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CPR - Exam II - Pharm > Asthma and COPD Drugs (Izard) > Flashcards

Asthma and COPD Drugs (Izard) Flashcards

1
Q

What are the two goals of asthma therapy?

A

Reduction in impairment

Reduction in risk

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2
Q

Most widely used drug class in asthma/COPD treatment?

A

Beta-2 receptor agonists

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3
Q

Primary action of Beta-2 agonists

A

Relax airway smooth-muscle cells of all airways

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4
Q

Albuterol class?

A

Short acting beta agonist (SABA)

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5
Q

Albuterol contraindications/warnings?

A

Paradoxical bronchospasm

CV effects

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6
Q

Terbutaline class?

A

SABA with preferential effects on the beta-2 receptors

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7
Q

Terbutaline uniqueness?

A

Only beta-2 drug available by subQ injection.

Can’t give in patients with sulfa allergy

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8
Q

Age approved in use of terbutaline?

A

12

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9
Q

Metaproterenol class?

A

SABA

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10
Q

Metaproterenol indication?

A

bronchial asthma and reversible bronchospasm

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11
Q

Metaproterenol warnings?

A

paradoxical bronchospasm

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12
Q

Pirbuterol class?

A

SABA

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13
Q

Pirbuterol indication? Age?

A

prevention and reversal of bronchospasm in patients 12 and older

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14
Q

Pirbuterol cautions?

A

can produce a clinically significant CV effect

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15
Q

Levalbuterol class?

A

SABA

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16
Q

Levalbuterol indication?

A

treatment or prevention of bronchospasm

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17
Q

Levalbuterol age?

A

4 years or older

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18
Q

Levalbuterol caution/warning?

A

Paradoxical bronchospasm

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19
Q

Beclomethasone class?

A

ICS

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20
Q

Beclomethasone indication? Age?

A

maintenance/treatment of asthma and as prophylactic therapy in patients 5 and older

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21
Q

Beclomethasone cautions/warnings?

A

Deaths due to adrenal insufficiency have occured in asthmatic patients during and after transfer from systemic corticosteroids to less systemically available inhaled corticosteroids .

Several months are required for recovery of HPA function

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22
Q

Most effective class for controlling asthma?

A

ICS

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23
Q

Which cells to ICS remove in the airway?

A

Eosinophils, Mast cells, and T lymphocytes

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24
Q

Major effect of corticosteroids in asthma?

A

switch off the transcription of multiple activated genes that encode inflammatory proteins

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25
Q

ICS dosing?

A

twice daily

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26
Q

If ICS does not control asthma, what is the next step?

A

LABA

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27
Q

Budesonide class?

A

ICS

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28
Q

Budesonide indication? Age?

A

Maintenance treatment of asthma as prophylactic therapy in patients 6 years and older

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29
Q

Budesonide caution/warning?

A

Should not be used where primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required.

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30
Q

Ciclesonide class?

A

ICS

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31
Q

Ciclesonide indication? Age?

A

Maintenance treatment of asthma as prophylactic therapy in patients 12 years and older

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32
Q

Ciclesonide cautions/warnings?

A

Not indicated for Asthma attacks

Use not recommended when patient has presence of Candida albicans infection of mouth/pharynx

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33
Q

Flunisolide class?

A

ICS

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34
Q

Flunisolide indication? Age

A

Maintenance treatment of asthma as prophylactic therapy in patients 6 years and older.

Asthma patients requiring oral corticosteroid therapy, where adding flunisolide therapy may reduce or eliminate the need

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35
Q

Fluticasone class?

36
Q

Fluticasone indication? Age?

A

Maintenance treatment of asthma as prophylactic therapy in patients 4 and older.

37
Q

Fluticasone cautions

A

Candida albicans infection of the mouth and pharynx may occur.

38
Q

Mometasone class?

39
Q

Mometasone indication? Age?

A

Asthma as prophylactic therapy in patients 4 and older.

40
Q

Mometasone cautions?

A

hypersensitivity to milk proteins

41
Q

Triamcinolone class?

42
Q

Triamcinolone indications?

A

Asthma

Patients who require systemic corticosteroid administration, where adding this agent may reduce or eliminate the need for the systemic corticosteroids

43
Q

Triamcinolone cautions?

A

Status asthmaticus or other acute episodes of asthma where intensive measures are required.

Care is needed in patients who are transferred from systemically active corticosteroids to Triamcinolone because deaths due to adrenal insufficiency have occurred.

44
Q

Oral and parenteral corticosteroid uses?

A

used in combination with SABAs to treat moderate to sever asthma flare-ups.

More likely to cause side effects

45
Q

Prednisone class?

46
Q

Prednisone indication?

A

Anti-inflammatory or immunosuppressive agent

treatment of certain endocrine conditions

47
Q

Prednisone cautions?

A

Adrenal Insufficiency

May lead to HPA axis suppression

48
Q

Fomoterol class?

49
Q

Fomoterol indication? Age?

A

Add on to an inhaled corticosteroid in asthma patients >5 yeras old.

COPD maintenance

50
Q

Fomoterol Contraindications?

A

LABAs increase risk of asthma-related deaths and asthma related hospitalizations, must use with use of a long-term asthma control medication.

51
Q

Salmeterol class?

52
Q

Salmeterol indication? Age?

A

exercise-induced bronchospasm in patients aged 4 and older.

COPD maintenance

53
Q

Indaceterol and Vilanterol class?

54
Q

Indaceterol and Vilanterol indication?

A

breathing problems caused by COPD

55
Q

Olodaterol class?

56
Q

Olodaterol indication?

A

chronic bronchitis
emphysema

Used in the long-term, once-daily maintenance bronchodilator treatment of airflow obstruction in patients

57
Q

MOA for anticholinergic drugs?

A

block acetylcholine from binding to its receptors on certain nerve cells.

Inhibit parasympathetic nerve impulses

anti-muscarinic agents most widely used in asthma/COPD

58
Q

Atropine class?

A

anticholinergic

59
Q

Atropine indication?

A

temporary blockade of severe or life threatening muscarinic effects.

60
Q

Atropine cautions?

A

atropine-induced tachycardia
Increased myocardial oxygen demand.

total dose should be restricted to 2 to 3 mg to avoid detrimental effects

61
Q

Ipratropium class?

A

anticholinergic

62
Q

Ipratropium indicaiton?

A

maintenance treatment of bronchospasm

poorly absorbed after aerosol administration and is therefore relatively free of systemic atropine-like effects

63
Q

Tiotropium class?

A

anticholinergic

64
Q

Tiotropium indication?

A

long-term, once-daily, maintenance treatment of bronchospasm

65
Q

Aclidinium class?

A

Anticholinergic

66
Q

Aclidinium indication?

A

long-term maintenance treatment of bronchospasm associated with COPD

67
Q

Theophyline class?

A

Methylxanthine

68
Q

Theophylline MOA?

A

Smooth muscle relaxation

suppression of the response of the airways to stimuli

69
Q

Theophylline cautions?

A

use extreme caution in patients with:

active peptic ulcer disease

seizure disorders

cardiac arrhythmias

70
Q

Leukotriene antagonist MOA?

A

Block cysteinyl leukotriene receptors and blocking their subsequent inflammatory cascade

71
Q

Montelukast class

A

Leukotriene antagonist

72
Q

Montelukast MOA

A

inhibit LTD4 at the CysLT1 receptor without any agonist activity

73
Q

Montelukast indications

A

allergies and prevent asthma attacks

74
Q

Montelukast cautions

A

Can’t use in acute asthma attacks

75
Q

Zafirlukast class?

A

Leukotriene antagonist

76
Q

Zafirlukast MOA?

A

selective and competitive receptor antagonist of Leukotriene D4 and E4

77
Q

Zafirlukast indication? Age?

A

Prophylaxis and chronic treatment of asthma in patients 5 years and older

78
Q

Zafirlukast caution?

A

Hepatotoxicity

79
Q

Zileuton MOA?

A

inhibitor of 5-lipoxygenase and thus inhibits LTB4, C4, D4, and E4 formation

80
Q

Is zileuton IR or ER?

81
Q

Zileuton indication? Age?

A

Prophylaxis and chronic treatment of asthma in patients 12 years and older

82
Q

Zileuton caution

A

Active liver disease/ liver enzymes 3x upper limit

83
Q

Omalizumab class

A

Monoclonal antibody

84
Q

Omalizumab MOA/indication?

A

anti-IgE antibody indicated for moderate to severe persistent asthma in patients 6 years of age and older with a positive skin test or in vitro reactivity to a perennial aeroallergen.

Chronic idiopathic urticaria in patients 12 years and older if h1 antihistamine treatment isn’t working.

85
Q

Omalizumab caution

A

Anaphylaxis

CPR - Exam II - Pharm (7 decks)

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