Exam 2 Prep - Respiratory Flashcards
There are two black box warnings for LABAs:
- NEVER EVER give them in an acute exacerbation, because they can actually make matters worse
- NEVER EVER give them without an ICS
There are two classifications of bronchodilators:
Anticholinergics (SAMA, LAMA)
Beta AGONISTS (SABA, LABA)
What is the most commonly used SAMA?
Ipratropium
What is the most commonly used SABA?
Albuterol
What do phosphodiesterase inhibitors do?
They inhibit the enzyme that breaks down cAMP
In smooth muscles, cAMP activation actually INHIBITS contraction
So if we increase the amount of cAMP in smooth muscle cells, we’re decreasing its contractility
Which respiratory drug class is comprised of phosphodiesterase inhibitors?
Methylxanthines are all phosphodiesterase inhibitors
Which type of bronchodilator is more effective in COPD: A beta agonist or an anticholinergic?
An anticholinergic (SAMA)
What percentage of MDIs is delivered to the lungs?
DPIs?
MDIs 10% without a spacer
DPIs 20%
Name two SABAs
Albuterol
Levalbuterol
Name two LABAs
Salmeterol
Formoterol
Name three ICSs
Beclomethasone (QVAR)
Budesonide (Pulmicort)
Fluticasone (Flovent)
Which oral glucocorticoids are used for relief of COPD and asthma?
Prednisone
Prednisolone
Name two drugs that are ICS/LABA combinations
Fluticasone/Salmeterol (Advair)
Budesonide/Formoterol (Symbicort)
Mast Cell Stabilizer
MOA, Therapeutic Use, Drug List
Blocks degranulation
Cromolyn
Used for asthma prevention, especially cold weather and exercise induced asthma
METHYLXANTHINES
Drugs, MOA, Uses
Theophylline
Phosphodiesterase Inhibitor
Long term control of COPD and nocturnal asthma attacks
What is a therapeutic theophylline level?
10-20
Levels >30 cause severe dysrhythmias
What are the symptoms of Theophylline overdose?
N/V/D
Tachydysrhythmias
(Makes sense, because increasing cAMP would cause increased inotropy in the heart)
Theophylline should never be taken by patients who consume large amounts of:
Caffeine
Name two anticholinergic bronchodilators:
SAMA: Ipratropium Bromide (DuoNeb, Atrovent)
LAMA: Tiotropium (Spiriva)
Name a Leukotriene Receptor Antagonist that is used is respiratory disease
Montelukast (Singular)
What is a major concern for patients taking Singular?
Studies have shown increased rates of suicide and depression
List the centrally acting and peripherally acting antihistamines
Centrally Acting
- Benadryl
- Chlorpheniramine
Peripherally Acting
- Fexofenadine (Allegra)
- Loratadine (Claritin)
- Cetirizine (Zyrtec)
- Levocetirizine (Xyzal)
Antihistamines are used for ______ rhinitis
Seasonal allergic
What is the first line treatment for perennial allergic rhinitis?
Intranasal glucocorticoids