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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
Example of anticholinergic bronchodilator
Ipratropium/Atrovent
26
What is the MOA of leukotriene inhibitors?
Competitive antagonists of leukotriene receptors D4, E4 in bronchial smooth muscle
27
Example of leukotriene receptor antagonist
Zafirlukast/Accolate
28
Indication for Zafirlukast/Accolate
prophylaxis and tx of chronic asthma. NOT for reversal of acute asthma attack
29
What enzyme do glucocorticoids inhibit, thereby blocking the release of what substance from membrane bound phospholipids?
Corticosteroids inhibit phospholipase A2. Phospholipase A2 facilitates the release of arachidonic acid, which is the precursor to prostaglandins and leukotrienes
30
Example of an inhaled corticosteroid
Beclomethasone/Beclovent
31
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?
Theophylline
32
Theophylline is a structural relative of what commonly ingested molecule?
Caffeine, which can also elicit bronchodilation
33
How do narcotics suppress cough?
Antitussives decrease the sensitivity of CNS cough centers. Occurs at a lower dose than required for analgesia
34
Which Antitussive is a synthetic derivative of morphine?
Dextromethorphan (DM)
35
Name 4 commonly used drugs in the tx of allergic rhinitis
antihistamines, corticosteroids, cromolyn, alpha adrenergic agonists
36
MOA for Benadryl
H1 receptor site blockade
37
Why does Benadryl cause sedation?
Readily crosses BBB
38
MOA for Claratin
H1 receptor antagonist
39
Why is Claritin non sedating?
Does not readily cross BBB
40
Example of alpha agonist nasal spray
Arrin, Oxymetazoline
41
Dopamine-norepinephrine reuptake inhibitor also found to act as partial nicotine receptor site antagonist
Bupropion SR/Wellbutrin, Zyban
42
Partial agonist of alpha4/beta2 nicotinic acetylcholine receptor sites
Chantix
43
Major Side effect of Chantix
nightmares or insomnia, depression and suicide ideation, increased agitation and rage
44
9 Classes of Anti HTN drugs
Diuretics, beta blockers, alpha blockers, calcium channel blockers, ACE inhibitors, Angiotensin 2 receptor antagonists, Centrally acting agents, direct vasodilators, renin antagonists
45
2 types of potassium wasting diuretics
Thiazides and Loop
46
2 Classifications of diuretics
Potassium wasting and potassium sparing
47
Best used in the initial treatment of mild HTN with chronic edema
Thiazide diuretics
48
Notable side effects of thiazide diuretics
Hypokalemia, hypomagnesemia, hypERcalcemia, hypERuricemia, glucose intolerance, hyponatremia (gout)
49
Order of diuretic drugs
lasiks, thiazides, least potent potassium sparing
50
preferred diuretic in pts with renal dz, HTN emergencies
loop diuretics (furosemide/lasix)
51
Also used to treat hypercalcemia
loop (Lasix), K sparing (Spironolactone)
52
Caution with gout, aspirin use, and pts prone to dehydration
loop diuretics
53
Example of a loop diuretic
furosemide/lasix
54
Drugs with sulfa moiety
HCTZ and Lasix
55
3 diseases in which to avoid using Potassium sparing diuretics
severe renal insufficiency, poorly controlled DM, Multiple Myeloma
56
Whenever possible, avoid using potassium sparing diuretics in combination with which drugs? (due to potential for hyperkalemia)
Potassium supplements, ACE Inhibitors, Angiotensin II Receptor Blockers
57
Example of potassium sparing diuretic
Spironolactone/Aldactone
58
Also used to treat hyperaldosteronism
Spironolactone/Aldactone
59
Has anti-androgenic properties, used for PCOS and hirsutism
Spironolactone/Aldactone
60
Direct agonist of aldosterone
Spironolactone/Aldactone
61
what hormone is used to reverse the bradycardic effects of beta blocker
glucagon
62
Cardio selective Beta-1 blocker
Atenolol/Tenormin
63
Never use in certain cardiac conduction abnormalities, severe asthma, severe COPD
Beta Blockers
64
Use cautiously in combo with calcium channel blockers
Atenolol/Tenormin
65
no longer considered first line agents in tx of HTN unless co morbid dz such as migraine, angina, or hx of MI
beta blockers
66
Can result in improved urine flow in BPH
Alpha blockers (Prazosin/Minipress)
67
Example of Alpha blockers
Prazosin/Minipress
68
Which drug is derived from rauwolfia alkaloid
Reserpine
69
Example of a calcium channel blocker
Verapamil/Isopten
70
Caution when using concurrently with beta blockers- potential increased risk for bradycardia and arrhythmias
calcium channel blockers
71
Example of Alpha blockers
Prazosin/Minipress
72
Which drug is derived from rauwolfia alkaloid
Reserpine
73
Example of a calcium channel blocker
Verapamil/Isopten
74
Caution when using concurrently with beta blockers- potential increased risk for bradycardia and arrhythmias
calcium channel blockers
75
Drug used especially for prinzmetal angina
Verapamil/Isopten (calcium channel blocker)
76
Side effects include hyperkalemia, dry cough, angioedema
ACE inhibitors (Lisinopril/Prinivil)
77
Least likely of the anti-HTN meds to cause sex dysfunction in males
ACE inhibitors (Lisinopril/Prinivil)
78
Side effects include angioedema, cough, hyperkalemia
ARBs
79
Drug of choice when treating diabetic pts with HTN
ACE inhibitors
80
Indication: HTN, diabetic neuropathy with proteinuria
Losartan/Cozaar
81
Generally reserved for severe HTN resistant to previous anti HTN tx (2)
Minoxidil/Loniten; Hydrazine/Apresoline
82
Direct vasodilator that can cause hirsutism
Minoxidil/Loniten
83
Example of ARB (Angiotensin II Receptor Blocker)
Losartan/Cozaar
84
Indication: HTN, diabetic neuropathy with proteinuria
Losartan/Cozaar
85
Generally reserved for severe HTN resistant to previous anti HTN tx (2)
Minoxidil/Loniten; Hydrazine/Apresoline
86
Direct vasodilator that can cause hirsutism
Minoxidil/Loniten
87
Direct vasodilator that can result in drug induced lupus syndrome
Hydrazine/Apresoline
88
New HTN drug, Renin Blocker, with side effects of hyperkalemia, angioedema
Aliskirien/Tekturna
89
Antidote to morphine
naloxone
90
Irreversibly inhibits COX enzyme
Aspirin
91
Used to reverse Heparin
Protamine sulfate
92
Used to reverse Enoxaparin/ Levenox (Low molecular weight Heparin)
Protamine sulfate
93
Antagonized Vit. K, interferes w/clotting factor II, VII, IX, X
Coumadin
94
Vitamin K may reverse
Coumadin
95
Thrombolytic (clot buster)
Streptokinase
96
Aminocaproic acid (amicar) is plasmin in-activator & antifibrinolytic
Streptokinase
97
Also used to treat hypocalcemia
HCTZ

Pharm Remediation (2 decks)

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