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MY NUR 326 > obstructive pulmonary PHARM > Flashcards

obstructive pulmonary PHARM Flashcards

1
Q

what are the three classes of bronchodilators

A

beta-adrenergic agonists
anti-cholinergics
xanthine derivatives

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2
Q

what are the short acting beta-adrenergic agonists

A

albuterol

levalbuterol

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3
Q

what are the long acting beta-adrenergic agonists

A

salmetrol

formoterol

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4
Q

inhalation times for short and long acting beta-adrenergic agonists

A

short: inhaled q4-6 hrs
long: inhaled q12 hrs

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5
Q

beta-adrenergic agonist MOA

A

mimic action of SNS (fight or flight)

relax and dilate the airways by stimulating the beta2-adrenergic receptors throughout the lungs

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6
Q

what is the goal of beta-adrenergic agonist

A

bronchial dilation and increased airflow into and out of the lungs

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7
Q

indications for beta adrenergic agonist

A

prevention or relief of bronchospasm related to asthma/bronchitis/other pulmonary conditions

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8
Q

contraindications of beta adrenergic agonist

A

uncontrolled hypertension, cardiac dysrhythmias, high risk for stroke

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9
Q

Nursing considerations for beta adrenergic agonist

A

beta blockers may reduce effect when given together
avoid use with MAOIs and sympathomimetics b/c risk of hypertension
diabetics may need higher doses of meds b/c raises blood sugar

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10
Q

SE of beta adrenergic agonist

A

insomnia, restlessness, anorexia, cardiac stimulation, hyperglycemia, tremor, vascular headache

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11
Q

why are long acting beta 2 agonists used

A

salmeterol and formoterol

given for maintenance twice daily

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12
Q

what drug is an anticholinergic

A

ipratroprium (Atrovent)

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13
Q

MOA of ipratroprium

A

blocks action of acetylcholine –> causes bronchodilation

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14
Q

indications for ipratroprium

A

used for prophylaxis and maintenance therapy

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15
Q

SE of ipratroprium

A 
urinary retention
dry throat, mouth, constipation
feeling hot, decreased sweating
tachycardia
blurred vision, dry eyes 
sedation, dizziness, confusion, hallucinations
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16
Q

pneumonic for SE of anticholinergic

A 
dry as a bone
hot as a hare
blind as a bat
red as a beet
mad as a hatter
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17
Q

drugs in xanthine derivatives class

A

theophylline

aminophylline

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18
Q

MOA of theophylline and aminophylline

A

increasing levels of the cAMP enzyme by inhibiting phosphodiesterase

xanthine derivatives class

19
Q

what are xanthine derivatives used for

A

theophylline and aminophylline

preventative treatment of asthma attacks and COPD

-second line treatment

20
Q

side effects of theophylline and aminophylline

A

xanthine derivatives class

toxicity, N/V/D, insomnia, head ache, tachycardia, dysrhythmias, seizures

21
Q

Drug classes of anti-inflammatories

A

LTRAs, inhaled corticosteroids, mast cell stabilizers

22
Q

drugs in leukotriene receptor antagonist class (LTRA)

A

montelukast

zafirlukast

23
Q

what is the MOA of montelukast

A

LTRAs prevent leukotrienes from attaching to receptors located on immune cells and within lungs –> prevents inflammation

24
Q

what is zafirlukast used for

A

LTRAs

used for oral prophylaxis and chronic treatment of asthma in adults and children
NOT FOR ACUTE ASTHMA ATTACKS

25
Q

side effects of LTRAs

A

headache, nausea, dizziness, insomnia, diarrhea

26
Q

what drugs are in inhaled corticosteroid class

A

beclomethasone diproprionate
budesonide
fluticasone

27
Q

MOA of inhaled corticosteroids

A

beclomethasone diproprionate
budesonide
fluticasone

reduce inflammation and enhance activity of beta agonists

28
Q

adverse effects of beclomethasone diporprionate

A

inhaled corticosteroid class

pharyngeal irritation, coughing, dry mouth, and oral fungal infections

29
Q

Are inhaled corticosteroids a rescue drug

A

NO, given to prevent persistent asthma attacks and long-term maintenance of severe COPD

30
Q

what drugs are in the combined inhaled glucocorticoid and bronchodilator class

A

budesonide & formoterol

fluticasone & salmeterol

31
Q

what is budesonide & formoterol used for

A

moderate to severe asthma, NOT FOR ACUTE ATTACKS

32
Q

what drug is in the mast cell stabilizer class

33
Q

MOA of cromolyn

A

mast cell stabilizer

stabilize membranes of mast cells and prevent release of broncho-constrictive inflammatory substances

34
Q

what is a mast cell stabilizer used for

A

cromolyn

to prevent acute asthma attack
-15-20 min prior to known triggers

35
Q

what drug is in monoclonal antibody anti-asthmatic class

A

omalizumab

36
Q

MOA of omalizumab

A

monoclonal antibody which selectively binds to immunoglobulin IgE –> limits the release of mediators of allergic response

37
Q

omalizumab NC

A

must be monitored closely for hypersensitivity reactions

38
Q

what is omalizumab used for

A

add-on therapy for asthma

39
Q

what drug is a selective PDE-4 inhibitor

A

roflumilast

40
Q

moa of roflumilast

A

selectively inhibits PDE4 enzyme in the lung cells

potent anti-inflammatory effects within the lungs

41
Q

what is roflumilast indicated for

A

prevention of COPD exacerbations

NOT FOR ACUTE/IMMEDIATE ACTION

42
Q

SE of roflumilast

A 
n/v/d
headache
muscle spasms
decreased appetite
uncontrollable tremors
43
Q

what are the classes of long term control medications/preventers

A 
anticholinergics 
xanthine derivative 
inhaled corticosteroids 
leukotriene modifiers 
mast cell stabilizers 
long acting beta 2 agonist agent
44
Q

what are the classes of quick relief meds/rescue meds

A

short acting beta 2 agonist

albuterol

MY NUR 326 (12 decks)

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