Obstructive Plum pharm - Exam 1B Flashcards
albuterol & levalbuterol are what class of drugs
short acting Beta-Adrenergic Agonists
(bronchodilators)
short acting Beta-Adrenergic Agonists
(bronchodilators) MOA
(Mimics action of SNS) relax and dilates the airways by stimulating the B2 adrenergic receptors throughout the lungs
albuterol & levalbuterol indications
Prevention (exercise induce asthma) or relief of bronchospasm related COPD disorders
rescue drugs esp for asthma
albuterol & levalbuterol SE
Hypertension
Hypotension
Insomnia
Restlessness
Anorexia
Cardiac stimulation
Hyperglycemia
Tremor
Vascular headache
albuterol & levalbuterol nursing considerations
Short acting duration = 4-6hr (rescue drugs)
Contraindications: uncontrolled HTN, cardiac dysrhythmias, high risk of stroke (can be given w/ beta blockers but may need increased BB dose)
Avoid use with MAOis & sympathomimetics (ephedrine/Sudafed) d/t HTN risk
Raises BG
antidote: beta blockers but watch for bronchospasm
what class are salmetrol and formoterol
long acting Beta-Adrenergic Agonists
(bronchodilators)
long acting Beta-Adrenergic Agonists
(bronchodilators) MOA
(Mimics action of SNS) relax and dilates the airways by stimulating the B2 adrenergic receptors throughout the lungs
salmetrol and formoterol indications
worsening COPD, moderate to severe asthma
salmetrol and formoterol SE
Hypertension
Hypotension
Insomnia
Restlessness
Anorexia
Cardiac stimulation
Hyperglycemia
Tremor
Vascular headache
salmetrol and formoterol nursing considerations
Long acting duration = 12-24 hr (prevention)
Always give long acting with a corticosteroid
Salmeterol has been associated w/ increased asthma related death
Contraindications: uncontrolled HTN, cardiac dysrhythmias, high risk of stroke (can be given w/ beta blockers but may need increased BB dose)
Avoid use with MAOis & sympathomimetics (ephedrine/Sudafed) d/t HTN risk
Raises BG
Antidote: beta blocker (but watch for bronchospasm)
what class is Ipratropium
Anticholinergics
(bronchodilators)
anticholingeric MOA
Blocks action of acetylcholine which turns off PNS and turns on SNS, causing bronchodilation and decreased mucus production
Ipratropium indication
Used for prophylaxis and maintenance asthma therapy
Ipratropium SE
Urinary retention, sedation, dizziness, confusion, hallucinations, blurred vision, dry eyes, tachycardia, feeling hot, decreased sweating, dry mouth & throat, constipation
anticholinergic affects
Ipratropium nursing consideration
Often given in combination with albuterol
Not a rescue drug
what class are Theophylline and Aminophylline
Xanthine Derivatives
(bronchodilators)
Xanthine derivatives MOA
Increasing levels of the cAMP enzyme by inhibiting phosphodiesterase (stimulates CNS & CVD, and causes bronchodilation by relaxing the smooth muscle)
Theophylline and Aminophylline indications
Preventative treatment of asthma attacks and COPD exacerbation
Theophylline and Aminophylline SE
Caffeine effect,
N/V/D, insomnia, tachycardia, dysrhythmias, seizures
Theophylline and Aminophylline nursing considerations
2nd line med d/t high toxicity risk and lots of drug-drug interactions
Interactions:
Caffeine (inc SE)
Smoking (dec absorb)
Theophylline and Aminophylline antidote
activated charcoal
Theophylline and Aminophylline contraindications
Uncontrolled cardiac dysrhythmias, seizure disorders, hyperthyroidism, peptic ulcer
what class are Montelukast and Zafirlukast
Leukotriene receptor antagonist
(anti inflammatory)
Leukotriene receptor antagonist MOA
LTRAs prevent leukotrienes from attaching to receptors located on immune cells and within the lungs to prevent inflammation
Montelukast and Zafirlukast indication
Prophylaxis and chronic treatment of asthma
Can be used for allergies
Montelukast and Zafirlukast SE
Headache, nausea, dizziness, insomnia, diarrhea
Montelukast and Zafirlukast nursing considerations
Montelukast can be given to kids <12mo, zafirlukast is for +5 yrs
Not a rescue drug
what class are Beclomethasone diproprionate, Budesonide and Fluticasone
inhaled corticosteroids
(anti inflammatory)
inhaled corticosteroids MOA
Reduce inflammation and enhance activity of beta agonists
Beclomethasone diproprionate, Budesonide and Fluticasone indications
Prevention of persistent asthma attacks and long-term maintenance of severe COPD
Beclomethasone diproprionate, Budesonide and Fluticasone SE
Pharyngeal irritation, coughing, dry mouth and oral fungal infections
Beclomethasone diproprionate, Budesonide and Fluticasone nursing considerations
Takes several weeks for full effect to be reached
Not a rescue drug
Usually take w/ bronchodilator, give bronchodilator first
Be sure to take on regular schedule, not PRN
Rinse out mouth after use
what class are Budesonide + Formoterol and
Fluticasone + Salmeterol
Combination inhaled glucocorticoid & bronchodilator
(anti inflammatory)
Combination inhaled glucocorticoid & bronchodilator MOA
Reduce inflammation and causes bronchodilation
Budesonide + Formoterol and
Fluticasone + Salmeterol indication
Prevention of persistent asthma attacks and long-term maintenance of severe COPD
Budesonide + Formoterol and
Fluticasone + Salmeterol SE
Pharyngeal irritation, coughing, dry mouth and oral fungal infections
Budesonide + Formoterol and
Fluticasone + Salmeterol nursing consideration
Not a rescue drug
what class is cromolyn
Mast cell stabilizer
(anti inflammatory)
Mast cell stabilizer MOA
Stabilizes membranes of mast cells & prevent release of broncho-constrictive inflammatory substances
cromolyn indications
Used for prevention of acute asthma attacks
cromolyn nursing considerations
Take 15-20 mins before encountering known trigger
Not a rescue drug
what class is Omalizumab
Monoclonal antibody anti asthmatic
Monoclonal antibody anti asthmatic MOA
Monoclonal antibody which selectively binds to immunoglobulin IgE which limits the release of mediator of the allergic response
Omalizumab indications
Add on therapy for asthma
Omalizumab SE
anaphylaxis
Omalizumab nursing considerations
Monitor closely for hypersensitivity reactions (anaphylaxis is big risk)
what class is Roflumilast
Selective PDE-4 inhibitor
Selective PDE-4 inhibitor MOA
Selectively inhibits PDE4 enzymes in the lung cells
Roflumilast indication
Prevention of COPD exacerbations
Roflumilast SE
N/V/D, headache, muscle spasms, decreased appetite, uncontrolled tremors
Roflumilast nursing consideration
Not a rescue drug
