Drugs for Restrictive Lung Disease and Pulm Artery HTN Flashcards
Silicosis increases your risk for
TB
Coal Workers Pneumocosis increases risk for?
Right sided heart failure
Asbestosis increases your risk for carcinoma and mesotheliom
true
Berryliosis increases your risk for?
multi-organ granuloma formation
What drugs have been shown to precipitate ARDS
Aspirin, Cocaine, Opioids, Phenothiazines, tricyclic anti-depressants
Alcohol abuse and ARDS
Alcohol abuse increases the risk of ARDS due to other causes but does not cause ARDS
NRDS
Neonatal Respiratory Distress Syndrome….Most common cause of respiratory failure in newborns. Surfactant deficiency–> increased surface tension, V/Q mismatch and shunting.
How do you treat NRDS
Give corticosteroids to women at risk of delivering early. This enhances fetal lung maturation
For babies born at less than 30 weeks, exogenous surfactant is administered.
True…give poractant alfa, calfactant, Beractant
Hall mark of Sarcoidosis
Non-caseating granulomas
Treatment of sarcoidosis
gluccocorticoids (anti-inflammatory), methotrexate (immunosuppression)
Gluccocorticoids
MOST POTENT ANTI-INFLAMMATORY AGENTS, act by BINDING GLUCOCORTICOID RECEPTOR and modulating transcriptional regulation in the nucleus. Prevent the production of inflammatory cytokines IL-1 and TNF Alpha and promoting IL-10 production (anti-inflammatory)
Is pulmonary fibrosis an interstitial lung disease?
No way. It doesn’t react to steroid treatment. Some clinicians use steroids to decide whether it is pulm fibrosis or not.
What is goodpastures syndrome
Type II Hypersensitivity reaction against the alpha III chain of Type IV Collagen
Wegners
ANCA positive autoimmune vasculititis of small medium vessels
What are prostanoids
drugs that induce pulmonary artery vasodilation, retard smooth muscle growth, and disrupt platelet aggregation.
PAH is a devastating disease
Drug costs over 35,000 annually because there is not an oral form. lloprost is the only form thats not IV, Epoprostenol and treprostinil are both IV drugs only. Drugs have a limited shelf life.
Four categories of PAH drugs
Prostanoids, Endothelin 1 Receptor Antagonists, Phosphodiesterase Type 5 Inhibitors, CCBs
What are Endothelin 1 Receptor antagonists
block smooth muscle proliferation and pulmonary artery vasoconstriction produced by endothelin when it binds to receptors.
What are phsophodiesterase Type 5 inhibitors
perpetuate cGMP production leading to vasodilation and reduced proliferation
What is the Precaution when prescribing phosphodiesterase type 5 inhibitors
DO NOT GIVE TO PATIENTS TAKING ORGANIC NITRATES
How do calcium channel blockers work
Prevent access to of calcium into cells during membrane depolarization and block smooth muscle contraction
How does methotrexate work
Increases Adenosine-mediated immunosuppresion
What are the prostanoids we need to know
EpoPROSTenol and Lloprost and Treprostinil
What are the Endothelin type 1 antagonists we need to know
Bosentan and Ambrisentan
What is the black box warning for Lloprost?
Hemoptysis
What is the calcium channel blocker we need to know
Diltiazem ,Amlodipine
What is Rituximab?
monoclonalantibody against CD20 on B cells, it is anti-inflammatory
What do you treat with Rituximab
Wegners, both sound german
How does Azothioprine work>
Inhibits DNA and RNA synthesis and fcilitates apoptosis of T cells thus promoting immunosuppression.
What do you treat with Azathioprine
Wegners
Big SE for calc channel blockers>
hypotension
