Chapter 15 (pulmonary drugs) Flashcards
COPD
chronic obstructive pulmonary disease; pts. have obstructed breathing with big chests, patients cannot exhale well b/c of air trapping
lower respiratory infections
called laryngotracheitis; infections of trachea, bronchi, and bronchioles
*though laryngotracheitis is usually just called an URI or bronchitis
bronchodilators
relax bronchial smooth muscle to treat asthma, emphysema (COPD), and exercise induced asthma (EIA)
Can be given by mouth, injection, nebulized liquid, or powder
EIA
exercise induced asthma
Primatene Mist
OTC inhaler of epinepherine; non-selective adrenergic agonist; best drug for bronchospasm, especially in emergency situations; although effects on heart and BP limit its use
front door bronchodilators
sympathomimetic drugs; B2 agonists that dilate bronchial smooth muscle
non-selective sympathomimetic bronchodilators
epinepherine, ephedrine, amphetamine, cocaine, etc.
Proventil MDI
albuterol; prototypical B2 selective agonist; rescue inhaler
Fast onset and short acting (lasts 4-6 hours)
Ventolin
albuterol; prototypical B2 selective agonist; rescue inhaler
Fast onset and short acting (lasts 4-6 hours)
LABA
long-acting B2 agonists used for prophylactic treatment b/c of 0.5 hour onset time (salmeterol and formoterol); last up to 12 hours
Servent
salmeterol; LABA; used for prophylaxis b/c of 0.5 hour onset time and 12 hour lasting effect
formoterol
LABA; used for prophylaxis b/c of 0.5 hour onset time and 12 hour lasting effect
Advair
salmeterol and flucticasone
back door bronchodilators
parasympatholytics; reduce parasympathetic effect of bronchoconstriction in order to dilate the airway
ipratropium
prototype parasympatholytic back door bronchodilator; has less cardiac effect than atropine and is longer acting
“vent”
means its a metered dose inhaler
MDI
metered dose inhaler; can be difficult to use b/c shouldn’t put mouth on it or not enough air will enter and drug will not move into lungs
Spacers help to solve this problem by allowing more volume in with the breathe so mouth can go directly on it
side door bronchodilators
xanthine derivatives; have nothing to do with ANS antagonism Phosphodiesterase inhibitors (specific type) that work at cellular level to increase cAMP levels to yield brochodilation and increase breathing rate by stimulating respiratory centers *also stimulate brain, so cause seizures in high doses and restlessness; stopped being used when corticosteroids and LABAs got better
cocoa beans
naturally rich in methylxanthine drugs caffeine and chemical relatives theobromine and theophylline
theobromine
xanthine; found in hot chocolate
Theo-Dur
theophylline; methylxanthine commonly found in black tea
nebulizers
turn liquid medicine into mist that can be breathed in easy to get medicine into lungs
Advair
salmeterol (LABA) and fluticasone (corticosteroid) combination
Often used as powder
powder vs. propellant
powder is easier to inhale and does not require the coordination of breathing required to take the propellant powered MDIs
LTAs
leukotriene rc antagonists (inhibit action of LT eicosanoids which are known to cause bronchoconstriction); treat asthma and severe hay fever that does not respond to antihistamine therapy
*hard to get insurance to pay for this as allergy treatment and must get waiver and show that you get much better relief than from antihistamines
Singulair
montelukast; leukotriene rc antagonist, oral tablet usually 1/day
Accolate
zafirlukast; leukotriene rc antagonist
Ultair
pranlukast; leukotriene rc antagonist in late stage trials for use in USA
cromolyn sodium
mast cell stabilizer; formulated as a liquid for nubulizers for inhalation (helps treat allergic rhinitis, allergic conjunctivitis, asthma, or general hay fever)
mast cell stabilizers
coat mast cells and prevent them from releasing their allergy causing granules; inert drugs
Only useful prophylactically
*also now used for people who get ulcers from allergies
Intal
cromolyn sodium inhalation aerosol; mast cell stabilizer
mast cell stabilizers and corticosteroids treatment timing
only used prophylactically b/c they do not promote immediate bronchodilation; just prevent bronchoconstriction from occuring
desensitizing immunotherapy
desensitization shots are a immunotherapy aimed at producing “blocking antibodies” of IgG type that prevent IgE-allergen complex from causing mast cell degranulation
*but must be done 1/week with increasing doses of allergen for 2+ years and costs thousands
corticosteroids
reduces inflammation by suppressing inflammatory products products; not actual bronchodilators so don’t help in acute phases of attack, but in 4-6 hours they dramatically reduce inflammation
Great for maintenance asthma therapy to decrease the number of acute attacks and has less side e’s than systemic corticosteroids
Vanceril MDI
beclomethasone; inhaled corticosteroid
Azmacort MDI
triamcinolone; inhaled corticosteroid
antibiotics for lung infections
same as those for ENT infections
oral antibiotics for treating bronchitis and pneumonia
pen VK, amoxicillin, macrolides like clarithromycin (Biaxin) and azithromycin (Zithromax), and ciproflaxacin (fluoroquinolone)
antitussive agents
suppress cough; opioids like dextromethorphan are the best
expectorant agents
thin mucous to aid in expectoration; guaifenesin derived from guaiac tree is most popular
*although in some diseases, like pneumonia, coughing is actually essential and cough should not be suppressed
DXM
dextromethorphan; non-opioid antitussive that is relatively non-addicting
Robitussin
guaifenesin; mucolytic; expectorant
drugs to help smoking cessation
NicoDerm (nicotine patch), Nicorette (nicotine chewing gum), or other nicotine products like spray
Zyban
bupropion; antidepressant Rx drug used to help people quit smoking
Chantix
varenicline; first of new compounds called nicotine rc blockers that block nicotine rc’s in brain
Newest and most effective addition to antismoking therapy; allows patients to ween themselves off nicotine effects while still smoking
problem with new smoking therapies
serious neruopsychiatric symptoms including suicidal ideation and erratic behavior has led a decline in Rx’ing of Chantix
ephedrine
sympathomimetic front door brochodilator; found usually in injection or syrup
Isuprel
isoproterenol; sympathomimetic; front door bronchodilator
Benadryl
diphenhydramine; 1st gen antihistamine
doxylamine
1st gen antihistamine
Phenergan
promethazine; 1st gen antihistamine; also used as a antinausea drug but not very good
Claritin
loratadine; 2nd gen antihistamine
Allegra
fexofenadine; 2nd gen antihistamine
Zyrtec
cetirizine; 2nd gen antihistamine
Flovent MDI
fluticasone; inhaled corticosteroid
lung antifungal therapy
would need to be systemic; Difulcan (fluconazole) and Lamisil (terbinafine)
antiinfluenza drugs
Tamiflu and Relenza; or prevent it with IIV4 or LAIV
Wellbutrin
bupropion; antidepressant Rx drug used to help people quit smoking
Survanta
a surfactant extracted from ground up cow lungs used to treat lung disease of premature infants (which is also called hyaline membrane disease)
TB cause
Mycobacterium tuberculosis; a very large, acid-fast bacterium
the Venturi effect
is what allows the MDI to work better if held a couple inches away from the mouth when sucked in b/c of decrease in pressure of gas when moving through a narrow space
