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Pharm Exam 2 > antiasthmatic and bronchodilators > Flashcards

antiasthmatic and bronchodilators Flashcards

1
Q

what is an anticholinergic inhaler?

A

(or muscarinic receptor antagonists) block the parasympathetic nerve reflexes that cause the airways to constrict, so allow the air passages to remain open

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2
Q

what are the examples of anticholinergic inhalers?

A

ends in -tropium

  • ipratropium (atrovent, combivent)
  • tiotropium (spiriva)
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3
Q

what is the primary action of anticholinergic inhalers?

A

bronchodilation

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4
Q

when would anticholinergic inhalers be used?

A

bronchospasms associated with COPD

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5
Q

what are the side effects of anticholinergic inhalers?

A 
A - agitation 
B - blurred vision
C - constipation, coughing, confusion
D - dry mouth (most common)
S - stasis of urine
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6
Q

what is different about tiotropium (Spiriva)?

A

it is a long-acting anticholinergic inhaler (bronchodilator)

  • dry powder
  • combined with albuterol
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7
Q

what are beta 2 agonists?

A

a group of drugs prescribed to treat asthma

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8
Q

what ending is seen with beta 2 agonist?

A
  • terol
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9
Q

what are examples of beta 2 agonists?

A

short-acting - albuterol

long-acting - formoterol (foradil) and salmeterol (serevent)

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10
Q

what is the name of the beta 2 agonist shorting acting inhaler (rescue inhaler)?

A

albuterol

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11
Q

what routes are beta 2 agonists given?

A
  • PO (rare)

- inhaler

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12
Q

what is the action of beta 2 agonists?

A

selective stimulation of bronchodilation, suppresses histamine, and increases cillary motion

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13
Q

what are the side effects of beta blockers

A
  • tachycardia and chest pain (related to beta 1)

- tremor (beta 2 in extremities)

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14
Q

how often is albuterol given?

A

typically PRN but for frequent attacks, it can be given on a fixed schedule

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15
Q

how often is formoterol (Foradil) or salmeterol (Serevent) given?

A

fixed schedule, typically 2 times a day

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16
Q

what black box warning is seen with formoterol (Foradil) and salmeterol (Serevent)?

A

increased mortality (mostly with incorrect use - not really seen much anymore)

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17
Q

what are glucocorticosteroids?

A

used as treatment for pts with frequent asthma symptoms (more than a couple of times a week)

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18
Q

would a pt still need a bronchodilator with glucocorticosteroids?

A

yes

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19
Q

what routes are used for glucocorticosteroids?

A

usually inhaled, but also PO and IV

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20
Q

what are the examples of glucocorticosteroids?

A
  • beclomethasone
  • budesonide (pulmicort)
  • fluticasone (flovent)
  • triamcinolone (azmacort)
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21
Q

what endings are used with glucocorticosteroids?

A
  • one

- ide

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22
Q

what are the adverse effects of inhaled glucocorticosteroids?

A
  • oropharyngeal candidiasis (thrush of the mouth)

- dysphonia (hoarseness)

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23
Q

why would you want to rinse your mouth out after inhaling glucocorticosteroids?

A

to prevent thrush in the mouth (oropharyngeal candidiasis)

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24
Q

what are the side effects of oral glucocorticosteroids?

A

typically occurs in times of sickness when the dose is increased

  • adrenal suppression
  • osteoporosis
  • hyperglycemia
  • PUD (peptic ulcer disease)
  • growth suppression in young
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25
Q

what is the main use of glucocorticosteroids?

A

prophylaxis of chronic asthma (given on a fixed schedule)

26
Q

are glucocorticosteroids given PRN or on a fixed schedule?

A

fixed schedule

27
Q

what is cromolyn (Intal) used for?

A

prophylactically

  • prior to allergen exposure
  • exercise-induced bronchospasms
28
Q

what is the action of cromolyn (Intal)?

A

suppress inflammation by stabilizing cytoplasmic membranes PREVENTING THE RELEASE OF HISTAMINE (allergic reaction response)

29
Q

is cromolyn (Intal) used long-term or as a rescue method?

A

long-term use

30
Q

what adverse effects are seen with cromolyn (Intal)

A

cough - otherwise well tolerated

31
Q

what is methylxanthines (theophylline) used for?

A

2nd line treatment for asthma and COPD

32
Q

is methylxanthines (theophylline) a first-line treatment or second-line treatment

A

2nd line

33
Q

what is the mechanism of action for methylxanthines (theophylline)?

A
  • relax bronchial smooth muscle

- nonsystemic action

34
Q

what are the adverse effects of methylxanthines (theophylline)?

A

cardiac arrest

35
Q

what antiasthmatic drug has a side effect of cardiac arrest?

A

methylxanthines (theophylline)

36
Q

what is the therapeutic range for methylxanthines (theophylline)? what is toxic?

A

therapeutic range - 5-15

toxicity - greater than 20

37
Q

what are the signs and symptoms of toxicity with methylxanthines (theophylline)?

A
  • nausea and vomiting
  • dysrhythmias
  • restlessness
  • confusion
38
Q

what education is needed with methylxanthines (theophylline)?

A

it is a stimulant so avoid caffeine cause that can lead to tachycardia which can then lead to dysrhythmias which then could lead to cardiac arrest

39
Q

what group of people would need a higher dose with methylxanthines (theophylline)?

A

children of smokers

40
Q

where is methylxanthines (theophylline) metabolized?

A

P450 system

41
Q

what kind of drug is a leukotriene modifier?

A

montelukast (singular)

42
Q

what is the action of leukotriene modifiers?

A

suppress effects of leukotrienes which promote bronchoconstriction and eosinophil infiltration

43
Q

what are leukotrienes?

A

they are associated with histamines and tightening of airway muscles

44
Q

what is the use for leukotriene modifiers?

A

maintenance of bronchodilation and allergies

- not relief of current symptoms

45
Q

what forms do leukotriene modifiers come in?

A
  • daily PO absorption
  • rapid absorption
  • chewable tablets for kids
46
Q

what is a concern seen with leukotriene modifiers?

A

neuropsychiatric effects in kids

47
Q

what drug is an example of IgE agonists?

A

omalizumab (Xolair)

48
Q

what does the ending -mab indicate?

A

immunosuppressant medication which increases the risk for anaphylaxis

49
Q

are IgE agonists a first-line treatment or a second-line treatment for allergy-induced asthma?

A

2nd line

50
Q

what are IgE agonists used for?

A

allergy-induced asthma

51
Q

what is the action of IgE agonists?

A
  • combines with IgE molecules to decrease the amount of IgE that can bind to MAST cells
  • work early in the allergy cascade
52
Q

what are the adverse effects of IgE agonists?

A
  • increased risk for cancer

- anaphylaxis

53
Q

what route can IgE agonists be given

A

subcutaneous (administered every 2-4 weeks in a providers office)

54
Q

what teaching is needed with IgE agonists?

A

it is given subcutaneously every 2-4 weeks in a providers office

55
Q

what drugs are allergic rhinitis treatment?

A 
first generation 
- diphenhydramine (benadryl) 
second generation 
- loratadine (claritin)
- cetirizine (zyrtec)
- fexofenadine (allegra)
56
Q

what is the mechanism of action for allergic rhinitis treatment?

A

histamine antagonist

57
Q

what is an adverse effect of allergic rhinitis treatment?

A

drowsiness

58
Q

what can allergic rhinitis treatment also be given with?

A
  • intranasal corticosteroids

- decongestants

59
Q

why would diphenhydramine (Benadryl) be given in a hospital?

A

could be given through an IV if using an allergin in a hospital, like dye

60
Q

what is the common ending for allergic rhinitis treatment?

A

-ine

Pharm Exam 2 (5 decks)

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