Drugs for Respiratory Disorders: Part 2

Question 1

Glucocorticoids are the..

Answer 1

Most effective anti-asthma drugs

Question 2

Routes of glucocorticoids

Answer 2

IV
Oral
Inhaled

Question 3

Are steroids emergency drugs?

Answer 3

NO but they go in and stop the inflammation that probably started the attack in the first place

Question 4

Steroids mechanism of action

Answer 4

Suppress inflammation
Decrease mucus production
Increase number of bronchial Beta2 receptors and responsiveness to beta 2 agonists (1+1=2)

Question 5

Uses in asthma

Answer 5

Prophylaxis!!

Fixed schedule, not PRN

Question 6

Modes of steroid administration

Answer 6

Inhalation

Oral

Question 7

Inhaled steroids

Answer 7

First0line therapy taken every day
Moderate - severe asthma
Very safe

Question 8

Oral steroids

Answer 8

For severe asthma

Question 9

Risk for toxicity of oral steroids increases with…

Answer 9

Duration of use

Question 10

Oral steroids are used when..

Answer 10

Symptom control inadequate with other meds

Question 11

If your patient is on steroids, they are not…

Answer 11

A happy healthy asthmatic

Question 12

_____ steroids will have fewer side effects

Answer 12

Inhaled

Question 13

Adverse effects of inhaled glucocorticoids

Answer 13

Adrenal suppression
Bone loss
Oropharyngeal candidiasis (thrush)
Dysphonia (hoarseness)

Question 14

How to minimize adverse effects of inhaled glucocorticoids

Answer 14

Gargle after administration

Use a spacer

Question 15

How do glucocorticoids cause hoarseness?

Answer 15

Because of tissue breakdown on vocal cords

Question 16

Oral glucocorticoids will have no adverse effects when…

Answer 16

Used acutely (< 10 days)

Question 17

Prolonged use of oral glucocorticoids can lead to…

Answer 17

Adrenal suppression 
Osteoporosis
Hyperglycemia
Peptic ulcer disease
Growth suppression in children (slows growth)

Question 18

Glucocorticoid / Beta 2 agonist combos

Answer 18

Advair diskus (indicated for patients with moderate to severe asthma)

Question 19

Advair originally got a bad rep b/c..

Answer 19

People died when they first were taking it because they were trying to take it for emergencies

Question 20

Cromolyn is used for..

Answer 20

PROHYLAXIS

Question 21

What is Comolyn similar to?

Answer 21

Steroids - suppresses airway inflammation

(Does not work as well as steroids but has almost no adverse effects)

Question 22

Random: Isuprel

Answer 22

Nonselective Beta 2 agonist

Question 23

Uses of Cromolyn

Answer 23

Chronic asthma
Exercise induced bronchospasm
Allergic rhinitis

Question 24

Cromolyn in the _____ of all asthma medications

Answer 24

Safest

Question 25

Adverse effect of Cromolyn

Answer 25

Occasionally cough / bronchospasm

Question 26

Methylxanthines mechanism of action

Answer 26

(OLD drugs) 
CNS excitation 
Bronchodilation 
Cardiac stimulation 
Vasodilation 
Diuresis

Question 27

Methylxanthines adverse effects

Answer 27

Cause anxiety, irritability

Not good for cardiac patients

Question 28

Methylxanthines: Theophylline

Answer 28

Bronchodilation - very narrow therapeutic range (MONITOR serum levels)

Question 29

Theophylline mild toxicity

Answer 29

N/V/D; insomnia, restlessness

Question 30

Theophylline serious toxicity

Answer 30

Dysrhythmias, convulsions, death

Question 31

Theophylline drug interactions

Answer 31

Caffeine

Question 32

Theophylline routes

Answer 32

Oral 
IV (emergencies only) - give slowly to avoid dysrhythmias