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Lungs > DRUGS > Flashcards

DRUGS Flashcards

1
Q

Fluticasone [Flovent HFA]

Class/Indications

A

Class: Glucocorticoid
Indications: Asthma, COPD

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2
Q

Fluticasone MOA

A

MoA: anti-inflammatory, immunosuppressive & anti-proliferative activity

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3
Q

Fluticasone SE/ADR

A

SE/ADRs: headache, oral thrush, URI, throat irritation, cough

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4
Q

Fluticasone Contra

A

Contra: Hypersensitivity, acute bronchospasm, latent TB, glaucoma, cataracts

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5
Q

Fluticasone Fun Fact

A

PG- C, lactation caution Inhalation long-term prophylaxis of bronchospasm; Children possible growth slowing but “catch up”; rinse mouth after use; Budesonide [Pulmocort inhalers]

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6
Q

Prednisone

Class/Indications

A

Class: Glucocorticoid
Indications: Adjunct therapy in exacerbation of bronchospasm; multiple others

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7
Q

Prednisone MOA

A

MoA: Anti-inflammatory early after administration by decreasing migration of WBCs, reversal capillary permeability, immunosuppressant; later onset of inhibition of protein synthesis

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8
Q

Prednisone SE/ADR

A

SE/ADRs: In short term use minimal; longer than 10-14 days multiple systemic

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9
Q

Prednisone Contra

A

Contra: Hypersensitivity, acute bronchospasm (unless as adjunct), latent TB, glaucoma, cataracts

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10
Q

Prednisone Dx-Dx

A

Dx-Dx: tNSAIDS, anti-diabetic meds, anti-HTN meds

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11
Q

Prednisone Fun Fact

A

Other: Short-term oral “burst” therapy in exacerbation bronchospasm; Asthma & COPD; avoid long-term oral use; Oral or IV routes; PG: Caution, Lact: Caution

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12
Q

Cromolyn Na [Crolom MDI]

Class/Indications

A

Class: Anti-inflammatory – Mast Cell Stabilizer
Indications: Childhood asthma

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13
Q

Cromolyn MOA

A

MoA: Stabilizes mast cell membrane to prevent degranulation and release of histamine, leukotrienes, slow-reacting substance of anaphylaxis

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14
Q

Cromolyn SE/ADR

A

SE/ADRs: Headache, unpleasant taste, hoarseness, cough

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15
Q

Cromolyn Fun Fact

A

Other: Generally works better in children than adults; inhalation route; PO route investigational for food allergy, IBD; PG: B

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16
Q

Zafirlukast

Class/Indications

A

Class: Oral leukotriene receptor antagonist
Indications: Asthma

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17
Q

Zafirlukast MOA

A

MoA: selective and competitive antagonist of leukotriene receptors D4 & E4, SRSA

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18
Q

Zafirlukast SE/ADR

A

SE/ADRs: Headache, nausea, diarrhea; Hepatitis

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19
Q

Zafirlukast Contra

A

Contra: Hypersensitivity; acute exacerbation of asthma; caution in alcoholic cirrhosis

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20
Q

Zafirlukast Dx-Dx

A

Dx-Dx: Concomitant food decr availability by 40%

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21
Q

Zafirlukast Fun Fact

A

Other: Can continue but not start Zafirlukast during acute exacerbation asthma; PG: B; lact: not rec

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22
Q

B- exercise induced asthma dose

A

2 puffs 5 mins before

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23
Q

B- fluticasone SE

A

oral thrush, rinse mouth

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24
Q

B- pg ICS

A

yes but diskus preferred

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25
Q

B- chantix MOA

A

partial nicotine agonist

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26
Q

Albuterol (Salbutamol) [Ventolinz]

Class/ Indication

A

Class: Beta2 agonist, short acting bronchodilator
Indications: Bronchospasm in asthma & COPD, EIB

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27
Q

Albuterol MOA

A

MoA: Bronchial smooth muscle Beta2 (sympathetic) receptor stimulation; racemic mixture w/ R isomer active & S isomer inactive (?side effects)

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28
Q

Albuterol SE/ADR

A

SE/ADRs: Angina, incr or decr BP, arrhythmias, palpitations, CNS stimulation, angioedema, restlessness, wakefulness

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29
Q

Albuterol CONTRA

A

Contra: Caution with HTN, CHF, arrhythmias, seizure d/o, diabetes, glaucoma, hyperthyroidism, low serum K+

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30
Q

Albuterol DX-DX

A

Beta-Blockers

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31
Q

Albuterol Monitoring

A

Spirometry

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32
Q

Albuterol Fun fact

A

Other: Treatment or prophylaxis; multiple formulations MDI, oral tablet & solution, Neb sol; IV in Canada; use of spacer/VHC with MDI; use in conjunction with anti-inflammatory agent for long term use for other than mild asthma; Tolerance develops with long term use of Beta2 agonists; PG: C, Lact: caution

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33
Q

Levalbuterol [Xopenex HFA]

Class/ Indication

A

Class: Beta2 Adrenergic Agonist, short acting bronchodilator
Indications: treatment or prevention of bronchospasm in reversible airway disease (Asthma, EIB, COPD)

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34
Q

Levalbuterol MOA

A

MoA: rapid acting selective Beta2 receptor agonist counteracts bronchospasm; pure R- isomer of drug

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35
Q

Levalbuterol SE/ADR

A

SE/ADRs: tremor, rhinitis, viral infection, headache, pharyngitis

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36
Q

Levalbuterol Contra

A

active cardiac disease

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37
Q

Levalbuterol Dx-DX

A

Dx-Dx: incr levels of loop diuretics, sympathomimetics; levels decr by Beta Blockers, combination Alpha/Beta Blockers

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38
Q

Levalbuterol Monitor

A

Spirometry, HR, BP

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39
Q

Levalbuterol Fun fact

A

Other: MDI & nebulizer solution available; use in conjunction with anti-inflammatory agent for long term use for other than mild asthma or EIB; PG: C, Lact: caution

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40
Q

Salmeterol [serevent diskus]

Class/Indications

A

Class: Beta2 Adrenergic Agonist, long acting bronchodilator
Indications: long term control of COPD, asthma control; EIB

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41
Q

Salmeterol MOA

A

MoA: selective, long-acting Beta2 adrenergic agonist

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42
Q

Salmeterol SE/ADR

A

SE/ADRs: headache, muscle pain, anxiety, insomnia

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43
Q

Salmeterol Contra

A

Contra: acute asthma or acute COPD; seizure d/o, CVD, diabetes, hyperthyroidism

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44
Q

Salmeterol DX-DX

A

Dx-Dx: incr levels of loop diuretics, sympathomimetics; levels incr by CYP3A4 inhibitors ; impact decr by Beta blockers

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45
Q

Salmeterol Monitor

A

Spirometry, HR,BP, glucose

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46
Q

Salmeterol Fun fact

A

Other: Black Box Warning re: asthma deaths, CVD outcomes; use in Exercise induced bronchospasm (EIB) discouraged; DPI rinse mouth after use; DPI 50mcg/inh; PG: C, Lact: caution

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47
Q

Formoterol Class/ Indication

A

Class: Beta2 Adrenergic Agonist, long acting bronchodilator
Indications: long term control COPD, asthma with steroid MDI

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48
Q

Formoterol MOA

A

long acting beta 2 agonist

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49
Q

Formoterol SE/ADR

A

SE/ADRs: tremor, chest pain, palpitations, anxiety, insomnia, muscle cramps

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50
Q

Formoterol Contra

A

Contra: acute asthma or COPD; active CVD

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51
Q

Formoterol Dx-DX

A

Dx-Dx: incr levels of loop diuretics, sympathomimetics; effect decr by Beta blockers

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52
Q

Formoterol Monitor

A

Spirometry, HR, BP, glucose

53
Q

Formoterol Fun Fact

A

Other: Black Box Warning re: asthma deaths, CVD; discourage use for EIB; DPI 12mcg/inh and neb sol: PG: C, Lact: caution

54
Q

Theophylline Class/Indication

A

Class: PDE inhibitor or Methylxanthine bronchodilator
Indications: reversal of bronchospasm

55
Q

Theophylline MOA

A

MoA: PDE blockade causes incr levels cAMP which produces bronchodilation, diuresis, CNS and cardiac stimulation, release of epinephrine

56
Q

Theophylline SE/ADR

A

SE/ADRs: tachycardia, headache, insomnia, seizures

57
Q

Theophylline Contra

A

Contra: CVD, HTN, hyperthyroidism, peptic ulcers, seizure d/o

58
Q

Theophylline Dx-Dx

A

Dx-Dx: levels incr by multiple CYP1A2, 3A4 inhibitor drugs

59
Q

Theophylline Monitor

A

Theophylline level, spirometry, HR,BP,glucose

60
Q

Theophylline Fun Fact

A

Other: narrow therapeutic index; target level 10-19.9mcg/mL serum; Sn & Sm toxicity include persistent vomiting, agitation; oral, IV formulations; PG: C, Lact: “compatible”

61
Q

Roflumilast Class/Indication

A

Class: PDE-4 Inhibitor anti-inflammatory agent
Indications: Adjunct therapy in COPD (chronic bronchitis)

62
Q

Roflumilast MOA

A

MoA: Drug and active metabolite inhibit PDE4 increasing cAMP in inflammatory and structural cells; suppress cytokine release; inhibit lung infiltration by WBC’s; decreases pulmonary remodeling

63
Q

Roflumilast SE/ADR

A

SE/ADRs: Headache, weight loss, diarrhea, nausea

64
Q

Roflumilast Contra

A

Contra: Mod- to severe liver impairment

65
Q

Roflumilast DX-DX

A

Dx-Dx: CYP3A4 inducers decr serum conc Roflumilast; Cipro incr conc; Rifampin decr conc

66
Q

Roflumilast Monitor

A

Spirometry

67
Q

Roflumiast Fun Fsact

A

Other: Adjunct to bronchodilator therapy only; with or without food; not for acute exacerbation; PG-avoid use and not in nursing; 500mcg tablet once daily

68
Q

Ipatropium Class/Indication

A

Class: Anticholinergic bronchodilator, short acting
Indications: acute and maintenance Tx of bronchospasm in COPD, asthma

69
Q

Ipatropium MOA

A

MoA: blocks acetylcholine cholinergic receptors in bronchial smooth muscle to reduce bronchospasm

70
Q

Ipatropium SE/ADR

A

SE/ADRs: URI, chest pain, palpitations, dyspepsia, xerostomia, dyspnea, flu-like syndrome

71
Q

Ipatropium Contra

A

Contra: narrow angle glaucoma, paradoxical bronchospasm; acute asthma except in conjunction with SABA drug; urinary tract outflow obstruction

72
Q

Ipatropium Dx-DX

A

Dx-Dx: decr effect of acetylcholinesterase inhibitors

73
Q

Ipatropium Fun Fact

A

Other: MDI, neb sol; First line COPD; adjunct in asthma; tolerance not seen with long term use; PG: C

74
Q

Tiotropium class/indication

A

Class: Anticholinergic bronchodilator, long acting
Indications: maintenance Tx bronchospasm in COPD, asthma

75
Q

Tiotropium MOA

A

MoA: blocks acetylcholine at parasympathetic receptors in bronchial smooth muscle producing bronchodilatation

76
Q

Tiotropium SE/ADR

A

SE/ADRs: URI, chest pain, palpitations, dyspepsia, xerostomia, dyspnea, flu-like syndrome

77
Q

Tiotropium Contra

A

Contra: paradoxical bronchospasm, acute bronchospasm, narrow angle glaucoma, urinary tract outflow obstruction

78
Q

Tiotropium Montior

A

spirometry HR

79
Q

Tiotropoim DX-DX

A

Dx-Dx: decr effect of acetylcholinesterase inhibitors

80
Q

Tiotropium Fun Fact

A

Other: First line COPD; adjunct in asthma; DPI; ~10x effect of ipratropium; PG: C; Lact: caution

81
Q

Omalizumab [Xolair] class/indication

A

Class: Anti-IgE antibody; Immunomodulator
Indications: maintenance Tx allergic asthma not controlled by inhaled steroids

82
Q

Omalizumab MOA

A

MoA: binds to IgE antibody receptors on mast cells, blocking attachment of IgE antibody and preventing degranulation release of histamines, leukotrienes
SE/ADRs: headache, injection site reaction, URI, pain; Anaphylaxis

83
Q

Omalizumab Contra

A

Contra: acute asthma, status asthmaticus

84
Q

Omalizumab dx-dx

A

impairs vaccines

85
Q

Omalizumab monitor

A

Monitor: Spirometry; [IgE]rises with Tx and may be elevated up to 1 year after cessation Tx

86
Q

Omalizumab Fun Fact

A

Other: 2nd line drug; expensive ($740/150mg); SQ admin in office due to possible anaphylaxis; dosed by pre-Tx [IgE] and weight; inject every 2 to 4 weeks; Black box Warning re anaphylaxis; PG: B, Lact: caution

87
Q

Fluticasone/Salmeterol[Advair HFA/Advair Diskus]

Class/ indication

A

Class: Combination Glucocorticoid and Long acting Beta 2 Agonist
Indications: Asthma (maintenance of bronchodilation), Asthma

88
Q

Fluticasone/Salmeterol (advair) MOA

A

MoA: anti-inflammatory action of steroid and bronchodilitation activity of Beta2 agonist

89
Q

Fluticasone/Salmeterol (advair) SE/ADR

A

SE/ADRs: Combo of SE/ADRs of both ingredients; increased risk death

90
Q

Fluticasone/Salmeterol (advair) Contra

A

Contra: Acute exacerbation of bronchospasm; status asthmaticus

91
Q

Fluticasone/Salmeterol (advair) dx-dx

A

Dx-Dx: Combo both ingredients

92
Q

Fluticasone/Salmeterol (advair) Monitor

A

Monitor: Spirometry, HR, BP, CNS stimulation; frequency of use of SABA; growth velocity in children

93
Q

Fluticasone/Salmeterol (advair) Fun fact

A

Other: MDI [Advair HFA] 45/21mcg/inh; 115/21mcg; 230/21mcg; Inhaled powder [Advair Diskus] 100/50mcg/inh; 250/50mcg, 500/50mcg; Black Box Warning re asthma-related deaths: PG: C, Lact: caution

94
Q

Budesonide/Formoterol [Symbicort MDI] class/ indication

A

Class: Combination Glucocorticoid and Long acting Beta 2 Agonist
Indications: Asthma (maintenance of bronchodilation); COPD

95
Q

Budesonide/Formoterol [Symbicort MDI] MOA

A

MoA: anti-inflammatory action of steroid and bronchodilitation activity of Beta2 agonist

96
Q

Budesonide/Formoterol [Symbicort MDI] SE/ADR

A

SE/ADRs: Combo of SE/ADRs of both ingredients; increased risk death

97
Q

Budesonide/Formoterol [Symbicort MDI] Contra

A

Contra: Acute exacerbation of bronchospasm; status asthmaticus

98
Q

Budesonide/Formoterol [Symbicort MDI]DX-DX

A

combo both

99
Q

Budesonide/Formoterol [Symbicort MDI] Monitor

A

Monitor: Spirometry, HR, BP, CNS stimulation; frequency of use of SABA; growth velocity in children

100
Q

Budesonide/Formoterol [Symbicort MDI] Fun Fact

A

Other: MDI 80/4.5 or 160/4.5 at 2 inh BID; in 60 and 120 inh MDI’s; Black Box Warning re asthma-related deaths; PG: C, lact: not

101
Q

Ipratropium/Albuterol [Combivent] class indications

A

Class: Short acting Anticholinergic & short acting Beta2 agonist
Indications: COPD pts requiring two bronchodilators

102
Q

Umeclidinium/Vilanterol [Anoro Elipta] class/ indication

A

Long-acting anticholinergic/Long-acting Beta Agonist Combo

Indications: COPD

103
Q

Umeclidinium/Vilanterol [Anoro Elipta] MOA

A

Combination of two agents with different bronchodilating action (anti-muscarinic and beta2 agonism)

104
Q

Umeclidinium/Vilanterol [Anoro Elipta] SE/ADR

A

Paradoxical bronchospasm, chest pain, limb pain, pharyngitis

105
Q

Umeclidinium/Vilanterol [Anoro Elipta] Contra

A

Severe milk protein allergy; caution with glaucoma; co-morbid thyrotoxicosis, seizure disorder, prostatic hyperplasia, low K+, diabetes

106
Q

Umeclidinium/Vilanterol [Anoro Elipta] dx-dx

A

Multiple but lower risk of occurrence

107
Q

Umeclidinium/Vilanterol [Anoro Elipta] Monitor

A

FEV1, peak flow, BP, HR, CNS stimulation, eye changes

108
Q

Umeclidinium/Vilanterol [Anoro Elipta] Fun Fact

A

: PG ‘C’, Lact caution; t1/2 = 11 H; 1 inh once daily

109
Q

Nicoderm class/indication

A

Class: Nicotine replacement agents
Indications: tobacco cessation aid

110
Q

Nicoderm MOA

A

MoA: biphasic CNS & ANS nicotine receptor stimulant; low dose -> stimulation ANS ganglia; large dose -> stim followed by blockade of transmission

111
Q

Nicoderm SE/ADR

A

SE/ADRs: headache, mucosal irritation, cough, rhinitis; toxicity -> tremors, respiratory excitation, convulsions, respiratory failure

112
Q

Nicoderm Contra

A

Contra: varies with formulation; recent AMI, life threatening arrhythmias; severe angina, TMJ d/o, hyperthryroidism, T1DM, bronchospastic d/o

113
Q

Nicoderm DX-DX

A

Dx-Dx: conc incr by Cimetadine

114
Q

Nicoderm Monitor

A

HR,BOP,Insomnia

115
Q

Nicoderm Fun Fact

A

Other: can use more than one formulation; PG: D (nasal formulation), Lact: unk

116
Q

Bupropion [Zyban] Class/indication

A

Class: Dopamine-reuptake inhibitor antidepressant
Indicatins: tobacco cessation [Zyban]; depression [Wellbutrin]

117
Q

Bupropion [Zyban] MOA

A

unknown

118
Q

Bupropion [Zyban] SE/ADR

A

SE/ADRs: tachycardia, headache, insomnia, nausea, xerostomia, weight loss, palpitations, agitation, constipation, diarrhea

119
Q

Bupropion [Zyban] Contra

A

Contra: Bipolar disorder, seizure disorder; active CVD, uncontrolled HTN

120
Q

Bupropion [Zyban] Dx-DX

A

Dx-Dx: MAO inhibitors, ethanol

121
Q

Bupropion [Zyban] Monitor

A

Monitor: psychiatric symptoms, tobacco use, BP

122
Q

Bupropion [Zyban] Fun Fact

A

Other: Black Box Warning: may precipitate or worsen depression, suicidal thoughts, suicide; dosing differences -> Zyban 150mg daily to twice daily for 12 weeks; Wellbutrin forms IR, SR, ER variable; PG: C, Lact: ??

123
Q

Varenicline [Chantix] class/indications

A

Class: Partial nicotine agonist
Indications: tobacco cessation aid

124
Q

Varenicline [Chantix]MOA

A

MoA: prevents nicotine stimulation of the mesolimbic dopamine system

125
Q

Varenicline [Chantix] SE/ADR

A

SE/ADRs: insomnia, headache, abnormal dreams, nausea

126
Q

Varenicline [Chantix] Contra

A

Contra: psychiatric disorders, decreased renal function, active CVD

127
Q

Varenicline [Chantix] dx-dx

A

unknown

128
Q

Varenicline [Chantix]monitor

A

Monitor: Psych changes; tobacco use

129
Q

Varenicline [Chantix] other

A

Other: Black Box Warning re: pscyhiatric events depression, suicidal thoughts, suicide, agitation; titrate dose up (0.5mg once daily to 1mg twice daily for 11 weeks w/ additional 12 weeks if needed); PG: C, Lact: not

Lungs (2 decks)

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