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PHARM > Asthma/COPD > Flashcards

Asthma/COPD Flashcards

1
Q

SABA
Albuterol
Levalbuterol

A

SABAs

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2
Q 
Salmeterol
Formoterol
Budesonide/Formoterol
Mometasone/Formoterol
Fluticasone/Salmeterol
Fluticasone/Vilanterol (Breo Ellipta)
A

LABAs

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3
Q

Tiotropium (Spiriva)

A

LAAC aka LAAM aka LAMA

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4
Q

DOC for long-term control of pts with any degree of persistent asthma

A

ICS (inhaled corticosteroids)

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5
Q

Sx tx of bronchospasm providing quick relief of acute bronchoconstriction; rapid onset 5-30 mins; 4-6 hour relief; monotherapy for patients with intermittent or exercise-induced asthma

A

SABA, albuterol and levalbuterol

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6
Q

Less tachycardic effects than albuterol

A

levalbuterol

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7
Q

A/E: Tachycardia, hyperglycemia, hypokalema, hypomagnesemia, B2-mediated skeletal muscle tremors

A

SABAs

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8
Q

Bronchodilation for ~12 hrs; slow onset of action
Monotherapy C/I for asthma patients
Used in conjunction with an ICS
Combination drugs now exist with an ICS (symbicort, advair, dulera, Breo Ellipta).

A

LABAs

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9
Q

Beclomethasone, Budesonide, Ciclesonide, Fluticasone, Mometasone; DOC for long-term control for pts with any degree of PERSISTENT asthma. Inhibits arachidonic acid which mediates normal inflammatory responses. Metabolism in the liver. Low bioavailability.

A

ICS

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10
Q

No direct on the airway smooth muscle

A

ICS

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11
Q

Directly targets underlying airway inflammation through daily use

A

ICS

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12
Q

IV methylprednisolone or oral prednisone needed to reduce airway inflammation during _____ exacerbations.

A

severe

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13
Q

Systemic administration of corticosteroids should be reserved for patients who are not controlled on ____.

A

ICS

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14
Q

A/E: Deposition on the oral and laryngeal mucosa can cause candidiasis and hoarseness. “Swish and Spit” required.

A

ICS

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15
Q

Useful for patients who are poorly controlled by conventional therapy or experience A/E secondary to corticosteroids. Not monotherapy.

Leukotriene modifiers
Cromolyn 
Chrolinergic Antagonists
Theophylline
Omalizumab
A

Alternative Asthma Treatment

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16
Q

Products of the 5-lipoxygenase pathway

A

Leukotrienes

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17
Q

5-lipoxygenase inhibitor

A

Zileuton

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18
Q

Not used for immediate bronchodilation
Alternate for prevention of exercise-induced asthma
Prevents formation of LTB4 and the cysteinyl leukotrienes. Asthma prophylaxis.

A

Zileuton

19
Q

Cysteinyl-leukotriene-1 receptor selective antagonist

A

Zafirlukast/Montelukast

20
Q

A/E: Elevation of hepatic enzymes, HA, dyspepsia

A

Leukotriene Modifiers

21
Q 
Prophylactic anti-infammatory
Mast cell stabilizer
Alternative for mild-persistent asthma
NOT USEFUL IN AN ACUTE ATTACK
A/E: Cough, irritation, unpleasant taste
NO BRONCHODILATOR ACTIVITY
A

Cromolyn

22
Q

Ipratropium
Not recommended for routine tx of acute bronchospasm
Onset slower than inhaled SABAs
Useful for patients who cannot tolerate SABA or with concomitant COPD
Joined with SABA = beneficial for ER acute exacerbations
A/E: cough, dry mouth, nausea, nervousness

A

SAAC

23
Q

Tiotropium
First for use in maintenance of treatment of persistent asthma
Approved for COPD
No guidelines for severe asthma, but considered an “add-on” option; not first line

A

LAAC

24
Q

Bronchodilator relieving airflow obstruction in chronic asthma; some anti-inflammatory action
Narrow therapeutic window
A/E: seizures, arrhythmias with overdose; adversely interacts with many drugs

A

Theophylline

25
Q

Cimetidine, macrolides and quinolones decrease it
Cigarettes, phenobarbital and phenytoin increase it
B-blockers diminish its bronchodilatory effects
It causes decreased effects of benzodiazepines

A

Theophylline

26
Q

Xolair
Recombinant DNA-derived monoclonal Ab
IgE selective
Indicated for moderate-severe persistant asthma in pts poorly controlled on conventional therapy
A/E: injection site rxn, viral infections, URI, sinusitis, HA, pharyngitis, anaphylaxis

A

Omalizumab

27
Q

Indacterol
Olodaterol
Salmeterol

A

LABAs for COPD

28
Q

Aclidinium
Glycopyrrolate
Tiotropium
Umeclidinium

A

LAACs for COPD

29
Q

LABA + LAAC (LAMA) combo
*LABAs are superior to LAMAs in preventing exacerbations

Formoterol/glycopyrrolate
Indacaterol/Glycopyrrolate
Olodaterol/Tiotropium
Vilanterol/Umeclidinium

A

First line for moderate COPD

30
Q

LABA + ICS combo
Formoterol/Budesonide
Salmeterol/Fluticasone
Vilanterol/Fluticasone

A

For severe to very severe COPD (with frequent exacerbations)

31
Q

LABA + LAAC (LAMA) + ICS

Fluticasone furoate/Umeclidinium/Vilanterol

A

For severe or very severe COPD (with continued exacerbations despite use of LABA + LAMA, or in pts who also have asthma)

32
Q

____ has been associated with an increased risk of pneumonia in COPD pts

A

ICS

33
Q 
Oral phosphodiesterase-4 inhibitor 
Reduces exacerbations in severe bronchitis
Not a bronchodilator
Not used acutely
Limited due to A/E: N/V/D/HA
A

Roflumilast

34
Q

LABAs have primarily replaced this drug in therapy.

A

Theophylline

35
Q

For allergic rhinitis, these are preferred.

A

antihistamines and/or intranasal corticosteroids

36
Q

Most frequently used in tx of sneezing associated with allergic rhinitis caused by histamine release; more effective for prevention than after dx have begun; differ in ability to causes sedation; Benadryl (first gen, sedation), Claritin, Zyrtec, Allegra (2nd gen)

A

Antihistamines

37
Q

Intranasal
Beclomethasone, budesonide, fluticasone, ciclesonide, mometasone, triamcinolone
Nasal spray for allergic rhinitis
Improves sneezing, itching, rhinorrhea and nasal congestion
A/E: nosebleed, sore throat, candidiasis (rare)

A

Corticosteroids

38
Q

Nasal decongestants that can reduce airway resistance
I-Phenylephrine (short acting)
Oxymetazoline (longer acting)
Rapid onset of action with few systemic effects
Combined frequently with antihistamines
Can cause rebound nasal congestion if used more than 3 days.

A

Alpha-adrenergic agonists

39
Q

Useful when administered before contact with an allergen. Dosed at least 1-2 weeks prior to exposure. Available OTC.

A

Intranasal Cromolyn

40
Q

Treat rhinorrhea associated with allergic rhinitis/common cold; but not for sneezing or nasal congestion

A

Intranasal Ipratropium

41
Q

Cough suppressant that decreases the sensitivity of CNS cough centers to peripheral stimuli; decreases mucosal secretion; lower doses for therapeutic effects than when used for analgesia; S/E include constipation, dysphoria and fatigue

A

Codeine

42
Q

Cough suppressant derived from morphine that suppresses the response from the cough center. Antitussive doses can trigger addiction. Safer than codeine, but with equal effectiveness.

A

Dextromethorphan (DM)

43
Q

Expectorant (robitussin/mucinex) used often with codeine or DM. Hydrate well to thin mucous.

A

Guaifenesin

44
Q

Cough suppressant that suppresses the cough reflex peripherally. Anesthetizes receptors located in the respiratory passages, lungs and pleura. Can cause dizziness, numbness of tongue/mouth/throat, and drowsiness.

A

Benzonatate

PHARM (5 decks)

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