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Resp II > Bronchodilators > Flashcards

Bronchodilators Flashcards

1
Q

inhaled corticosteroids

A

budesonide

fluticasone

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2
Q

oral corticosteroids

A

prednisone
methyprednisolone
prednisolone

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3
Q

cromolyn compounds

A

cromolyn sodium

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4
Q

leukotriene inhibitors

A

montelukast

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5
Q

short acting beta 2 agonists

A

alburerol

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6
Q

long acting beta 2 agonists

A

formoterol

salmeterol

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7
Q

other beta agonists

A

Epi

racemic epi

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8
Q

muscarinic antagonits

A

ipratropium bromide

tiotropium

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9
Q

combivent

A

albuterol +ipratropium

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10
Q

methyxanthines

A

theophylline

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11
Q

anti IgE

A

omalizumab

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12
Q

decongestants

A

alpha-agonists-phyenlephrine

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13
Q

antitussives

A

opioids (codeine, dextromethorphan)

non opioids

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14
Q

expectorants

A

guaifenesin

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15
Q

mucolytics

A

n-actylcysteine

DNAase

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16
Q

> 10um

A

deposit in mouth and oropharynx

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17
Q

<.5um

A

inhaled then exhaled

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18
Q

1-5um

A

deposit in small airways

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19
Q

MDI

A

metered dose inhaler
delivers drug w/HFA, co-solvents, and/or surfactants
low cost
hand held coordination

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20
Q

spacer devices

A

attach to MDI improve ratio of inhaled to swallowed drug and reduce need for coordination

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21
Q

VHCs

A

valved holding chambers

have one way valves to prevent patient from exhaling into device, better for kids

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22
Q

nebulizers

A

severe asthma exacerbations w/poor inspiratory capacity or unable to coordinate

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23
Q

dry powder inhalers

A

require high air flow and can be irritating

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24
Q

beta 2 agonists

A

preferred therapy for bronchoconstriction

immediately effective for acute attacks

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25
Q

MOA beta agonists

A

stimulate AC and increase cAMP -> decrease Ca -> smooth mm relaxation and inhibit mast cells

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26
Q

albuterol

A

onset <15min

lasts 2-6hrs

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27
Q

levalbuterol

A

R isomer of racemic albuterol

28
Q

Epi

A

nebulized solution in kids and infants
drug of choice for emergency Tx of anaphylactic rxns via SQ injection
causes bronchodilation and vasoconstiction

29
Q

Salmerterol

A

long acting 12hours
not suitable for acute bronchospasm
prevention of nighttime asthma attacks

30
Q

formoterol

A

long acting dry powder for maintence of asthma and COPD

NOT for acute attacks

31
Q

arformoterol

A

COPD

32
Q

long term use of LABA

A

may down regulate expression of beta 2 R and loss of drug effectiveness -> more death and hospitalizations
should be combined w/corticosterioid

33
Q

oral administration of beta agonists side effects

A 
skeletal mm tremor
mm cramps
cardiac tachyarrhythmias
metabolic disturbances
hypokalemia (especially with diuretics)
hyperglycemia
34
Q

indications for oral beta agonists

A

<5yrs who cannot use inhalers

severe asthma exacerbations may be unable to tolerant nebulizer or inhaler

35
Q

most common adverse effect of beta agonists

A

skeletal mm tremors

36
Q

CNS side effects of beta agonists

A

restlessness, apprehension, anxiety, tremors

37
Q

CVS side effects of beta agonists

A

tachycardia, dsyrhymias, hyper or hypotension

38
Q

drug interactions of beta agonists

A

potentiate cardiotoxcity of thyroid, digitals, and methylaxthines

39
Q

ipratropium bromide and tiotropium

A

quaternary amine muscarinic agonists
COPD
little to no side effects b/c not well absorbed

40
Q

ipratropioum

A

exclusively as aerosol
lasts for 6hrs
can be used intranasal or allergic rhinitis and chronic post nasal drip

41
Q

combivent

A

albuterol + ipratropoum

treatment of choice for COPD patients

42
Q

methylxanthines

A

adenosine R antagonists
inhibits cyclic nucleotide phosphodiesterases -> increase cAMP and cGMP
decrease Ca-> hyperpolerize cell membranes

43
Q

effects of theophylline

A 
bronchodialtion
CNS stimulation (HA, nausea, vommiting, anxiety)
cardiac stimulation
modest peripheral vasodilation
improved skeletal m contractility 
thiazide like diuresis
44
Q

clinical theophylline

A

narrow therapeutic index
must use slow release formulas
should not be used unless blood levels can be regularly monitored
can be used for nocturnal asthma, but not first line

45
Q

roflumilast

A

severe COPD

oral PDE4 inhibitor -> increase cAMP -> reduce inflammation

46
Q

roflumilast side effects

A 
nausea
diarrhea
psychiatric symptoms
weight loss
last resort
47
Q

corticosteroids

A

asthmatics who require inhaled beta agonists 4+/wk

48
Q

high dose corticosteroids

A

spacer device to reduce risk of adverse effects mandatory

dose can often be reduced over time

49
Q

corticosteroids MOA

A 
bind intracellular cortisol Rs -> TF
inhibit production and release of:
cytokines
vasoactive and chemoattractive factors
lipolytic and proteolytic enzymes
decrease mobilization of leukocytes 
antiinflammatory
50
Q

adverse effects of corticosteroids

A 
oral candidasis and dysphonia (spacer)
hypothalamic-pituitary-adrenal axis suppression
bone resorption
cataracts and skin thinning
purpura
growth retardation in children
glucose intolerance
weight gain
HTN
osteoporosis
immunosupression
mood disorders
51
Q

cromolyn sodium

A

inhibits release of histamine
indirectly inhibits Ag-induced bronchospasm
suppress chemoattractants-> decrease Eos, neutrophils, and monocytes
does not directly relax smooth m
primary prophylactic

52
Q

LTB4

A

neutrophil attractant

53
Q

LTC4 and LTD4

A

bronchoconstriction
increased bronchial reactivity
mucosal edema
mucus hypersecretion

54
Q

zafirlukast and montelukast

A 
selective for LTD4
oral
peak 1-3hrs
useful for aspirin induced asthma
dyspnea most common side effect
55
Q

zarfirlukast

A

kids >12

liver damage

56
Q

montelukast

A

6-12yrs

safe for long term use

57
Q

zyflo

A

> 12yrs

58
Q

omalizumab

A

anti-IgE
serious and life-threatening hypersensitivity rxns to drug can occur
expensive

59
Q

allergic rhinits

A

topical corticosteroids-> nasal spray
croolyn sodium
antihistaimines
nasal decongestants

60
Q

nadal decongestants

A

alpha agonists -> vasoconstrict

61
Q

COPD

A

inhaled ipratropoum or tiotropoum w/beta agonists (combivent)
monotherpay w/corticosteroids not approved

62
Q

triple therapy for COPD

A

tiotropium
formoterol/salmeterol
fluticasone or budesonide)

63
Q

opioids

A

act at CNS suppress cough reflec

64
Q

adverse effects of opioids

A

CNS- euphoria, depression of respiratory and vasomotor centers
GI- constipation, nausea, vomiting
GU- hesitancy or retention

65
Q

opioid drug interaction

A

additive CNS depression w/sedative hypnotics, phenotiazines and tricyclic antidepressents

66
Q

non-opioids

A

local anesthetics and demulcents act directly on nn endings in pharynx

Resp II (15 decks)

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