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PHARM > LIPID LOWERING AGENTS/LOWER RESP DRUGS > Flashcards

LIPID LOWERING AGENTS/LOWER RESP DRUGS Flashcards

1
Q

LIPID LOW. AGENTS ACROSS LIFESPAN

A

Children: typically due to genetics
1st: dietary measures first
2nd: fibrates and HMG - CoA inhibitors (statins)

Pregnancy: bile acid sequestrants

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2
Q

HMG-CoA reductase inhibitors

A

Statins

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3
Q

Statins (drug names)

A

“Statin”
-atorvastatin
-lovastatin
-pravastatin

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4
Q

Statins (therapeutic actions)

A

-HMG-CoA reductase (an enzyme) is needed to synthesize cholesterol in the liver
-if this enzyme is blocked, serum cholesterol and LDL decrease since the liver can’t produce cholesterol
-increases HDL levels too

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5
Q

Statins (indications)

A

-treats elevated cholesterol, triglycerides and LDL

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6
Q

Statins (caution and interactions)

A

-renal impairment (can be worsened if rhabdomyolysis occurs)
-impaired endocrine function

-interactions with antibiotics, antifungals, immunosuppressants (increased adverse effects) grapefruit juice (toxicity) and St. John’s wort (statin effectiveness decrease)

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7
Q

Common adverse effects of statins

A

-GI system: flatulence and abdominal pain
-Liver: elevated liver enzymes (ALT/AST) and acute liver failure
-muscle soreness and aches
-iu

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8
Q

Rhabdomyolysis

A

Breakdown of muscles which releases waste products that can injure the glomerulus and result in acute renal failure

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9
Q

Implementation of statins

A

-administer at bedtime
-monetary cholesterol, LDL and LFTs

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10
Q

STATins

A

-sore muscles
-toxic liver
-avoid grapefruit in St. John’s wort
-take at night

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11
Q

Bile acid sequestrants (drug names)

A

“Chole-“ or “Cole-“
-cholestyramine
-colestipol
-colesevelam

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12
Q

Bile acid sequestrants (therapeutic actions)

A

-binds bile acids in the intestine, allows excretion in feces instead of reabsorption
- my definition: helps lower cholesterol by binding to bile acids in the intestines, preventing them from being absorbed in the blood

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13
Q

Bile acid sequestrants (indications)

A

-Hypercholesterolemia: high cholesterol and high LDLs
-pruritis associated with partial biliary obstruction

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14
Q

Bile acid sequestrants (contraindications)

A

-complete biliary obstruction; abnormal intestinal function

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15
Q

Bile acid sequestrants (caution and interactions)

A
  • Caution: pregnancy

-interactions with malabsorption of fat soluble vitamins
-affects absorption of other oral drugs

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16
Q

Common adverse effects of bile acid sequestrants

A

-Direct G.I. irritation: including nausea and constipation
-vitamin A D Eand K deficiencies (increased bleeding times)

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17
Q

Implementation of Bile acid sequestrants

A

-powder drugs need to be mixed in liquid
-tablets swallowed hole only
-Give drug in the morning
-administer other oral drugs one hour before or 4-6 hours after bile acid sequestrants

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18
Q

Cholesterol absorption inhibitors

A

Ezetimibe

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19
Q

Cholesterol absorption inhibitors (therapeutic actions)

A

-works in small intestine to decrease the absorption of dietary cholesterol
-Less cholesterol is circulated to the liver
-Liver clears more cholesterol from the blood, which results in less circulating cholesterol
-decrees total cholesterol levels, LDL‘s, and triglycerides

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20
Q

Why do we give Cholesterol absorption inhibitors

A

For hypercholesterolemia

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21
Q

Cholesterol absorption inhibitors (cautions and interactions)

A

-Caution: liver disease
-Interaction with cyclosporine (increased risk of ezetimibe toxicity)

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22
Q

Common adverse effects of Cholesterol absorption inhibitors

A
  • GI: abdominal pain and diarrhea
    -possible blood in the urine
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23
Q

Cholesterol absorption inhibitors implementation

A

-Monitor labs before enduring therapy

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24
Q

Proprotein Convertase Subtilism/Kexin type 9 inhibitors (PCSK9) DRUG NAMES

A

“-ocumab”
-alirocumab
-evolocumab

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25
Q

Proprotein Convertase Subtilism/Kexin type 9 inhibitors (therapeutic actions)

A

-monoclonal antibodies prevent PCSK9 enzymes from attaching to the LDL receptors on the liver cell
-This allows for LDLs to attach those liver cells and be metabolized (removed from the blood)
-decreases LDL levels and total cholesterol

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26
Q

Proprotein Convertase Subtilism/Kexin type 9 inhibitors (indications/why do we give it?)

A

-Treatment of hypercholesterolemia
-Used with a statin drug or alone if statins can’t be taken

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27
Q

Proprotein Convertase Subtilism/Kexin type 9 inhibitors (interactions)

A

None/unknown

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28
Q

Proprotein Convertase Subtilism/Kexin type 9 inhibitors (adverse effects)

A

-Risk of infection
-injection site reactions

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29
Q

Fibrates

A

-fenofibrate
-gemfibrozil
-fenofibric acid

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30
Q

Vitamin B3

A

Niacin

31
Q

Why do we give fibrates and or vitamin B3?

A

-for patients with hypercholesterolemia
-it helps lower triglycerides and LDL
-increases HDL

32
Q

Lower respiratory tract

A

-Is where gas exchange occurs
-includes bronchial tree and alveoli

33
Q

What sort of things occur in the lower respiratory tract?

A

-asthma
-COPD
-Pneumonia
-Respiratory distress syndrome (neonates)
-adult respiratory distress syndrome

34
Q

Lower respiratory tract

Life span: children

A

Used frequently in children
-Long acting inhaled steroid
-short acting beta2 agonist (SABA)
-Leukotriene receptor antagonist

Treatment changes as as child grows

Prevention
-avoidance of allergens, smoke, crowds, and dusty areas

35
Q

Xanthines (drug names)

A

-caffeine
-theophylline

also called methylxanthines
-narrow margin of safety
-Interact with many drugs
-Numerous adverse effects
-reserved for when other drugs don’t work or critical situation in ICU

36
Q

Xanthines (therapeutic actions)

A

-Direct effect on the smooth muscles of the respiratory tract, both in the bronchi and in the blood vessels
-exact MOA is not known

37
Q

Xanthines (indications/why do we give it?)

A

-Symptomatic, relief or prevention of asthma and COPD
-Reversal of broncospasm

38
Q

Xanthines (caution and interactions)

A

Caution
-G.I. problems
-Heart disease
-Renal hepatic disease
-alcoholism
-hyperthyroidism

-interactions include any drug metabolized in the liver that has the potential to interact with with xanthines
-substances in cigarettes

39
Q

Xanthines (common adverse effects)

A

-G.I. issues
-Cardiac
-central nervous system
-severe toxicity: seizures, life-threatening, arrhythmias, hypotension, coma.

40
Q

Implementation of xanthines

A

-Administer with food or milk to relieve G.I. upset
-switch from IV to oral as soon as possible

41
Q

Sympathomimetics (drug names)

A

“-terol”
“-proterenol”
-levalbuterol
-salmeterol
-albuterol (inhaler)
-formoterol
-isoproterenol
-metaproterenol

Epinephrine (drug of choice in bronchospasm)

42
Q

Sympathomimetics (therapeutic actions)

A

-beta 2 selective adrenergic agonists
-dilates bronchi
-Increases respiratory rate
-Increases depth of respirations
-SABA/LABA

43
Q

Sympathomimetics (indications/why do we give it?)

A

-acute asthma attack
-bronco spasm
-Prevention of exercise induced asthma
-Maintenance medication for chronic respiratory diseases

44
Q

Sympathomimetics (cautions and interactions)

A

Caution
-Conditions that would be aggravated by SNS stimulation
-Depends on the severity of the underlying condition

-interactions with beta blockers, other drugs that increase blood pressure or heart rate, substances, and cigarettes.

45
Q

Sympathomimetics (common adverse effects)

A
  • bronchospasm (sometimes it causes the thing it’s supposed to prevent)
    -Sympathomimetic stimulation: CNS stimulation, G.I. upset, cardiac (arrhythmias, hypertension, sweating, pallor, flushing)
46
Q

Sympathomimetics implementation

A

-take 30 to 60 minutes before exercise

47
Q

Anticholinergics (drug names)

A

“Tropium”
-IPratropium
-tiotropium

“Clidinium”
-aclidinium
-umeclidinium

48
Q

Anticholinergics (therapeutic actions)

A
  • blocks the vagal effect leading to relaxation of smooth muscle and bronchi (broncodilation)
49
Q

Anticholinergics (indications/why do we give it?)

A

-Maintenance treatment of COPD

50
Q

Anticholinergics (contraindications)

A

-acute bronchospasm requiring immediate intervention

51
Q

Anticholinergics (caution and interactions)

A

Caution
-any condition aggravated by the Anticholinergic effects

Interactions with other anticholinergics

52
Q

Anticholinergics (common adverse effects)

A
  • dry mouth, hoarseness, sore throat
    -dizzy, headache, fatigue, nervous, palpitations, and urinary retention
    -paradoxical bronchoconstriction
53
Q

Anticholinergics implementation

A

-void prior to medication administration
-Humidification and hydration

54
Q

Anticholinergics TIP

A

-can’t see
-can’t pee
-Can’t spit
-can’t shit

55
Q

Inhaled steroids (drug names)

A

“One”
-beclomethasone
-fluticasone
-triamcinolone

“Esonide”
-budesonide
-ciclesonide

56
Q

Inhaled steroids (therapeutic actions)

A

-Decreases the inflammatory response in the airways
-takes 2 to 3 weeks to be effective

57
Q

Inhaled steroids (indication/why do we get it?)

A

-Prevention and treatment of asthma
-Maintenance treatment of COPD

58
Q

Inhaled steroids (indication/why do we get it?)

A

-Prevention and treatment of asthma
-Maintenance treatment of COPD

59
Q

Inhaled steroids(contraindications)

A
  • not an emergency drug for an acute asthma attack
60
Q

Inhaled steroids (cautions and interactions)

A

Caution
- active respiratory infection

No known interaction

61
Q

Common adverse effects of inhaled steroids

A
  • sore throat/hoarseness
    -coughing, dry mouth
    -fungal infections
62
Q

Inhaled steroids implementations

A
  • rinse mouth after using inhaler
    -Monitor for respiratory infection signs
63
Q

Leukotriene Receptor antagonist (drug names)

A

“-lukast”
-zafirlukast
-montelukast

64
Q

Leukotriene Receptor antagonist (therapeutic actions)

A

-Lock receptors for the production of leukotrienes
-they don’t have an immediate effect
-takes one to two weeks to reach full effect

65
Q

Leukotriene Receptor antagonist (indications/why do we give it?)

A

-long-term asthma treatment

66
Q

Leukotriene Receptor antagonist (contraindications)

A

-Allergy or acute asthma attack

67
Q

Leukotriene Receptor antagonist (caution and interactions)

A

caution
-hepatic impairment

-there are several interactions. You must check before you administer.

68
Q

Leukotriene Receptor antagonist ( common adverse effects)

A
  • flu like symptoms
    -CNS: headache, dizzy
    -G.I. upset
    Black box warning
    -neuropsychiatric effects, including aggressive behavior, depression/suicide, hallucinations (behavioral changes are especially seen in children)
69
Q

Leukotriene Receptor antagonist implementation

A

-not for use in acute asthma attack. Long-term asthma treatment only.

70
Q

Lung surfactants (drug names)

A

“Actant”
-beractant
-calfactant
-lucinactant
-poractant

71
Q

Lung surfactants (therapeutic actions)

A

-replace the surfactant that is missing in the lungs of neonates with RDS
-Begins to work immediately

72
Q

Leukotriene Receptor antagonist (why do we give it?)

A

-to treat respiratory distress syndrome, and premature infants, and help them breathe

73
Q

Implementation of lung surfactants

A
  • Monitor continuously
    -Ensure to placement before administering
    -suction before administering but wait two hours after administering to suction again

PHARM (7 decks)

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