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PHARM > Anti-inflammatory (respiratory) > Flashcards

Anti-inflammatory (respiratory) Flashcards

1
Q

Therapeutic uses of inhaled glucocorticoids?

A

Maintenance treatment of asthma as prophylactic therapy and long-term control of COPD.

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2
Q

What is the prototype for inhaled glucocorticoids?

A

Beclomethasone (QVAR)

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3
Q

What are the adverse effects of Beclomethasone (QVAR)?

A

oropharyngeal fungal infections, dysphonia, bronchospasm, osteoporosis (high doses), and adrenal suppression

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4
Q

Precautions to take with QVAR?

A

active untreated infections; diabetes or glaucoma; underlying immunosuppression; systemic corticoid therapy

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5
Q

MOA of glucocorticoids?

A

prevent inflammation, suppress airway mucus production, promote responsiveness of beta 2 receptors in the bronchial tree

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6
Q

When is an oral glucocorticoid use vs the inhaled route?

A

When sx cannot be controlled by an inhaled form

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7
Q

Prototype for oral steroid?

A

Prednisone

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8
Q

Adverse effects of Prednisone?

A

adrenal suppression; myopathy; hyperglycemia; PUD; growth suppression in children; osteoporosis; infection; fluid and electrolyte disturbances; increased appetite and weight gain; Cushing’s, cataracts/glaucoma, psychotic disorders

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9
Q

Contraindications for beclomethasone?

A

Hypersensitivity; acute attack of asthma/status asthmaticus

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10
Q

How can adverse effects of dysphonia and oral candidiasis with use of steroids be minimized?

A

rinse mouth and gargle

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11
Q

Difference between short-term and long-term oral therapy of steroids?

A

Short-term: manifestations following an acute asthma episode.
Long-term: chronic severe asthma

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12
Q

What route is used for status asthmaticus?

A

short-term IV

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13
Q

Why should we monitor blood glucose levels with the use of prednisone?

A

prednisone will cause insulin resistance → insulin is less effective at moving glucose into the cells → increased blood glucose

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14
Q

Precautions for steroid use?

A

pregnancy, young children, DM, HTN, heart failure, PUD, osteoporosis, kidney dysfunction, and current resistant infection.

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15
Q

Contraindications for prednisone?

A

systemic fungal infections and live vaccines

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16
Q

Prednisone drug interactions?

A
  • concurrent use of drugs that increase the risk of hypokalemia (diuretics).
  • concurrent use of NSAIDs which can increase the risk of GI ulceration.
  • Concurrent use of glucocorticoids and hypoglycemic agents (insulin). Effects of insulin will be lowered.
17
Q

T/F. Oral glucocorticoids are used short-term for 3-10 days following an acute asthma exacerbation.

A

True

18
Q

What are leukotriene modifiers?

A

Suppress the effects of leukotrienes

19
Q

What do leukotrienes mediate?

A

airway edema, smooth msl constriction, and increase mucous production

20
Q

MOA of leukotriene modifiers?

A

reduce inflammation, bronchoconstriction, airway edema, and mucous production

21
Q

Example of a leukotriene modifiers?

A

Zafirlukast (Accolate)

22
Q

Adverse effects of Accolate?

A

HA, N/V, diarrhea, arthralgia, myalgia, and neuropsychiatric events

23
Q

What is the route of administration of Accolate?

A

oral → rapid absorption

24
Q

What are two drugs that interact with Accolate?

A

warfarin and Theophylline

25
Q

What are the manifestation of Theophylline toxicity?

A

N/V and seizures

26
Q

What are the therapeutic uses for mast cell stabilizers?

A

chronic asthma, mild persistent prophylaxis seasonal allergies, and exercise induced asthma

27
Q

What is an example of a mast cell stabilizer?

A

Cromolyn

28
Q

How is Cromolyn administered?

A

nebulized

29
Q

MOA of Cromolyn?

A

stabilizes mast cells, preventing the release of histamine

30
Q

Adverse effects of Cromolyn?

A

throat irritation, bad taste, cough, and wheezing

31
Q

What is churg strauss syndrome?

A

Fatal adverse effect of Zafirlukast (Accolate). Characterized by weight loss, flu sx, and pulmonary vasculitis.

32
Q

What are phosphodiesterase-4 inhibitors (PDE4)?

A

Potent anti-inflammatory agents

33
Q

MOA PDE4 inhibitors?

A

inhibition leads to an accumulation of cyclic AMP (cAMP) in the lung tissue.

34
Q

Prototype for PDE4 inhibitors?

A

Roflumilast (Daliresp) PO

35
Q

Therapeutic use of Roflumilast?

A

To reduce the risk of COPD exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations

36
Q

Adverse effects of Roflumilast?

A

diarrhea, weight loss, suicidal thoughts, and angioedema

37
Q

Patient education for Roflumilast?

A
  • Not indicated for the relief of acute bronchospasms (Not a bronchodilator)
  • Inform provider of any neuropsychiatric effects
38
Q

What is the role of cAMP?

A

a molecule that plays a role in relaxing airway smooth muscles and suppressing inflammation

PHARM (35 decks)

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