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M3 Pharm B1 > Anti-inflammatory Drugs 2 > Flashcards

Anti-inflammatory Drugs 2 Flashcards

1
Q

Bronchodilators are what type of agonists and used for what?

A

Asthma

B2 agonists

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2
Q

Bronchodilators: Short-acting B2 agonists

A

Albuterol
Metaproterenol
Terbutaline

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3
Q

Bronchodilators: Long-acting B2 agonists

A

Salmeterol

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4
Q

Bronchodilators: B1 and B2 agonist

A

Isoproterenol

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5
Q

Bronchodilators: Alpha-1, B1, B2 agonist

A

Epinephrine

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6
Q

Bronchodilators B2 Agonist MOA:

A

Bind to B2 receptors in the lung –> stimulate adenyl cyclase –> produce cAMP –> relaxation of smooth muscle of bronchi

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7
Q

Bronchodilators B2 Agonist: Indications

A

Bronchospasms
Long active (Salmetrol): prophylaxis only
Aerosolics have low systemic toxicity potential

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8
Q

Bronchodilators B2 Agonist: Contraindications

A

Uncontrolled arrhythmia

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9
Q

Bronchodilators B2 Agonist: Adverse Reactions

A

Anxiety, tremors, headache, palpitations

tachycardia, hypertension and arrhythmia

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10
Q

Xanthine Bronchodilators: Buzzword

A

Theophylline

Aminophylline

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11
Q

Xanthine Bronchodilators: MOA

A

It competitively inhibits phosphodiesterase (enzyme that metabolizes cAMP) –> Increase cAMP –> Relaxation of bronchial muscles

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12
Q

Xanthine BronchodilatorsL Theophylline Drug Interactions

A
  1. Has narrow TI
  2. Drugs that affect theophylline elimination
    Macrolide: erythromycin
    Quinolones: Ciprofloxacin
  3. Drugs that increase theophylline metabolism (thereby decreasing its effects)
    CNS depressants: Phenobarbital
    Antiepilectics: Carbamezepine
    Tobacco and Marijuana
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13
Q

Anticholinergic Bronchodilators (M Blockers): Buzzword

A

Ipratropium (Antimuscarinic)

Local bronchodialtion after inhalation

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14
Q

Anticholinergic Bronchodilators (M Blockers): Side effects

A 
Like Atropine (anticholinergics) 
Dry mouth 
Constipation 
Urinary retention 
Tachycardia 
Mydriasis
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15
Q

Anticholinergic Bronchodilators (M Blockers): Indications

A
  1. Drug of choice in bronchospasm caused by beta blockers (blocking effects of B agonist)
    B blockers overdose –> Use M blockers to block the effective of B agonist
  2. Adjunct bronchodilator inhaler in Asthma for bronchodilation in acute asthma in COPD
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16
Q

Corticosteroids: Buzzword and Drugs

A

Inhaled Corticosteroids

Beclomethason
Fluticasone 
Triamcinolone 
Oral corticosteroids 
Prednisone
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17
Q

Corticosteroids: MOA

A

Anti-inflammatory:
1. Inhibit the release of inflammtory mediators: kinins, histamine, that cause airway narrowing

  1. Inhibit the synthesis of leukotrienes –> reducing bronchoconstriction and mucus secretion
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18
Q

Corticosteroids: Indications

A

Chronic bronchitis
Bronchial asthma
Allergic rhinitis

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19
Q

Corticosteroids: Contraindications and Adverse rxns

A

Acute bronchospasm

Abd distress, anorexia, unpleasant taste in moth
oral infection (thrush)—steroid suppressing the
immune system

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20
Q

Leukiotriene Antagonists

A

Montelukast (tablet, not vent)

Zafirlukast

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21
Q

Leukiotriene Antagonists: MOA

A

Antagonists at LTD3 receptors

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22
Q

LOX Antagonist: Buzzword and MOA

A

Zileuton

Antagonist of LTs

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23
Q

LOX Antagonist: Indications

A

PROPHYLAXSIS and chronic tx of asthma seasonal allergic

rhinitis

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24
Q

LOX Antagonist:

A

Headache, dental pain, GI distress, rash

- ↑ LFTs*

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25
Q

Mast Cell Stabilizers: Buzzword

A

Cromolyn

Nedocromil

26
Q

Mast Cell Stabilizers: MOA

A

Prevent degranulation of pulmonary mast cells
Inhibit release of histamine, LTBs from mast cells
-Used towards more exercise or other induced types of asthma—stabilizing mast cells (prophylactic)
-Not bronchodilators or for acute attack

27
Q

Mast Cell Stabilizers: Indications

A

Prevention of bronchospasm
Prophylactic in exercise induced asthma
NOT ACUTE ATTACK

28
Q

Mast Cell Stabilizers: Adverse Effects

A

Cough, hoarseness, diarrhea, myalgia, bad taste in the mouth after
use of inhaler

29
Q

Monoclonal Antibody: Buzzword

A

Omalizumab

30
Q

Monoclonal Antibody: MOA

A

Binds to IgE receptors on the mast cell

31
Q

Monoclonal Antibody: Indications

A

Moderate to severe persistent asthma

NOT ACUTE ATTACK

32
Q

Monoclonal Antibody: Adverse Reactions

A

Local injection site irritation
Headache
Increaed rate of viral or respiratory tract infections

33
Q

Approach for Managing Asthma: Infants and 5 years and younger

A

Short acting B2 agonist

Inhaled albuterol

34
Q

Approach for Managing Asthma: Infants and 5 years and younger

Mild intermittent attacks:
< 2 days/week or < 2 nights/month

A

No daily medications needed

35
Q

Approach for Managing Asthma: Infants and 5 years and younger

Mild persistent:
> 2 days/week
> 2 nights/month

A

Low-dose inhaled beclomethasone

Or inhaled cromolyn
Or montelukast oral

36
Q

Approach for Managing Asthma: Infants and 5 years and younger

Moderate persistent:
Daily
> 1 night/week

A

Low-dose inhaled beclomethasone

+ Salmetrol or Montelukast

Medium-dose inhaled beclomethasone

37
Q

Approach for Managing Asthma: Quick relief for adults and greater than 5 years

A

Short acting B2 agonist

Inhaled Albuterol

38
Q

Approach for Managing Asthma: Adults and greater than 5 years

Mild intermittent attacks:
< 2 days/week or < 2 nights/month

A

No daily medication needed

39
Q

Approach for Managing Asthma: Adults and greater than 5 years

Mild persistent:
> 2 days/week
> 2 nights/month

A

Low-dose inhaled beclomethasone

Or Montelukast and/or Cromolyn

Or theophylline

40
Q

Approach for Managing Asthma: Adults and greater than 5 years

Moderate persistent:
Daily
> 1 night/week

A

Low-to-medium dose inhaled beclomethasone + Salmetrol or Montelukast

41
Q

Approach for Managing Asthma: Infants and 5 years and younger

Severe persistent
Daily
Night: frequent

A

High-dose inhaled beclomethasone
+ salmetrol
+ oral prednisone

42
Q

Approach for Managing Asthma: Adults and greater than 5 years

Severe persistent:
Daily
Night: frequent

A

High-dose inhaled beclomethasone
+ salmetrol
+ oral prednisone

43
Q

Goals of Asthma Control Therapy

A
  1. Minimal or no chronic symptoms day or night
  2. Minimal or no exacerbations
  3. No limitations on activities
  4. Maintain or no adverse effects from meds
  5. Minimal use of short-acting inhaled B2 agonists
  6. Minimal or no adverse effects from meds
44
Q

Status Asthmaticus in Children

A
  1. Supplemental Oxygen
  2. Inhaled Albuterol
  3. IV methylprednisone
  4. Nebulized Ipratropium (Anticholinergics)
  5. IV or SC epinephrine (in severe attack and not responding to inhaled drugs)
45
Q

Antitussives: Opoid

A

Codeine (addictive, controlled substance)

46
Q

Antitussives: Opoid MOA

A

Supressing gag reflex –> Cough reflex

47
Q

Antitussives: Opoid Indications

A

Tx nonproductive cough and cough that interfere with daily activities and sleep

48
Q

Antitussives: Non-Opoid

A

Dextrometorphan (Robitussin) and Benzonate

49
Q

Expectorants: Buzzword

A

Guafenesin

50
Q

Expectorants: MOA

A

Decrease viscosity of secretion

51
Q

Expectorants: Indications

A

Associated w/
common cold and URIs

Not recommended for
persistent cough associated
w/ smoking, asthma, and
emphysema

52
Q

Diluents: Buzzword

A

Water

Normal

53
Q

Diluents: MOA and Administered

A

To dilute respiratory secretions

Administered by ultrasonic nebulizer

54
Q

Mucolytics (CF): Buzzword

A

Acetylcysteine (Mucomyst)

Break down the mucoprotein molecules

55
Q

Mucolytics (CF): Indication

A

Treatment for thick or abnormal mucus in cystic fibrosis or atlectasis

56
Q

Mucolytics: Acetylcysteine Buzz Word:

A

Antidote for acetominophen (Tylenol) overdose

57
Q

Dornase alfa used for?

A

Cystic fibrosis

Administered via nebulizer

58
Q

Decongestants: Buzzword

A

Pseudoephedrine (Sudafed)

Phenylephrine

59
Q

Decongestants: MOA

A

Stimulate alpha-1 receptors: Vasoconstriction

60
Q

Decongestants: Indications

A

Nasal congestions

M3 Pharm B1 (8 decks)

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