Respiratory

Question 1

Beta-2 Agonists

Name and Mechanism

Answer 1

Salbutamol, terbutaline, salmeterol

GPCR relaxes smooth muscle to improve airflow and stimulates Na/K-ATPase pumps reducing hyperkalaemia

Question 2

Beta-2 agonists

Indications

Answer 2

Asthma, COPD, hyperkalaemia

Question 3

Beta-2 Agonists

Contraindications

Answer 3

CVD (tachycardia –> angina)

Question 4

Beta-2 Agonists

Side effects

Answer 4

SNS stimulation (tremor, tachy, palps, anxiety, ^ glucose), increase serum lactate (cramps)

Question 5

Beta-2 agonists

Interactions

Answer 5

Beta-blockers, theophylline, corticosteroids (hypoK)

Question 6

Antimuscarinics

Name and mechanism

Answer 6

Tiotropium, ipratropium

Anticholinergics prevent PNS tone, relaxes smooth muscle, reduces secretions

Question 7

Antimuscarinics

Indications

Answer 7

COPD, asthma (step 4)

Question 8

Antimuscarinics

Contraindications

Answer 8

Angle closure glaucoma, arrhythmias

Question 9

Antimuscarinics

Side effets

Answer 9

Dry mouth, little systemic absorption so minimal effects

Question 10

Corticosteroid

Name and mechanism

Answer 10

Prednisolone
Glucocorticoid target receptors regulating gene transmission, anti-inflammatoru, catabolises muscle, retention of Na, loss of K

Question 11

Prednisolone

Indications

Answer 11

Allergy/inflammatory asthma

Question 12

Prednisolone

Contraindications

Answer 12

Infections, children

Question 13

Prednisolone

Side effects

Answer 13

Immunosuppression
Cushings
ACTH suppression +/- WD addisonian crisis

Question 14

Prednisolone

Interactions

Answer 14

Hypokalaemic increase, risk with NSAIDs, efficacy reduced by CYP450 inhibitors

Question 15

Inhaled Corticosteroid

Name and Mechanism

Answer 15

Beclometasone, budesonide, fluticasone

Reduced inflammation local to AW

Question 16

Beclometasone

Indications

Answer 16

Asthma, COPD

Question 17

beclometasone

Contraindications

Answer 17

Pneumonia in COPD, children

Question 18

Beclometasone

side effects

Answer 18

oral candidiasis, hoarse voice, ^pneumonia risk

Question 19

Mucolytic

Name and mechanism

Answer 19

Carbocysteine
Decreases viscosity (expectorant) by increasing sialomucin content of mucous

Question 20

Carbocysteine

Indications

Answer 20

COPD

Question 21

Carbocysteine

Contraindications

Answer 21

Allergy, breast-feeding, children

Question 22

Carbocysteine

Side effects

Answer 22

GI, nausea, low BM, GI bleed

Question 23

Theophylline

Mechanism of action

Answer 23

Non-selective PDE inhibitor, reduces inflammation and innate immune response (adenosine antagonist -> heart)

Question 24

Theophyllines

Indications

Answer 24

Asthma, COPD, infant apnoea, adenosine reverse

Question 25

Theophyllines | Contraindications

Answer 25

Allergy, high caffeine, dipyramidole IV

Question 26

Theophylline | Side effects

Answer 26

Narrow TPI, N&D, tachy, arrhythmia, CNS excitation

Question 27

Theophylline | Interactions

Answer 27

Cimetidine, phenytoin. eliminated CYP450

Question 28

Oxygen | Mechanism

Answer 28

Increase Pa)2 to improve tissue delivery, increase nitrogen excretion and reduce half life of carboxyhaemoglobin

Question 29

Oxygen | Indications

Answer 29

Hypoxaemia, pneumothorax, CO poisoning

Question 30

Oxygen | Contraindications

Answer 30

Limit use in COPD with T2RF, near heat source/naked flame

Question 31

Oxygen | Side effects

Answer 31

Dry throat/device discomfort

Question 32

Oxygen | Prescription

Answer 32

Give target therapeutic range, may req venturi (start low and titrate up)