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Clinical pharmacology and therapeutics > Respiratory drugs > Flashcards

Respiratory drugs Flashcards

1
Q

Name some adrenergic agonist respiratory drugs

A

Salbutamol

Salmeterol

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2
Q

Name some anticholinergic respiratory drugs

A

Tiotropium

Ipatropium

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3
Q

Name a methyxanthine

A

Aminophylline

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4
Q

Name two types of anti=inflammatory drugs used in respiratory illness

A

Steroids

Leukotreine inhibitors

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5
Q

Name some mucokinetic agents

A

Carbocysteine
Hypertonic saline
Dnase

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6
Q

List some inhaled drug devices

A

Metered dose inhalers
Dry powder inhalers
Nebulisers

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7
Q

Describe the metered dose inhaler technique

A

Deep exhale/inhale and puff/ hold breath for slow 10 count/ exhale slowly/ wait one minute before 2nd puff

Use spacer

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8
Q

Describe the dry powder inhaler technique

A

Usually one inhalation, not a puff

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9
Q

Describe the duration of salbutamol

A

Short 3-5hr

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10
Q

List the routes of administration of salbutamol

A

Inhaled
IV
Oral

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11
Q

Describe the mechanism of action of salbutamol

A

Binding to beta 2 adrenoreceptors on the smooth muscle of the bronchioles causes them to relax and leads to bronchodilation

Increased cAMP production by activating adenylate cyclase

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12
Q

What conditions is salbutamol used in?

A

Asthma

COPD

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13
Q

Describe the duration of action of salmeterol

A

Long acting 10-12hr

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14
Q

List the routes of salmeterol administration

A

Inhaled

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15
Q

Give the mechanism of action of salmeterol

A

Long acting beta adrenoceptor agonist

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16
Q

Describe the use of salmeterol

A

Asthma - in patients requiring long term regular bronchodilator therapy on ICS
COPD persistent symptoms despite therapy

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17
Q

Describe the duration of tiotropium

A

24 hrs - long acting

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18
Q

Give the routes of tiotropium

A

Inhaled - dry powder handihaler

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19
Q

Describe the mechanism of action of tiotropium

A

Lon acting antimuscarinic agent which is often referred to as an anticholinergic
Similar affinity to the subtypes of muscarinic receptors M1-M5
In the airways it inhibits M3 leading to bronchodilation

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20
Q

Give the indications for tiotropium

A

Stable COPD despite SABA

Asthma - new indication step 3

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21
Q

Give the duration of theophylline

A

Half life 5hrs

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22
Q

Give the routes of administration of theophylline

A

IV/PO

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23
Q

Describe the mechanism of action of theophylline

A

Phosphodiesterase inhibitor

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24
Q

What are the indications for theophylline use?

A

PO - COPD and asthma - persistent symptoms

IV - COPD and asthma medical emergencies

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25
Q

List the adverse effects of bronchodilators

A 
Tachycardia
Nervousness
Irritability 
Tremor
Inhaled preparations - less common
Oral preparations - systemic symptoms - more chance of tachyarrhythmia and angina 
Dose related
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26
Q

Name a systemic steroid

A

Prednisolone

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27
Q

Describe systemic steroids

A

IV/PO
Stronger effects
Action unaffected by lung restriction
More side effects especially with long term therapy

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28
Q

Name an inhaled steroid

A

Beclometasone

29
Q

Describe inhaled steroids

A

Localised action
Fewer systemic side effects - some absorption occurs
Disease may prevent penetration to some areas

30
Q

Describe the airway effects of steroids

A

Decrease release of inflammatory mediators
Decrease infiltration and action of WBCs
Decrease airway oedema
Decrease airway mucus production
Increase number and sensitivity of beta 2 receptors

31
Q

List some adverse effects of inhaled steroids

A

Oral candidasis

Dysphonia

32
Q

List the general adverse effects of steroids

A 
Adrenal suppression
Bone loss
Slow growth in children
Increase risk of cataracts and glaucoma
Increased risk of infection
Gastric ulceration 
Hypertension
Diabetes
Mood disturbance
33
Q

List some medications used in allergic rhinitis

A

Antihistamines
Intranasal glucocorticoids
Montelukast
Sympathomimetics

34
Q

Describe the action of a montelukast

A

Inhibits leukotriene receptors

Decreases inflammation, bronchoconstriction, oedema, mucus, recruitment of eosinophils

35
Q

Name some antihistamines

A

Cetirizine

Chlorpheniramine

36
Q

Describe the asthma treatment ladder

A

5 Steps
Move up and down as required

Step 1 - short acting inhaled B2 agonist
Step 2 - inhaled steroid (regular preventer therapy)
Step 3 - Add inhaled long acting B 2 agonist (LABA)
Step 4 - Increase inhaled steroid dose, addition of leukotriene receptor drug
Step 5 - Daily steroid tablet

37
Q

Describe the treatment options in COPD

A

SABA/SAMA
LABA/LAMA/LABA+ICS
LAMA + ICS/ LAMA+LABA+ICS

38
Q

What can occur from over oxygenation?

A

Type 2 respiratory failure

39
Q

List some penicillins

A

Amoxicillin
Co-amoxiclav
Tazobactum

40
Q

Describe amoxicillin use in respiratory infection

A 
Moderate spectrum 
Beta lactam 
Bacteriolytic
Routes - IV/Oral
Used in CAP/bronchitis/COPD exacerbation
Gram positive and negative
41
Q

Describe co-amoxicalv

A

Amoxicillin plus clavulinic acid - resistant to beta lactamase degredation

42
Q

What is tazobactum used to treat?

A

Hospital acquired pneumonia and gram negative bacteria

Extended spectrum beta lactam antibiotic

43
Q

Describe the mechanism of action of tetracycline antibiotics

A

Inhibits protein synthesis

44
Q

Describe the spectrum of tetracycline antibiotics

A

Broad spectrum action gram negative and positive

45
Q

What are tetracycline antibiotics useful for treating?

A

Atypical infections

46
Q

Describe the route of administation of doxycyline

A

Oral only

47
Q

List the side effects of tetracycline antibiotics

A 
GI upset
Teeth Staining
Lupus
Allergy
Photosensitivity
48
Q

Name some quinolones

A

Ciprofloxacin

Moxifloxacin

49
Q

Describe the mechanism of action of quinolones

A

DNA fragmentation

50
Q

Describe the spectrum of activity of quinolones

A

Gram positive and negative and pseudomonas coverage

51
Q

Describe the route of administration of quinolones

A

IV/PO/inhaled

52
Q

Describe the side effects of quinolones

A 
GI upset
C difficile 
Tendonitis
Liver upset
Prologned QTc 
Arrhythmia
53
Q

Name a macrolide

A

Clarithromycin

54
Q

Describe the use of macrolides

A

Commonly used in respiratory infection

55
Q

Describe the mechanism of action of macrolides

A

Protein synthesis inhibitors

56
Q

Give the routes of administration of macrolides

A

IV/PO

57
Q

Describe the spectrum of action of macrolides

A

Gram positive

Limited gram negative

58
Q

Give the side effects of macrolides

A

GI disturbance
Allergy
Liver abnormality
Prolonged QTc

59
Q

What is the standard TB therapy

A 
2 months (initial phase) - Isoniazid, rifampicin, ethambutol and pyrazinamide
4 months (continuation phase) - Isoniazid and Rifampicin
60
Q

Describe the administration of TB therapy

A

Direct observed treatment

1 hr before breakfast on empty stomach

61
Q

Describe the mechanism of action of isoniazid

A

Bactericidal and bacteriostatic
Inhibits cell wall growth
Cytochrome P450 inhibitor

62
Q

List the side effects of isoniazid

A

Optic neuritis
Peripheral neuropathy
Fever

63
Q

Describe the mechanism of action of rifampicin

A

Inhibits bacterial DNA dependent RNA synthesis

64
Q

List the main side effect of rifampicin

A

Red urine

65
Q

What does pyrazinamide cause?

A

Accumulation of pyrazinoic acid

66
Q

Describe the mechanism of action of ethambutol

A

Bacteriostatic obstructs synthesis of cell wall

67
Q

List the side effects of ethambutol

A

AKI, gout, optic neuropathy, peripheral neuropathy

68
Q

Name a Cystic fibrosis immunomodulating drug

A

Ivakaftor

Clinical pharmacology and therapeutics (27 decks)

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