Respiratory: Bronchodilators

Question 1

The selective beta2 agonists are: (2)

Answer 1

Salbutamol

Terbutaline sulfate

Question 2

The less selective beta2 agonists, such as ___________ ________ are less suitable and less safe as a bronchodilator because it is more likely to cause ________.

Answer 2

Less selective: ephedrine hydrochloride.

Can cause arhythmias.

Question 3

What are the uses of adrenaline/epinephrine (which has both alpha- and beta-adrenoceptor agonist properties)? [4]

Answer 3

1. Emergency management of acute allergic and anaphylactic reactions.
2. Angioedema
3. Cardiopulmonary resuscitation
4. Management of severe croup

Question 4

If beta2 agonist inhalation is needed more often than _____ per week, of if night-time symptoms occur at least ______ a week, or if the patient has suffered an exacerbation in the last two years, then prophylactic treatment should be considered.

Answer 4

Twice per week.

Once a week night time symptoms

Question 5

What type of beta2 agonists are formoterol and salmeterol?

Answer 5

Longer acting.

Question 6

What is the difference between salmeterol and formeterol in terms of onset of action? what are the implications of this?

Answer 6

Salmeterol has a slower onset of action than either salbutamol or terbutaline sulfate and as such should not be used for the relief of an asthma attack.

Formoterol is licensed for short-term symptom relief and for the prevention of exercise-induced bronchospasm.

Question 7

Indacaterol and olodaterol are long-acting beta2 agonists licensed for what?

Answer 7

COPD in adults, NOT the relief of acute bronchospasm

Question 8

What is vilanterol?

Answer 8

an Ultra long-acting beta2 agonist available only in a combination inhaler with fluticasone or with umeclidinium.

Relvar elipta: vilanterol and fluticasone.

Anoro elipta: vilanterol and umeclidinium.

Question 9

Bambuterol hydrochloride is what type of beta2 agonist?

Answer 9

A longer-acting ORAL preparation which may be of value in nocturnal asthma but has a limited role in general

Question 10

What are the antimuscarinic bronchodilators?

Answer 10

1. Ipratropium
2. Aclidinium bromide
3. Glycopyrronium bromide
4. Tiotropium
5. Umeclidinium

Question 11

Anoro Ellipta:

Answer 11

Vilanterol and umeclidinium

Question 12

Which antimuscarinics can provide short-term relief in chronic asthma?

Answer 12

Only Ipratropium

Question 13

Aclidinium bromide, glycopyrronium bromide, tiotropium and umeclidinium are all licensed for

Answer 13

The maintenance treatment of adults with COPD.

Question 14

Tiotropium (via ______ device) is also licensed as an adjunct to inhaled corticosteroids and long-acting beta2 agonists for the maintenance treatment of

Answer 14

Respimat (R), for the treatment of patients with asthma who have suffered one or more severe exacerbations in the last year.

Question 15

Relvar Ellipta:

Answer 15

Vilanterol and fluticasone

Question 16

_________ is a xanthine used as a bronchodilator in ashthma and stable COPD.

Answer 16

Theophylline.

Question 17

Theophylline is given by injection as _________

Answer 17

Aminophylline, a mixture or theophylline with ethylenediamine, which is 20 times more soluble than theophylline alone.

Question 18

Smoking has what effect on theophylline clearance from the body? What does this mean?

Answer 18

Smoking increases the clearance of theophylline and thus increased doses of theopylline are therefore required, dose adjustment is likely to be needed if smoking is started or stopped during treatment.

Question 19

A potentially serious electrolyte imbalance can occur from beta2-agonist therapy. What is this?

Answer 19

HYPOkalaemia.