Resp drugs

Question 1

COPD medication ladder

Answer 1

Salbutamol or ipratropium inhaler PRN
+ long acting b2 agonist (salmeterol)
+ beclomethasone
+ long acting muscarinic (tiotropium)

Question 2

Cautions of theophylline

Answer 2

Arrhythmias
HTN
Hyperthyroidism 
Ulcers
Epilepsy

Question 3

Side effects of theophylline

Answer 3

Palpitations
N+V
Tachycardia

Question 4

Cautions + action of tiotropium

Answer 4

Muscarinic receptor antagonists
Inhibitor of acetylcholine
Reduces smooth muscle tone + reduces secretions = inhibits bronchoconstriction
Caution in angle-closure glaucoma + arrhythmias

Question 5

SE + key info with tiotropium

Answer 5

SE: dry mouth, headache, constipation, dry eyes

Lowers seizure threshold

Question 6

Actions, SE + interactions of beta 2 agonists

Answer 6

Salbutamol
Bronchodilation by smooth muscle contraction (increase cAMP)
SE: tachycardia, tremor, raised BM, muscle crampls, palpitations, hypokalaemia
Efficacy reduced by BB

Salbutamol + corticosteroids + theophylline = hypokalaemia