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NUR 326-Pathopharm > Obstructive Pulmonary Pharm > Flashcards

Obstructive Pulmonary Pharm Flashcards

1
Q

bronchodilators

A

-Beta2 agonists
-anticholinergics
-xanthine derivatives

-used to treat all respiratory diseases
-work by relaxing bronchial smooth muscle

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2
Q

anti-inflammatories

A

-leukotriene receptor antagonist
-inhaled glucocorticoids
-mast cell stabilizers

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3
Q

beta adrenergic agonist drugs

A

-short acting: albuterol (po/inhalant) and levalbuterol (inhalant)
-long acting- salmeterol and formoterol (both inhalants)

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4
Q

short vs long acting

A

-most inhaled B2 agonist are short acting
-SABA are rescue drugs-duration q 4-6 hrs
-long acting beta2 agonist: preventors
-duration: 12-24 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
-bronchial dilation and increased airflow into and out of the lungs=goal

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6
Q

non selective beta adrenergic agonist

A

-non selective drugs (epinephrine) stimulate alpha receptors=vasoconstriction: decreased edema/swelling in mucous membranes, limits amount of secretions
-non-selective also stimulate beta1= CV effects
-CNS stimulation occurs- nervousness/tremors occur

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7
Q

beta adrenergic agonist indications

A

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

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8
Q

beta adrenergic agonist contraindications

A

-uncontrolled HTN
-cardiac dysrhythmias
-high risk for stroke
-avoid use with MAOI’s and sympathomimetics bc of risk of HTN

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9
Q

beta adrenergic agonist adverse effects

A

-non selective have the most
-can reverse overdose with beta blockers
-insomnia
-restlessness
-anorexia
-cardiac stimulation
-hyperglycemia
-tremor
-vascular headache

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10
Q

selective beta agonist

A

-albuterol/proventil
-SABA
-MDI or nebulizer
-indications: treatment of asthma, bronchitis, and emphysema
-treatment of ACUTE episodes of wheezing, chest tightness, SOA

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11
Q

albuterol

A

-SABA
-use of more than one canister per month indicates inadequate control of asthma and need for initiating or intensifying anti inflammatory therapy

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12
Q

long acting beta 2 agonist

A

-salmeterol
-LABA
-given twice daily
-warning: has been associated with increased asthma-related deaths
-always given with an inhaled corticosteroid, not indicated for monotherapy

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13
Q

salmeterol indications

A

-worsening of COPD
-moderate-severe asthma

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14
Q

Anticholinergics

A

-still a type of bronchodilator-but work on acetylcholine receptors
-giving anticholinergic agents results in: turning off cholinergic response (PNS) and turning on SNS- thus increasing perfusion to heart, lungs, and brain
-KEY POINT: by blocking the effect of acetylcholine, we inhibit the normal physiological response

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15
Q

anticholinergic drug

A

ipratropium

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16
Q

ipratropium

A

MOA: blocks action of acetylcholiine-creates bronchodilation
-indications: used for PROPHYLAXIS and maintenance therapy
-often given in combination with albuterol

17
Q

anticholinergic adverse effects

A

-urinary retention
-sedation, dizziness, confusion, hallucinations
-blurred vision, dry eyes
-tachycardia
-feeling hot, decreased sweating
-dry throat and mouth, constipation
-think DRYING effect

18
Q

xanthine derivative drugs

A

-theophylline
-aminophylline

19
Q

xanthine derivatives MOA/uses

A

-increasing levels of the cAMP enzyme by inhibiting phosphodiesterase
-used as a second line drug because of the high risk of toxicity and drug-drug interactions
-preventative treatment of asthma attacks and COPD exacerbation

20
Q

xanthine derivatives AE and contraindications

A

-toxicity- N/V/D, insomnia, H/A, tachycardia, seizures, dysrhythmias, hyperthyroid, peptic ulcers
-interactions: caffeine may increase side effects and smoking can decrease absorption
-has a narrow therapeutic index- monitor serum levels and watch for toxicity
-lots of drug interactions

21
Q

leukotriene receptor antagonist drugs (LTRA)

A

-montelukast
-zafirlukast

22
Q

LTRAs MOA

A

-leukotrienes cause inflammation, bronchoconstriction, and mucus production
-prevent leukotrienes from attaching to receptors located on immune cells and within the lungs

23
Q

LTRA’s route and uses

A

-PO
-oral prophylaxis and chronic treatment of asthma in adults and children

24
Q

LTRAs adverse effects

A

-headache
-nausea
-dizziness
-insomnia
-diarrhea
-montelukast has few drug-drug interactions, but zafirlukast has several

25
Q

inhaled corticosteroid drugs

A

-beclomethasone diprpionate
-budesonide
-fluticasone

26
Q

inhaled corticosteroids MOA

A

reduce inflammation and enhance activity of beta agonists

27
Q

inhaled corticosteroids use and route

A

-given via nebulizer or MDI
-can take several weeks of continuous therapy before full effect of the steroids realized
-NOT a rescue drug
-given for prevention of persistent asthma attacks and long term maintenance of severe COPD
-for asthma- teach to take on a regular schedule, and give the bronchodilator first to allow more thorough absorption of the steroids

28
Q

inhaled corticosteroid adverse effects

A

-pharyngeal irritation
-coughing
-dry mouth
-oral fungal infections
-RINSE MOUTH after use

29
Q

combinations: inhaled glucocorticoid and bronchodilator

A

-budesonide and formeterol
-fluticasone and salmeterol

-used for moderate-severe asthma
-NEVER for acute attacks

30
Q

mast cell stabilizer drug

A

cromolyn

31
Q

cromolyn MOA

A

stabilize membranes of mast cells and prevent release of broncho-constrictive inflammatory substances
-used for prevention of acute asthma attacks (15-20 mins prior to known triggers)

32
Q

monoclonal antibody anti asthmatic drug

A

-omalizumab

33
Q

omalizumab MOA

A

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

34
Q

omalizumab

A

-must be monitored closely for hypersensitivity reactions
-given via injection
-indicated for add on therapy for asthma

35
Q

selective PDE4 inhibitor

A

-drug: rofumilast
-MOA: selectively inhibits PDE4 enzyme in the lung cells
-indicated for prevention of COPD exacerbations
-given orally
-SE: N/V/D, headache, muscle spasms, decreased appetite, uncontrollable tremors

NUR 326-Pathopharm (24 decks)

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