Respiratory

Question 1

What is status asthmaticus?

Answer 1

An acute severe asthma attack

Question 2

What treatment should be given in status asthmaticus?

Answer 2

Oxygen
Nebulise salbutamol
IV hydrocortisone
Aminophylline or Magnesium
Oral prednisolone

Question 3

When should a steroid be given in asthma?

Answer 3

When control is inadequate on steroid alone ie. using more than once daily or nightime symptoms

Question 4

Name a SABA

Answer 4

Salbutamol

Question 5

Name two LABAs?

Answer 5

Salmeterol

Formoterol

Question 6

What are the side effects of a B2 adrenoceptor agonist?

Answer 6

Desensitisation and endocytosis
Fine tremor
tachycardia

Question 7

Name two CysLT1 receptor antagonist?

Answer 7

Montelukast

Zafirlukast

Question 8

Name two Xanthines?

Answer 8

Theophylline

Aminophyline

Question 9

When should a xanthine be used?

Answer 9

If LABA not working

Question 10

What are the side effects of xanthines>

Answer 10

nausea
vomiting
abdominal discomfort
headache

Question 11

Whee are corticosteroids produced in the body?

Answer 11

Adrenal cortex

Question 12

What are the effects of glucocorticoids?

Answer 12

decreases inflammatory responses

decreases immunological responses

Question 13

What other effects do glucocorticoids have on metabolism?

Answer 13

increases glycogen depositions
increases gluconeogenesis
increases glucose output from liver
decreases gluose utilisation
increases bone metabolism
increases gastric acid and pepsin sectrection

Question 14

What is the main glucocorticoid in the body?

Answer 14

cortisol (hydrocortisone)

Question 15

What is the main mineralocorticoid in the body>

Answer 15

Aldosterone

Question 16

Why are synthetic dericitates of cortisol useful>

Answer 16

Have little mineralcorticoid effect

Question 17

Name to glucocorticoids

Answer 17

Beclometasone

Prednisolone

Question 18

What drugs can be used to treat the inflammatory component of asthma?

Answer 18

Xanthines
Glucocorticoids
Cromolins (rarely)
Monoclonal antibodies (expensive)

Question 19

Name two SAMA’s

Answer 19

Ipratropium

Oxitropium

Question 20

Name two LAMA’s

Answer 20

Tiotropium

Aclidinium

Question 21

Why is there little systemic absorption of muscarinic antagonists?

Answer 21

Quaternary ammonium group

Question 22

Name the non selective muscarinic blocker

Answer 22

Ipratropium

Question 23

Name an M3 selective agent

Answer 23

Tiotropium

Alcidinium

Question 24

What are the effects of SAMAs and LAMAs

Answer 24

Relax bronchospasm caused by irritant stimuli
Decrease mucus secretion
Palliative- little effect of progression of disease

Question 25

Why is tiotropium superor to iprotripium?

Answer 25

Greater half life at M3 receptors

Question 26

Why is block of M2 not desirable?

Answer 26

Causes release of Ach

Question 27

Name an 'ultra LABA'

Answer 27

indacaterol

Question 28

What is the most effective treatment dor COPD?

Answer 28

smoking cessation LABA/LAMA combination Salmeterol/tiotropium

Question 29

What other drugs can be used to treat COPD?

Answer 29

PDE4 inhibitors eg Rofumilast Oral theophylline Corticosteroids in severe cases or exacerbations

Question 30

What glucocorticoids can be used in rhinitis?

Answer 30

Beclometasone Fluticasone Prednisolone (oral)

Question 31

What are the effects of anti histamines?

Answer 31

``` Antagonists of H1 receptors Reduce effects of mast cell derived histamine Vasodilation Activation of sensory nerves Mucus secretion ```

Question 32

Name an intra nasal anti histamine?

Answer 32

Azelastine

Question 33

Give examples of second generation anti histamines?

Answer 33

Loratidine Fexofenadine Cetirizine These do not cross blood brain barrier so do not sedate

Question 34

What muscarinic antagonist can be used in rhinitis?

Answer 34

Ipratropium

Question 35

What are the effects of vasoconstrictors in rhinitis?

Answer 35

Mimic noradrenaline Decrease swelling Act on alpha 1 adrenoceptors

Question 36

Name an vasoconstrictor

Answer 36

Oxymetazoline

Question 37

Why is it not recommended to give a vasoconstrictor for more than a few days?

Answer 37

Increases nasal congestion upon discontinuation (rhinitis medicamentosa) due to desenisization

Question 38

What is a side effect of using an anticholinergic in rhinitis?

Answer 38

Dry nose

Question 39

What effect do glucocorticoids have in rhinitis

Answer 39

reduce all symptoms including congestion

Question 40

What effect do anti histamines have on rhinitis?

Answer 40

Dont really affect congestion | Help all other symptoms

Question 41

What affect do ant cholinegic drugs have in rhinitis?

Answer 41

Help reduce rhinnorhoea