Exam 2 - Pulmonary Pharmacology Flashcards
1
Q
bronchodilators class
A
- beta2 agonists
- anticholinergics
- xanthine derivatives
2
Q
anti-inflammatories class
A
- leukotriene receptor antagonist (LTRAs)
- inhaled glucocorticoids
- mast cell stabilizers
3
Q
what do bronchodilators do
A
- used to treat ALL respiratory diseases
- work by relaxing bronchial smooth muscle
4
Q
short acting beta-adrenergic agonists
A
- albuterol
- levalbuterol
5
Q
long acting beta-adrenergic agonists
A
- salmetrol
- formoterol
6
Q
MOA: beta-adrenergic agonist
A
- mimic action of SNS: fight or flight
- relax and dilate the airways by stimulating the beta2-adrenergic receptors throughout the lungs
- bronchial dilation and increased airflow into and out of the lungs is the goal
7
Q
when are beta-adrenergic agonist contraindicated
A
- uncontrolled hypertension
- cardiac dysrhythmias
- high risk for stroke
8
Q
albuterol
A
- short acting beta2 agonist
- RESCUE DRUG
- treatment of ACUTE episodes of wheezing, chest tightness, SOA
9
Q
what does use of more than one canister of albuterol a month indicate
A
- inadequate control of asthma and need for initiating or intensifying anti-inflammatory therapy
10
Q
salmeterol
A
- long acting beta2 agonist
- not for acute treatments, this is a maintenance drug
- given twice a day
11
Q
salmeterol warning
A
- has been associated with increased asthma-related deaths
- more common in black/african Americans
12
Q
indications for salmeterol
A
- worsening of COPD
- moderate to severe asthma
13
Q
what is salmeterol always given with
A
- an inhaled corticosteroid, not indicated for monotherapy
14
Q
what does giving anticholinergics result in
A
- turning off cholinergic response (PNS) and turning on SNS
- SNS dominates = bronchodilaton
- perfuses increases to heart, lungs, and brain
15
Q
what is a key point with anticholinergics
A
- blocking the effect of acetylcholine, we inhibit the normal physiological response
16
Q
anticholinergic drug
A
ipratroprium
17
Q
MOA: ipratroprium
A
- blocks action of acetylcholine and creates bronchodilaton
18
Q
indications of ipratroprium
A
- used for prophylaxis and maintenance therapy
- NOT a rescue drug
- often given in combination with albuterol
19
Q
side effects of anticholinergics
A
- dry
- hot
- blind
- red
- mad
20
Q
xanthine derivatives
A
- theophylline
- aminophylline
21
Q
MOA: xanthine derivatives
A
- increasing levels of the cAMP enzyme by inhibiting phosphodiesterase
- stimulates CNS and CVD system
22
Q
side effects of xanthine derivatives
A
- toxic!!!
- n/v/d
- insomnia
- h/a
- tachycardia
- dysrhythmias
- seizures (more common in elderly)
23
Q
contraindications of xanthine derivatives
A
- uncontrolled cardiac dysrhythmias
- seizure disorders
- hyperthyroid
- peptic ulcers
24
Q
interactions of xanthine derivatives
A
- caffeine may increase side effects
- smoking may decrease absorption
25
nursing considerations for xanthine derivatives
- has a narrow therapeutic index: monitor serum levels and watch for toxicity
- lots of drug interactions
26
what do leukotrienes do
- they cause inflammation, bronchoconstriction, and mucus production
27
leukotriene receptor antagonist (LTRA) drugs
- montelukast
- zafirlukast
28
MOA: LTRAs
- prevent leukotrienes from attaching to receptors located on immune cells and within the lungs
- prevents inflammation
29
what are LTRAs used for
- oral prophylaxis and chronic treatment of asthma in adults and children
- NOT for acute asthma attacks
- can also be given for allergies
30
side effects of LTRAs
- headache
- nausea
- dizziness
- insomnia
- diarrhea
31
LTRAs drug interactions
- montelukast has a few drug-drug interactions
- zafirlukast has several drug-drug interactions
32
inhaled corticosteroid drugs
- beclomethasone
- budesonide
- fluticasone
33
MOA: inhaled corticosteroids
- reduce inflammation and enhance activity of beta agonists
- also helps with bronchodilaton
34
how long can it take for inhaled corticosteroids to work
- can take several weeks of continuous therapy before full effect of the steroids are realized
35
side effects of inhaled corticosteroids
- pharyngeal irritation
- coughing
- dry mouth
- oral infections
- RINSE MOUTH AFTER USE
36
what should you teach asthma patients who are using an inhaled corticosteroid
- teach to take on a regular schedule, not PRN and give the bronchodilator first to allow more thorough absorption of the steroids
37
combination: inhaled glucocorticoid and bronchodilator drugs
- budesonide and formoterol
- fluticasone and salmeterol
38
key teaching for combinations
- used for moderate to severe asthma
- THESE ARE NEVER FOR ACUTE ATTACKS
39
mast cell stabilizer drug
- cromolyn
40
MOA: mast cell stabilizer
- stabilize membranes of mast cells and prevent release of broncho-constrictive inflammatory substances
- used for prevention of acute asthma attacks
- 15-20 minutes prior to known triggers
41
monoclonal antibody anti-asthmatic drug
omalizumab
42
MOA: monoclonal antibody anti-asthmatic
- monoclonal antibody selectively binds to immunoglobulin IgE which limits the release of mediators of allergic response
43
why must monoclonal antibody anti-asthmatic drugs be monitored closely
- hypersensitivity reactions
- anaphylaxis is a big risk
