respiratory pharamcology

Question 1

what are the main characteristics of asthma

Answer 1

• airway inflammation
• obstruction
• bronchial hyper-responsiveness

Question 2

mild asthma characteristics

Answer 2

• below best level of function due to wheeze
• PEFR >75% best predicted

Question 3

moderate asthma characteristics

Answer 3

• PEFR >50-75% best or predicted
• able to speak sentences
• increasing symptoms: HR and RR

Question 4

acute severe asthma characteristics

Answer 4

• PEFR 33-50% best or predicted
• SpO2 >92%
• inability to complete sentences in one breath
• HR >110
• RR >25

Question 5

life threatening asthma characteristics

Answer 5

• PEFR <33%
• Spo2 <92%
• altered level of conscious
• exhaustion
• cyanosis
• poor respiratory effort
• arrhythmia
• hypotension

Question 6

what is the mechanism of actions of B2-adrenoceptor agonist (bronchodilators)

Answer 6

• mimic action of the natural ligand - adrenaline or noradrenaline
• activated receptors cause bronchodilation

Question 7

what are examples of short acting b-agonists (bronchodilators)

Answer 7

• salbutamol
• terbutaline

Question 8

what are features of short acting b-agonists

Answer 8

• inhalation
• short onset and duration of action
• relievers
• as you need basis

Question 9

what are examples of long acting B-agonists (bronchodilators)

Answer 9

• salmeterol
• formoterol

Question 10

what are features of long acting B-agonists

Answer 10

• inhalation
• slow onset and long duration
• not used as needed
• add on therapy

Question 11

what are adverse effects of B2-adrenoceptor agonists

Answer 11

• tremors
• tachycardia

Question 12

what medications fall under B2-adrenoceptor agonists

Answer 12

• short-acting B-agonists
• long-acting B-agonists

Question 13

when are inhaled corticosteroids used

Answer 13

moderate to severe asthma

Question 14

when are oral/ systemic corticosteroids used

Answer 14

for severe asthma

Question 15

what is the mechanism of action of corticosteroids

Answer 15

1. inhibit production of inflammatory cytokines TNFa, IL1 and IL8
2. reduces expression of inflammatory cell adhesion molecules
3. inhibit gene transcription of COX2
4. increase synthesis of anti-inflammatory factors
5. stabilise mast cells and basophil membrane decreasing histamine release

Question 16

adverse effects of inhaled corticosetroids

Answer 16

• oral thrush
• voice problems

Question 17

what are the adverse effects of corticosteroids

Answer 17

• hypokalaemia
• palpitations
• hypertension
• mood changes
• hyperlipidaemia
• osteoporosis
• delayed healing
• hyperglycaemia

Question 18

what is the mechanism of action of magnesium sulfate to treat asthma

Answer 18

1. blocks calcium influx
2. inhibits Ach and histamine
3. no more Ach means no more bronchoconstriction

Question 19

what are the adverse effects of magnesium sulfate

Answer 19

• hypotension
• muscle paralysis
• weakness
• cardiac, CNS and respiratory depression

Question 20

what is COPD

Answer 20

chronic and progressive, abnormal inflammatory response that is not fully reversible

Question 21

what are the characteristics of COPD for diagnosis

Answer 21

• sputum producing cough
• 3 months a year over 2 years

Question 22

what is emphysema

Answer 22

• alveoli wall destruction
• sacs are full of air throughout exhalation

Question 23

what are the 2 types of muscarinic receptor antagonists

Answer 23

• short acting muscarinic antagonists
• long acting muscarinic antagonists

Question 24

what are examples of short acting muscarinic antagonists

Answer 24

ipratropium bromide

Question 25

what are examples of long acting muscarinic antagonists

Answer 25

- tiotropium - aclidinium - umeclidinium

Question 26

what is the mechanism of action of muscarinic receptor antagonists

Answer 26

- competitively inhibit cholinergic receptors - M3 - inhibition in airway smooth muscle and mucus glands

Question 27

what is the action time of muscarinic receptor antagonists

Answer 27

- slow onset of action - slow and long duration depending on drug

Question 28

what are the adverse effects of muscarinic receptor antagonists

Answer 28

dry mouth

Question 29

what are the features of acute exacerbation of COPD

Answer 29

- increased dyspnoea - increase sputum volume - increased cough - upper airway symptoms - increased wheeze - chest tightness - reduced exercise tolerance - fluid retention - increased fatigue - acute confusion

Question 30

what are the severe features of COPD exacerbation

Answer 30

- marked dyspnoea - tachypnoea - pursed lips breathing - accessory respiratory muscle use - acute confusion - new onset cyanosis - new onset peripheral oedema - reduction in activities

Question 31

what is croup

Answer 31

- upper respiratory viral infection - swelling and inflammation of mucosal and submucosal tissue

Question 32

what are the symptoms of croup

Answer 32

- runny nose - sore throat - fever - cough - stridor

Question 33

what can be used to treat croup

Answer 33

- O2 is sats are low - adrenaline - oral steroids

Question 34

why is adrenaline used to treat croup

Answer 34

- is a bronchodilator - functional or physiological antagonists - acts on 2 different receptors having opposite effect on each other