Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology 2 > 2 - Respiratory Pharmacology > Flashcards

2 - Respiratory Pharmacology Flashcards

1
Q

What are the 3 types of nasal decongestants?

A
  1. Direct alpha adrenergic stimulants
  2. Mixed function adrenergic stimulants
  3. Orally administered
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the mechanism for direct alpha adrenergic stimulants?

A
  • Vasocontriction to reduce edema
  • Decrease bloodflow to tissues in nose, which decrease tissue volume, making it easier to breathe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the preparations of direct alpha adrenergic stimulants?

A
  • Nasal spray
  • Vasoconstrictors:
    • propylhexedrine (Benzedrex - OTC)
    • oxymetazoline (Afrin)
    • tetrahydrozoline (Visine)
    • naphazoline (“Clear Eyes”)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why is Afrin limited use to only 3 days?

A

Addictive: it crosses the BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the side effects of direct alpha adrenergic stimulants?

A
  • Increased peripheral resistance
  • Bradycardia
  • Rebound congestion with extended use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the mechanism of Mixed function adrenergic stimulants?

A
  • Alpha and beta stimulation, direct and indirect effects (sympathomimetic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the preparations of mixed function adrenergic stimulants?

A
  • ephedrine - releases tissue stores of epinephrine, thus stimulates alpha and beta receptors
    • Crosses BBB and causes CNS excitation, bronchial dilation / relaxation
  • phenylephrine (Neo-Synephrine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the mechanism of orally administered direct-acting alpha and beta agonists (sympatheticomimetic)?

A
  • Directly stimulates alpha receptors of respiratory mucosa causing vasoconstriction
  • Directly stimulates beta receptors causing bronchial relaxation
  • Works systemically, not locally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the common preparations of orally administered direct-acting alpha and beta agonists?

A
  • pseudoephedrine (Sudafed, Actifed)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When a patient is taking decongestants, what must be given with caution and why?

A
  • epinephrine (vasoconstrictor)
  • These drugs are sympathomimetics and may enhance cardiac stimulation (tachycardia) and elevate blood pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does the antigen-antibody response of bronchial asthma cause to be released?

A
  • Histamine - vasodilation and edema, bronchoconstriction
  • PGD2 - bronchoconstriction, inflammation
  • LTC4/LTD4 - urticaria/angiodema, mucosal edema, smooth muscle spasm, attracts eosinophils
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the main symptoms of bronchial asthma?

A
  • Functional increase in airway resistance and decrease in lung compliance
  • Inflammation, mucous secretions, spasm of airway
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are medications that can trigger asthma?

A
  • Aspirin - bronchoconstriction in 10% of pts with asthma
  • NSAIDS
  • Antihypertensives - beta blockers, ACE inhibitors
  • Sulfites (preservatives) - found in dental local anesthetics that contain epinephrine to prevent oxidation of vasoconstrictor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the basic principle behind using medications to treat asthma?

A
  • Many beta adrenergic drugs block phosphodiesterase which increases tissue concentrations of cAMP
  • Which promotes catecholamine stimulation and epinephrine release from adrenal medulla = this accounts for their cardiac side effects
  • Increased cAMP in inlammatory cells decrease release of autocoids = desired effect
  • Tradeoff: bronchodilation but with adverse cardiac events
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the mechanism of epinephrine?

A

Increases cAMP in inflammatory cells which reduce autocoid release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How can the action of epinephrine be blocked?

A

By propranolol (Inderal), a non-selective beta blocker used as an antihypertensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the important rescue drug for asthma?

A

Inhalers - reversal of airway obstruction and bronchoconstriction; acute treatment of bronchospasm “asthma attack”

18
Q

What is the mechanism for inhalers?

A

Target beta 2 receptors in airway, resulting in bronchodilation

19
Q

What are the short acting beta adrenergic stimulants (rescue drugs)?

A
  • albuterol (Proventil, Ventolin) - in all dental office emergeny kits
  • levalbuterol (Xopenex) - R enantiomer of albuterol
  • metaproterenol (Alupent)
  • pirbuterol (Maxair)
  • terbutaline (Brethaire)
20
Q

What are the long-acting beta adrenergice stimulants (maintenance/prevention)?

A
  • salmeterol (Serevent Diskus) - duration to 12 hours
  • salmeterol with fluticasone (steroid) (Advair Diskus)
21
Q

What are some important dental considerations with inhalers?

A
  • Taste alteration
  • Oral candidiasis (with combined steriods)
  • Overuse of inhalers can lead to a hyper reflexive airway
  • Have pts bring inhalers with them
22
Q

Why ask your patients about how often they are using their inhalers?

A

If its more than once daily or 2 days per week it suggests uncontrolled asthma = REFER

23
Q

What type of drug are methylxanthines?

A

Beta Adrenergic Stimulants

Older class of asthma drugs that are now typically thought of as reserve drugs, used for patients for whom newer, better asthma meds are ineffective.

24
Q

Why are xanthines considered “red flag” drugs?

A
  • Cause dangerous drug interactions resulting in CNS stimulation and increased risk for seizures
    • Antibiotics: macrolides
    • Systemic (azole) antifungals - ketoconazole
25
Q

What type of drugs block phosphodiesterase which increases cAMP?

A

Methylxanthines

26
Q

What’s the preparations of methylxanthines?

A
  • theophylline (Elixophyllin, Theochron, Theo-24)
27
Q

What are the drugs of choice for reducing inflammation?

A

Steroids

28
Q

What are steroids mechanism of action?

A
  • Reduce cytokine production
  • Inhibition of accumulation of basophils, eosinophils and leukocytes
29
Q

What are dental considerations of steroids?

A
  • Oral candidiasis
  • Susceptibility to infection
  • Delayed wound healing
  • Adrenal suppression
30
Q

What is acetylcysteine (Mucomyst) and what does it do?

A

Mucolytic

Exerts mucolytic action through its free sulhydryl group = opens up disulfide bonds in mucoproteins, thus lowering mucous viscosity

31
Q

What drug is used for chronic bronchopulmonary diseases and cystic fibrosis?

A

Mucolytics - acetylcysteine (Mucomyst),

dornase alfa (Pulmozyme) just for CF

32
Q

What drug is a DNA enzyme (recombinant) which cleaves DNA, reducing mucous viscosity?

A

dornase alfa (Pulmozyme) for cystic fibrosis

33
Q

What are expectorants mechanism of action and what’s the common prep?

A

Irritation of stomach while stimulating respiratory fluid volume, decreases mucous viscosity

guaifenesin (Mucinex, Robitussin)

34
Q

What type of drugs depress cough center in medulla?

A

Anti-tussive drugs

35
Q

What is a common prep of an anti-tussive drug?

A

dextromethorphan (Delsym, Robitussin, Triaminic, Vicks 44)

Relative of morphine, lacking narcotic properties except in overdose

36
Q

What type of drug is codeine?

A

D,L racemic mixture form of codeine will be anti-tussive, but also addictive, D form is less

37
Q

Of the Leukotriene drugs, which drug inhibits the synthesis of leukotriens and which one blocks luekotriene receptors?

A
  • zileutron (Zyflo) = inhibits synthesis
  • zafirlukast (Accolate) & montelukast (Singulair) = blocks leukotriene receptors
38
Q

What type of drugs are used for prevention of seasonal allergies and exercise-induced asthma? And what are the common preps?

A

Mast cell inhibitors

  • cromolyn (Nasalcrom - OTC)
  • nedocromil (Tilade) - inhaled only
39
Q

What is the drug of choice for emphysema? And what’s it’s mechanism?

A

Anticholinergic medication

ipratropium (Atrovent)

Blocks action of acetylcholine at parasympathetic sites in bronchial smooth muscle causing bronchodilation

40
Q

What’s the mechanism for respiratory depressants?

A

Decreases sensitivity to increased PCO2 levels and to hypoxic drive

Narcotics, barbiturates, ethanol overdose

41
Q

What’s a common prep for a respiratory stimulant?

A

doxapram (Dopram)

Pharmacology 2 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions