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Advanced Pharmacology > Lesson 1: Adrenergic Bronchodilators, Anticholinergics & Xanthines > Flashcards

Lesson 1: Adrenergic Bronchodilators, Anticholinergics & Xanthines Flashcards

1
Q

Binds to a receptor and produces a physiological response

A

Agonist

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2
Q

Binds to a receptor and does NOT produce a physiological response

A

Antagonist

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3
Q

What is a adrenergic bronchodialator

A

Drug that stimulates the sympathetic nervous system

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4
Q

What effect does a adrenergic bronchodilator cause

A

Smooth muscle relaxation

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5
Q

Sympathomimetic is another word for….

A

Adrenergic

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6
Q

Indication for use of adrenergic bronchodilators is

A

Reversible airflow obstruction

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7
Q

a- receptor stimulation
-Location
-Action

A

Location: Pulmonary and bronchial blood vessles
Action: Vasoconstriction effect

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8
Q

B1- Receptor stimulation
-Location
-Action

A

Location: Heart
Action: Increased HR and contractile force

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9
Q

B2- Receptor stimulation
-Location
-Action

A

Location: Bronchial smooth muscle, pulmonary and bronchial blood vessles

Action: bronchodilator, vasodialation

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10
Q

Sympathomimetic bronchodilators are this or derivatives of this

A

Catecholamines

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11
Q

Catecholamines mimic what neurotransmitter

A

Epinephrine (fight or flight)

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12
Q

Catecholamine symptoms

A

Tachycardia
Elevated BP
Smooth muscle relaxation
Skeletal muscle tremor
CNS stimulation

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13
Q

Stereoisomers are

A

Non-superimposable molecular mirror images

2 types:
(R)-Isomer (right isomer)
(S)-Isomer (left isomer)

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14
Q

These have similar physical and chemical properties but different physiological effects

A

Stereoisomers

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15
Q

If a drug contains a equal amount of both left and right isomers it is…

A

Racemic

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16
Q

What is the racemic version of levalbuterol

A

Albuterol

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17
Q

What are the ultra short acting B2 bronchodilators

A

Epinephrine and Racemic Epinephrine

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18
Q

What is the duration of a ultra short acting B2 bronchodilators

A

Less than 3 hours

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19
Q

Epinephrine:
-Brand name
-MDI brand name
-Routes of admin

A

Brand name: Adrenaline Chloride
MDI Brand name: Primatene Mist
Routes of Admin: SVN, MDI, IV, IO, IM

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20
Q

When to use epinephrine

A

Cardiac stimulant, anaphylactic reactions, acute asthma

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21
Q

What is the onset of epinephrine

A

Approx. 3 min

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22
Q

Racemic epinephrine
-Brand name
-Route of admin
-Use

A

Brand name: asthmanefrin
Route of admin: SVN
Use: reduce swelling in upper airways (croup and epiglottitis) and tx of bleeding during bronchs

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23
Q

What is the keyhole theory

A

Theory that explains the B2 specificity of sympathomimetic bronchodilators

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24
Q

SABA is used for

A

Relief of reversible acute airway obstructions

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25
LABA is used for
Maintenance bronchodilation, nocturnal symptoms for asthma and COPD
26
SABA duration LABA duration
SABA: 4-6 hrs LABA: 12-24 hrs
27
What are the 3 types of SABAs
Albuterol Levalbuterol Metaproterenol
28
What are the 5 types of LABAs
Salmeterol : Severent Diskus Formoterol: Perforomist Arformeterol: Brovana Indacaterol: Arcapta Neohaler Olodaterol: Stiverdi-Respimat
29
Where in the national asthma guidelines is a LABA reccomended?
Step 3
30
Stimulation of a and b receptors causes what response?
Adrenergic response
31
What types of receptors are types of G protein liked receptors?
a and b
32
Increase in cAMP is the goal of ________, through the stimulus of _________, causing __________.
Adrenergic bronchodilators, B2 receptors, bronchodilation
33
The difference of how SABAs and LABAs work is due to what?
How the drug binds to the G-protein linked receptor
34
When giving high doses of albuterol, what should you monitor?
Heart rate, glucose, potassium
35
What happens to a patients glucose or potassium with high doses of albuterol?
Glucose: levels may increase bc of the fight or flight response that albuterol gives. More energy is needed during FoF, so if the pt isn't expending that energy it can lead to hyperglycemia Potassium: levels may decrease bc albuterol stimulates the Na/K/ATPase pump cause of shift of potassium from serum into the intracellular space.
36
What are the two cholinergic receptors?
Muscarinic and Nicotinic
37
Stimulation of what receptors cause activation of the parasympathetic system?
Muscarinic and Nicotinic
38
What is the neurotransmitter for the parasympathetic system?
Acetylcholine
39
3 main muscarinic receptors
M1, M2, M3 are found in the lung
40
What are the muscarinic receptors (M1, M2, M3) found
M1 receptors: are present at the parasympathetic ganglion on the post junctional membrane M2 receptors: are localized at the presynaptic membrane of postganglionic parasympathetic nerve endings M3 receptors: are found on submucosal glands and airway smooth muscle
41
How do anticholingerics cause bronchodilation
By blocking the M1 receptors at the parasympathetic ganglia, which facilitates neurotransmission to M3, which cause bronchoconstriction Bronchodilation will only occur if the bronchoconstriction is due to cholinergic activity
42
Duration of action for anticholinergics
Atrovent: 6 hrs Others: 12 or 24 hrs
43
What common allergen is used in Atrovent HFA and Combivent Respimat (inhaler version of Atrovent)?
Soy lecithin
44
Umeclidinium bromide and vilanterol Brand name and duration
Anoro Ellipta 24 hrs
45
Glycopyrrolate bromide and formoterol Brand name and duration
Bevespi Aerosphere 12 hrs
46
Glycopyrrolate bromide and indacaterol Brand name and duration
Utibron neohaler 12 hrs
47
What is atropine used for
Anticholinergic used for bradycardia
48
What is the dose of atropine
1 mg IV push with epi or vasopressin
49
What is the parasympathomimetic drug we use in the bronchial challenge test
Methacholine
50
What is methacholine used to do
promote bronchoconstriction to diagnose asthma
51
What is edrophonium
Drug used for the Tensilon Test to diagnose Myasthenia Gravis
52
How does edrophonium work
Inhibits acetylocholineesterase which is the enzyme that breaks down acetylcholine. By inhibiting this, ACh will not be broken down, leading to an increase in the amount of ACh available, and greater likelihood of attaching to receptors.
53
What causes cholinergic toxicity
Nerve gasses: such as sarin Organophosphates: insecticides
54
What syndrome does cholinergic toxicity lead to
SLUDGE syndrome
55
What does SLUDGE stand for
Salivation Lacrimation Urination Defecation Gastrointestinal cramping Emesis
56
How do you treat SLUDGE syndrome
Atropine (Anticholinergic)
57
What are the two forms of xanthines
Theophylline and Caffeine
58
What are effects of xanthines
CNS stimulation Cardiac muscle stimulation Diuresis Bronchial, uterine, and vascular smooth muscle relaxation Peripheral and coronary vasodilation Cerebral vasoconstriction
59
Theophylline has a _______ therapeutic index so dosage must be titrated to clinical effectiveness
small
60
What group of people will need higher doses of theophylline
Smokers bc smoking decreases theophylline levels
61
What are the recommended dosages for asthma and COPD with theophylline
Asthma: 5-15 μg/mL ( for pts 5 yrs and older) COPD: 5-10 μg/mL (O and 10 together, to remember)
62
How to treat apnea of prematurity
Xanthines are given to stimulate CNS bc preterm infants do not have a fully developed CNS Theophylline was used in the past, now caffeine is the preferred method bc of the fewer side effects
63
What does of caffeine would you give of AOP
Loading dose: 20 mg/kg Daily maintenance dose: 5 mg/kg

Advanced Pharmacology (5 decks)

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