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Pharm Remediation > Exam 1- Respiratory, HTN, Anti-Angina > Flashcards

Exam 1- Respiratory, HTN, Anti-Angina Flashcards

1
Q

What are the 6 classes of asthma drugs

A

Adrenergic agonists, anticholinergics, leukotriene receptor antagonists, corticosteroids, cromolyn, methylxanthines/Theophylline

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2
Q

Difference between antagonist and agonist

A

Agonist: binds to receptor site and elicits a defined therapeutic response
Antagonist: Inhibits or blocks responses caused by an agonist

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3
Q

Two ways in which asthma medications act

A

relax bronchial smooth muscle, reduce inflammation

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4
Q

in the airways, …. tone causes bronchodilation, whereas …. tone causes bronchoconstriction

A

sympathetic (adrenergic); parasympathetic (cholinergic)

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5
Q

In general, adrenergic agonists do what

A

increase sympathetic tone and cause bronchodilation

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6
Q

3 Adrenergic agonists

A

Epinephrine, albuterol, salmeterol

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7
Q

Epinephrine is (selective/non selective)

A

Non selective

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8
Q

Main side effect of epinephrine

A

tachycardia (cardiac stimulation of beta-1 receptors)

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9
Q

What route is ineffective for epi?

A

Oral (main is sub-Q)

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10
Q

Albuterol belongs specifically to which class of adrenergic agonists?

A

Beta-2 agonist

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11
Q

How does Albuterol cause bronchodilation?

A

Via beta-2 adrenergic receptor stimulation, increasing cAMP levels, which results in bronchial smooth muscle relaxation

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12
Q

How quickly does Albuterol cause bronchodilation?

A

Inhaled: 15 mins (lasts 3-4hrs) PO: 30 mins (lasts 4-8hrs)

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13
Q

What class of drugs inhibit the activity of albuterol?

A

beta blockers

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14
Q

Does Albuterol have anti-inflammatory effects?

A

no

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15
Q

Why use a spacer with albuterol?

A

slower velocity of delivery so that a greater of volume of smaller, slower velocity particles reach the lung

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16
Q

What is a nebulizer?

A

device used to change liquid medication into an aerosol particulate form

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17
Q

What are the indications for Salmeterol and when should it NOT be used?

A

used for chronic treatment of asthma and bronchospasm. Should NOT be used for acute asthma symptoms

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18
Q

What is the onset of action and duration for Salmeterol?

A

20-30mins, lasts 12 hrs. Dosed 2x/day

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19
Q

Asthma drugs that are similar to atropine and effects are parasympatholytic

A

Anticholinergics

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20
Q

Poor systemic absorption of anti-cholinergic drugs results in

A

fewer cardiac side effects

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21
Q

What is MOA of anti-cholinergic drugs?

A

Competitive antagonists at muscarinic acetylcholine receptor sites

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22
Q

Anti-cholinergic’s are similar in structure to what other drug?

A

Atropine

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23
Q

What effect do anticholinergics have on bronchial wall?

A

Anticholinergics are parasympatholytic, which means they are anti-parasympathetic

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24
Q

How is bronchodilation achieved with anticholinergics?

A

Acetylcholine receptors are blocked so that sympathetic tone becomes dominate and the SM can relax; SM relation = bronchi and bronchioles can dilate

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25
Q

Example of anticholinergic bronchodilator

A

Ipratropium/Atrovent

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26
Q

What is the MOA of leukotriene inhibitors?

A

Competitive antagonists of leukotriene receptors D4, E4 in bronchial smooth muscle

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27
Q

Example of leukotriene receptor antagonist

A

Zafirlukast/Accolate

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28
Q

Indication for Zafirlukast/Accolate

A

prophylaxis and tx of chronic asthma. NOT for reversal of acute asthma attack

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29
Q

What enzyme do glucocorticoids inhibit, thereby blocking the release of what substance from membrane bound phospholipids?

A

Corticosteroids inhibit phospholipase A2. Phospholipase A2 facilitates the release of arachidonic acid, which is the precursor to prostaglandins and leukotrienes

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30
Q

Example of an inhaled corticosteroid

A

Beclomethasone/Beclovent

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31
Q

Which class of asthma drugs has a narrow therapeutic window and has a potential for severe, life-threatening arrhythmias along with potential for multiple drug interactions?

A

Theophylline

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32
Q

Theophylline is a structural relative of what commonly ingested molecule?

A

Caffeine, which can also elicit bronchodilation

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33
Q

How do narcotics suppress cough?

A

Antitussives decrease the sensitivity of CNS cough centers. Occurs at a lower dose than required for analgesia

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34
Q

Which Antitussive is a synthetic derivative of morphine?

A

Dextromethorphan (DM)

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35
Q

Name 4 commonly used drugs in the tx of allergic rhinitis

A

antihistamines, corticosteroids, cromolyn, alpha adrenergic agonists

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36
Q

MOA for Benadryl

A

H1 receptor site blockade

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37
Q

Why does Benadryl cause sedation?

A

Readily crosses BBB

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38
Q

MOA for Claratin

A

H1 receptor antagonist

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39
Q

Why is Claritin non sedating?

A

Does not readily cross BBB

40
Q

Example of alpha agonist nasal spray

A

Arrin, Oxymetazoline

41
Q

Dopamine-norepinephrine reuptake inhibitor also found to act as partial nicotine receptor site antagonist

A

Bupropion SR/Wellbutrin, Zyban

42
Q

Partial agonist of alpha4/beta2 nicotinic acetylcholine receptor sites

A

Chantix

43
Q

Major Side effect of Chantix

A

nightmares or insomnia, depression and suicide ideation, increased agitation and rage

44
Q

9 Classes of Anti HTN drugs

A

Diuretics, beta blockers, alpha blockers, calcium channel blockers, ACE inhibitors, Angiotensin 2 receptor antagonists, Centrally acting agents, direct vasodilators, renin antagonists

45
Q

2 types of potassium wasting diuretics

A

Thiazides and Loop

46
Q

2 Classifications of diuretics

A

Potassium wasting and potassium sparing

47
Q

Best used in the initial treatment of mild HTN with chronic edema

A

Thiazide diuretics

48
Q

Notable side effects of thiazide diuretics

A

Hypokalemia, hypomagnesemia, hypERcalcemia, hypERuricemia, glucose intolerance, hyponatremia (gout)

49
Q

Order of diuretic drugs

A

lasiks, thiazides, least potent potassium sparing

50
Q

preferred diuretic in pts with renal dz, HTN emergencies

A

loop diuretics (furosemide/lasix)

51
Q

Also used to treat hypercalcemia

A

loop (Lasix), K sparing (Spironolactone)

52
Q

Caution with gout, aspirin use, and pts prone to dehydration

A

loop diuretics

53
Q

Example of a loop diuretic

A

furosemide/lasix

54
Q

Drugs with sulfa moiety

A

HCTZ and Lasix

55
Q

3 diseases in which to avoid using Potassium sparing diuretics

A

severe renal insufficiency, poorly controlled DM, Multiple Myeloma

56
Q

Whenever possible, avoid using potassium sparing diuretics in combination with which drugs? (due to potential for hyperkalemia)

A

Potassium supplements, ACE Inhibitors, Angiotensin II Receptor Blockers

57
Q

Example of potassium sparing diuretic

A

Spironolactone/Aldactone

58
Q

Also used to treat hyperaldosteronism

A

Spironolactone/Aldactone

59
Q

Has anti-androgenic properties, used for PCOS and hirsutism

A

Spironolactone/Aldactone

60
Q

Direct agonist of aldosterone

A

Spironolactone/Aldactone

61
Q

what hormone is used to reverse the bradycardic effects of beta blocker

A

glucagon

62
Q

Cardio selective Beta-1 blocker

A

Atenolol/Tenormin

63
Q

Never use in certain cardiac conduction abnormalities, severe asthma, severe COPD

A

Beta Blockers

64
Q

Use cautiously in combo with calcium channel blockers

A

Atenolol/Tenormin

65
Q

no longer considered first line agents in tx of HTN unless co morbid dz such as migraine, angina, or hx of MI

A

beta blockers

66
Q

Can result in improved urine flow in BPH

A

Alpha blockers (Prazosin/Minipress)

67
Q

Example of Alpha blockers

A

Prazosin/Minipress

68
Q

Which drug is derived from rauwolfia alkaloid

A

Reserpine

69
Q

Example of a calcium channel blocker

A

Verapamil/Isopten

70
Q

Caution when using concurrently with beta blockers- potential increased risk for bradycardia and arrhythmias

A

calcium channel blockers

71
Q

Example of Alpha blockers

A

Prazosin/Minipress

72
Q

Which drug is derived from rauwolfia alkaloid

A

Reserpine

73
Q

Example of a calcium channel blocker

A

Verapamil/Isopten

74
Q

Caution when using concurrently with beta blockers- potential increased risk for bradycardia and arrhythmias

A

calcium channel blockers

75
Q

Drug used especially for prinzmetal angina

A

Verapamil/Isopten (calcium channel blocker)

76
Q

Side effects include hyperkalemia, dry cough, angioedema

A

ACE inhibitors (Lisinopril/Prinivil)

77
Q

Least likely of the anti-HTN meds to cause sex dysfunction in males

A

ACE inhibitors (Lisinopril/Prinivil)

78
Q

Side effects include angioedema, cough, hyperkalemia

A

ARBs

79
Q

Drug of choice when treating diabetic pts with HTN

A

ACE inhibitors

80
Q

Indication: HTN, diabetic neuropathy with proteinuria

A

Losartan/Cozaar

81
Q

Generally reserved for severe HTN resistant to previous anti HTN tx (2)

A

Minoxidil/Loniten; Hydrazine/Apresoline

82
Q

Direct vasodilator that can cause hirsutism

A

Minoxidil/Loniten

83
Q

Example of ARB (Angiotensin II Receptor Blocker)

A

Losartan/Cozaar

84
Q

Indication: HTN, diabetic neuropathy with proteinuria

A

Losartan/Cozaar

85
Q

Generally reserved for severe HTN resistant to previous anti HTN tx (2)

A

Minoxidil/Loniten; Hydrazine/Apresoline

86
Q

Direct vasodilator that can cause hirsutism

A

Minoxidil/Loniten

87
Q

Direct vasodilator that can result in drug induced lupus syndrome

A

Hydrazine/Apresoline

88
Q

New HTN drug, Renin Blocker, with side effects of hyperkalemia, angioedema

A

Aliskirien/Tekturna

89
Q

Antidote to morphine

A

naloxone

90
Q

Irreversibly inhibits COX enzyme

A

Aspirin

91
Q

Used to reverse Heparin

A

Protamine sulfate

92
Q

Used to reverse Enoxaparin/ Levenox (Low molecular weight Heparin)

A

Protamine sulfate

93
Q

Antagonized Vit. K, interferes w/clotting factor II, VII, IX, X

A

Coumadin

94
Q

Vitamin K may reverse

A

Coumadin

95
Q

Thrombolytic (clot buster)

A

Streptokinase

96
Q

Aminocaproic acid (amicar) is plasmin in-activator & antifibrinolytic

A

Streptokinase

97
Q

Also used to treat hypocalcemia

A

HCTZ

Pharm Remediation (2 decks)

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