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PHARM > Bronchodilators > Flashcards

Bronchodilators Flashcards

1
Q

Where are beta 2 adrenergic receptors located?

A

lungs, uterus, select arterioles, liver, and skeletal muscle

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2
Q

Therapeutic use of short-acting beta 2 agonist (SABA) Albuterol?

A

QUICK RELIEF agent for ASTHMA → acute bronchospasm and for prevention of exercise-induced bronchospasm.

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3
Q

Example of a SABA?

A

Albuterol (Proventil HFA, Ventolin HFA, ProAir)

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4
Q

MOA of Albuterol?

A

Stimulates beta 2 adrenergic receptors in the smooth msl of the bronchi and bronchioles → bronchodilation

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5
Q

Adverse effects of albuterol?

A

Nervousness, restlessness, tremor, CP, insomnia, arrhythmias, HTN, hypokalemia, paradoxical bronchospasm

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6
Q

Route for albuterol?

A

oral- long acting (long-term control)

inhaled- short acting

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7
Q

Contraindications for albuterol?

A

hypersensitivity

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8
Q

Precautions for albuterol?

A

Be cautious if you have cardiac disease, HTN, hyperthyroidism, diabetes, excess inhaler use may lead to tolerance and paradoxical bronchospasm.

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9
Q

Drug interactions with albuterol?

A

Beta adrenergic blockers; MAOIs, tricyclics, and caffeine products can increase HR; Theophylline; some cold products (Naproxen or Ibuprofen)

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10
Q

How do we evaluate the effectiveness of the albuterol?

A

peak expiratory flow rate (PEF), symptom frequency, and SABA use

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11
Q

T/F. Albuterol is the only rescue inhaler to be used during asthma attacks

A

True

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12
Q

For an acute asthma attack what are the next two medications that should be administered?

A

Ipratropium (Atrovent) and Methyl prednisolone (Solu-Medrol)

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13
Q

Onset of action for Ipratropium?

A

short acting; 1-3 minutes

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14
Q

Route of administration for Ipratropium?

A

inhalant and intranasal

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15
Q

Therapeutic uses of Ipratropium (Atrovent)?

A
  • MAINTENANCE therapy of reversible airway obstruction d/t COPD
  • off label use for asthma exacerbations with albuterol
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16
Q

MOA of Ipratropium (Atrovent)?

A

Anticholinergic agent; muscarinic antagonist; blocks the muscarinic receptors in the bronchi to block the action of Ach

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17
Q

Adverse effects of IpratropIum (Atrovent)? Hint: anticholinergic

A

dry mouth, Irritation of pharynx, Increased intraocular pressure

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18
Q

Ipratropium (Atrovent) contraindications?

A

hypersensitivity to ipratropium, atropine, belladonna alkaloids, or bromide.

19
Q

Precautions for Ipratropium? (PUG)

A

use cautiously in patients with prostatic hyperplasia, glaucoma, or urinary retention

20
Q

Therapeutic use for a long-acting beta 2 agonist (LABA)? Salmeterol

A
  • Long-term control of asthma but not the 1st choice.
  • Asthma and bronchospasms (as concomitant therapy with an inhaled corticosteroid).
  • Exercise induced asthma
21
Q

LABA prototype?

A

Salmeterol (Serevent diskus)

22
Q

MOA of Salmeterol?

A

stimulates adenyl cyclase resulting in increased intracellular cyclic AMP level at the beta 2 receptors which in turn triggers bronchial smooth muscles relaxation.

23
Q

T/F. long acting agents like Salmeterol are not to be used alone but prescribed in combination with an inhaled glucocorticoid

A

True

24
Q

How often is Salmeterol dosed?

A

Q12h

25
Q

Adverse effects of Salmeterol?

A

HA, asthma related death when used alone

26
Q

What class of agent is Theophylline (Elixophyllin, Theo-24)?

A

Xanthine; Methylxanthines; bronchodilator

27
Q

MOA of Theophylline?

A

relaxes smooth msls of the bronchi

28
Q

Therapeutic use of Theophylline?

A

second line agent for long-term control of chronic asthma or COPD

29
Q

Adverse effects of TheoPhylliNe?

A

ANXIETY, tachycardia, N/V, HA, palpitations, tremors, anorexia, seizures, arrhythmias

30
Q

Precautions to take with Theophylline? Hint: toxicity

A

cautious use in patients with cardiac arrhythmias, heart failure, liver or kidney dysfunction

31
Q

Drug interactions with Theophylline?

A

multiple (caffeine). “CRANKY drug”

32
Q

Route of administration-Theophylline?

A

oral or IV

33
Q

Example of long-acting muscarinic antagonist?

A

Tiotropium (Spiriva) inhalation

34
Q

MOA of Spiriva?

A

causes bronchial dilation by selectively and reversibly inhibiting acetylcholine at type 3 muscarinic receptors

35
Q

Therapeutic use of Tiotropium (Spiriva)? Hint: anticholinergic, LAMA

A

MAINTENANCE therapy of bronchoconstriction associated with COPD

36
Q

Adverse effects of Tiotropium (Spiriva)?

A

dry mouth, glaucoma, and angioedema

37
Q

Spiriva drug class?

A

Anticholinergic, antimuscarinic, and bronchodilator

38
Q

Patient education for Tiotropium (spiriva)? Hint: anticholinergic

A

Notify provider of angioedema or glaucoma

39
Q

What is the most common combination of drugs for COPD?

A

SABA and short acting anticholinergic

40
Q

What is the black box warning for LABA and corticosteroid combination?

A

can possibly increase asthma severity/asthma related deaths

41
Q

What are the goals for asthma tx?

A

reducing impairment and reducing risk

42
Q

What are the goals for COPD tx?

A

reduce sx and reduce risk and mortality

43
Q

What type of medications are used to manage stable COPD?

A

LABA, LAMA, ICS, and PDE4 inhibitors

44
Q

What medications are used to mange COPD exacerbations?

A

SABA, SAMA, systemic glucocorticoids, antibodies, and supplemental oxygen

PHARM (35 decks)

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