LRT Drugs

Question 1

Bronchodilator Meds

Answer 1

Xanthines
Sympathomimetics
Anticholinergics

Question 2

Anti-inflammatory Meds

Answer 2

Inhaled Steroids
Leukotriene Receptor Antagonists
Immune Modulators

Question 3

Xanthines protoype

Answer 3

Theophylline

Not the gold standard anymore

Question 4

Xanthines TA

Answer 4

Directly effects the smooth muscle of the resp tract

Question 5

Xanthines Indications

Answer 5

Treats COPD and bronchospasms and asthma

Question 6

Xanthines Pharmaco

Answer 6

Cross placenta and milk!
Rapid GI absorption
Hepatic metabolism
Urine excretion

Question 7

Xanthines Contraindications

Answer 7

GI problems
Coronary disease
Resp dysfunction
Renal or hepatic disease
Alcoholism
Hyperthyroidism

Question 8

Xanthines Cautions

Answer 8

Prego and lactation

Question 9

Xanthines AE

Answer 9

IRRITABILITY, RESTLESSNESS, DIZZINESS IF LEVELS HIGHER THAN 20 MCG/ML

Tremors, nervousness, insomnia, and tachyarrythmias can also occur when over 20mcg/mL.

All depends on level of theophylline in the blood

Question 10

Xanthines DD Interactions

Answer 10

Substances in cigarettes

Question 11

Sympathomimetics protoypes

Answer 11

ALBUTERAL
EPI
FORMOTEROL
SALMETEROL

Question 12

Sympathomimetics TA

Answer 12

Increase the rate and depth of respirations

Question 13

Sympathomimetics Indications

Answer 13

Some are short term/emergency use to reverse bronchospasm in allergic reactions or asthma attacks (albuterol, epi)

Others are longer acting and are taken on a schedule to decrease symptoms of COPD or asthma (formoterol, salmeterol)

Question 14

Sympathomimetics Pharmaco

Answer 14

Does not cross!

Rapid distribution
Transformed to metabolites in the liver and urine excretion

Question 15

Sympathomimetics Contraindications and Cautions

Answer 15

Conditions that would aggravate sympathetic stimulation (depends on severity)

Prego and lactation

Question 16

Sympathomimetics AE

Answer 16

Fear, anxiety, restlessness, palpitations, tachycardia (think sympathetic nervous system, fight or flight)

Rare: life threatening paradoxical bronchospasms

Question 17

Sympathomimetics DD interactions

Answer 17

General anesthetics cyclopropane and halogenated hydrocarbons

Other meds that increase HR and BP

Question 18

Anticholinergics prototypes

Answer 18

Ipratropium and tiotropium

Question 19

Anticholinergics TA

Answer 19

Causes relaxation of smooth muscle in bronchi

blocks action of acetylcholine at vagal mediated receptor sites

Question 20

Anticholinergics Indications

Answer 20

Treats bronchospasm in those with COPD

Question 21

Anticholinergics Pharmaco

Answer 21

Most not absorbed when inhaled
Metabolism, excretion and half life vary
Most are partially excreted unchanged in urine

Question 22

Anticholinergics Contraindications

Answer 22

Known allergies

Question 23

Anticholinergics Cautions

Answer 23

Any condition that would be aggravated by the anticholinergic or atropine like effects of the drug

prego and lactation

Question 24

Anticholinergics AE

Answer 24

LESS AE THAN SYMPATHOMIMETICS

Dizziness, nervousness, headache, nausea, cough, visual changes

Question 25

Anticholinergics DD interactions

Answer 25

Other anticholinergics

Question 26

Inhaled Steroids prototypes

Answer 26

Budesonide and fluticasone

Question 27

Inhaled Steroids TA

Answer 27

Decreases swelling and promotes beta adrenergic receptor activity

Question 28

Inhaled Steroids Indications

Answer 28

Prevention and treatment of asthma

Question 29

Inhaled Steroids Pharmaco

Answer 29

Glucocorticoids cross placenta and enter milk! Rapid absorption into the resp tract Hepatic metabolism mostly Urine excretion

Question 30

Inhaled Steroids Contraindications

Answer 30

ARE CONTROLLERS OR RELIEVERS (not for emergencies!!) Prego and lactation

Question 31

Inhaled Steroids Cautions

Answer 31

Active infection of resp system

Question 32

Inhaled Steroids AE

Answer 32

PHARYNGEAL AND LARYNGEAL FUNGAL INFECTIONS (Thrush! Swish after using) Fever AE when inhaled Sore throat hoarseness coughing dry mouth glaucoma, cataracts, decreased bone mineral density in long term use

Question 33

Inhaled Steroids DD Interations

Answer 33

None known

Question 34

Leukotriene Receptor Antagonists prototypes

Answer 34

Montelukast

Question 35

Leukotriene Receptor Antagonists TA

Answer 35

Selectively and competitively block or antagonize receptors for production of leukotrienes

Question 36

Leukotriene Receptor Antagonists Indications

Answer 36

Prophylactically Also treats asthma

Question 37

Leukotriene Receptor Antagonists Pharmaco

Answer 37

Cross placenta and milk! Rapid GI tract absorption Hepatic metabolism Excretion varies

Question 38

Leukotriene Receptor Antagonists Contraindications

Answer 38

NOT FOR THE TREATMENT OF ACUTE ASTHMA ATTACKS

Question 39

Leukotriene Receptor Antagonists Cautions

Answer 39

Zeleuton and zafirlukast: hepatic or renal impairment Prego and lactation

Question 40

Leukotriene Receptor Antagonists AE

Answer 40

Upper resp infection pharyngitis cough headache dizziness N/V diarrhea abd pain elevated liver enzymes generalized pain fever myalgia Serious neuropsychiatric events

Question 41

Leukotriene Receptor Antagonists DD interations

Answer 41

Warfarin, theophylline, phenytonin, aspirin

Question 42

Immune Modulators Protoype

Answer 42

Dupilumab

Question 43

Immune Modulators TA

Answer 43

Binds to specific receptors to decrease inflammation

Question 44

Immune Modulators Indications

Answer 44

Add on therapy for asthma

Question 45

Immune Modulators Pharmaco

Answer 45

Most adminstered sub-q and are slowly absorbed over several days

Question 46

Immune Modulators Contraindications

Answer 46

Not for the treatment of acute asthmatic attacks Hypersensitivity reactions to components

Question 47

Immune Modulators AE

Answer 47

Arthralgia, fatigue, rash, infection site reaction, URI

Question 48

Immune Modulators DD interactions

Answer 48

Corticosteroids