Chapter 3- Respiratory System Flashcards Preview

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Flashcards in Chapter 3- Respiratory System Deck (40)
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1
Q

Two advantages of giving drugs via the respiratory tract

A

Dose required is smaller Side effects are reduced

2
Q

True or false - budesonide ans beclometasone are approximately equivalent in clinical practice

A

True but there may be variations with different drug delivery devices

3
Q

Fluticasone and mometasone provide equal activity to beclometasone and budesonide at what dose

A

Half of the dose

4
Q

In children, high doses of inhaled corticosteroids can be associated with what systemic side effects

A

Growth failure Reduced bone mineral density Adrenal suppression

5
Q

Four symptoms of asthma

A

Cough Wheezing Chest tightness SoB

6
Q

What 3 things define moderate acute asthma

A

Increasing symptoms Peak flow > 50-75% best or predicted No signs of severe acute asthma

7
Q

What 4 things define severe acute asthma

A

Peak flow 33-50% best or predicted RR >25/min HR >110/min Inability to complete sentences

8
Q

Name two inhaled short acting b2 agonists

A

Salbutamol Terbutaline

9
Q

Name a less selective b2agonist less appropriate for use as a bronchodilator due to risk of causing arrhythmias

A

Ephedrine/adrenaline

10
Q

Name two long acting b2 agonists used in asthma

A

Formeterol Salmeterol

11
Q

Which has a quicker onset of action: salmeterol or formeterol

A

Formeterol - similar to the speed of salbutamol

12
Q

Name 2 long acting b2agonists indicated in COPD

A

Indacaterol Olodaterol

13
Q

Which act quicker - SABA or SAMA

A

SABAAAA

14
Q

Ipratroprium inhalation reaches peak effect when and lass how long

A

30-60mins after use Lads 3-6 hours

15
Q

Combination of b2 agonists + theophylline increase risks of what

A

HYPOkalaemia

16
Q

List 7 indications where a lower concentration of oxygen therapy may be required

A

COPD Advanced cystic fibrosis Severe non CF bronchiectasis Severe kyphoscoliosis or severe ankylosing spondylitis Severe lung scarring from TB Musculoskeletal disorders with respiratory weakness Overdose of opioids, BZ or others causing resp depression

17
Q

Name 4 types of oxygen therapy

A

Emergency oxygen Short burst (intermittent) Long term Ambulatory

18
Q

What’s the caution on ipratropium

A

Acute angle-closure glaucoma : ensure to keep nebuliser solution away from eyes

19
Q

Bambuterol is a prodrug of what

A

Terbutaline

20
Q

High doses of salbutamol can cause what type of acidosis

A

Lactic acidosis

21
Q

True or false: QVAR has extra fine particles and is more potent than other beclometasone containing inhalers- it is three times as potent as clenil

A

True apart from it’s TWICE as potent as clenil

22
Q

Name three monoclonal antibodies used in severe asthma

A

Mepolizumab Omalizumab Reslizumab

23
Q

Name two leukotriene receptor antagonists used in asthma

A

Montelukast Zafirlukast

24
Q

How does montelukast and zafirlukast work

A

They are leukotriene receptor antagonists so they block the effects of cysteinyl leukotrienes in the airways

25
Q

What is roflumilast

A

Phosphodiesterase type 4 inhibitor used as an adjunct in COPD

26
Q

What do you need to do when dosing aminophylline in extremes of body weight

A

Use ideal weight for height

27
Q

The plasma theophylline concentration is increased in what 3 conditions

A

Heart failure Hepatic impairment Viral infections

28
Q

True or false: the plasma theophylline level is increased in smokers

A

False it’s decreased in smokers

29
Q

True or false: the plasma theophylline level is decreased by alcohol consumption

A

True

30
Q

Signs of overdose of theophylline

A

Vomiting Agitation Restlessness Dilated pupils Sinus tachycardia Hyperglycaemia Haematemesis Convulsions Supraventricular and ventricular arrhythmias Hypokalaemia

31
Q

Name 8 non-sedating antihistamines

A

Acrivastine Bilastine Cetirazine Desloratadine Fexofenadine Levocetirizine Loratadine Mizolastine

32
Q

What’s the caution with high doses of the sedating antihistamine: alimemazine

A

Photosensitivity - avoid exposure to sunlight

33
Q

MHRA warning about chlorphenamine

A

Children under 6 should not be given OTC cough and cold medicines containing chlorphenamine

34
Q

True or false: many antihistamines should be avoided in acute porphyrias

A

True! - some are thought to be safe though

35
Q

MHRA warning with hydroxyzine

A

Risk of QT prolongation and torsade de pointes

36
Q

Risk factors for QT prolongation

A

Electrolyte imbalances Bradycardia CVD Family history of cardiac death Concomitant drugs that prolong QT

37
Q

MHRA warning advice with promethazine

A

Children under 6 years should not be given OTC cough and cold medicines containing promethazine

38
Q

Contraindication of mucolytics

A

Active peptic ulceration

39
Q

What is dornase alpha

A

Mucolytic used in cyatic fibrosis

40
Q

What drug is indicated for the treatment of cystic fibrosis in patients who have a G551D mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene

A

Ivacaftor