carbocysteine work?

A

dissolves chemical bonds in mucous to reduce the viscosity making it easier to cough up

28
Q

what are the indications to take carbocysteine?

A

cough associated with thick bronchial secretions eg bronchitis, bronchiectasis, CF and emphysema

29
Q

what are the contraindications to taking carbocysteine?

A

active peptic ulceration (disrupts gastric mucosal barrier)

30
Q

what are the side effects of carbocysteine?

A

bronchospasm - a bronchodilator should be given immediately before

31
Q

what are the interactions with carbocysteine?

A

very few important ones

potentially increase adverse effects of some drugs inc chloramphenicol, gliclazide

32
Q

How does Theophylline work?

A

competitive PDE inhibitor - reduced inflammation and lower innate immunity
adenosine antagonist - increase HR, bronchodilates and relaxes smooth muscle

33
Q

what are the indications to take theophylline?

A

Reversible airways obstruction, severe acute asthma

34
Q

what are the contraindications to taking theophylline?

A

Cardiac arrhythmias/cardiac disease, hypertensions, hyperthyroidism, peptic ulcer, epilepsy, elderly, fever

35
Q

what are the side effects of theophylline?

A

Nausea, vomiting, gastric irritation, diarrhoea, palpitation, tachycardia, arrhythmias, headache, CNS stimulation, insomnia, convulsions

36
Q

what are the interactions with theophylline?

A

corticosteroids - increases hypokalaemia
B2 agonists - increases hypokalaemia
adenosine - competitive inhibition
quinolones - increase toxicity

37
Q

how does oxygen work?

A

Increases oxygen levels in blood, also decreases resistance to blood flow in many types of diseased lungs

38
Q

what are the indications for oxygen?

A

(high conc): pneumonia, PE, pulmonary fibrosis, shock, severe trauma, sepsis, anaphylaxis (in uncomplicated cases)
(low conc for risk of hypercapnic resp failure): COPD, advanced CF, severe bronchiectasis, severe ankylosing spondylitis, severe lung scarring from TB, opioid overdose

39
Q

what are the contraindications for oxygen?

A

type 2 respiratory failure - reduces hypercapnic drive

smoking - risk of explosion

40
Q

what are the side effects of oxygen?

A

uncomfortable mask

dry mouth

Year 3 - Drug Profiles (9 decks)

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