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nur 326 > opd pharm > Flashcards

opd pharm Flashcards

1
Q

bronchodilators

A

beta 2 agonists
anticholinergics
xanthine derivatives

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2
Q

antiinflammatories

A

LTRAs
inhaled glucocorticoids
mast cell stabilizers

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3
Q

bronchodilators

A

all resp disease
work by stimulating beta 2 adrenergic receptors in lungs relaxing bronchial smooth muscle - cause dilation of bronchi/bronchioles and increased airflow
mimic sns (fight or flight)

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4
Q

beta adrenergic agonists

A

long or short acting
-erol
asthma attack = short term only

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5
Q

short acting beta

A

albuterol (PO/inhaled)
levalbuterol (inhalant)
q4-6hr, rescue drugs

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6
Q

long acting beta

A

selmetrol
formoterol
all inhalant
q12 - 14hr, preventer

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7
Q

non selective adrenergic drugs

A

stimulate beta 1 and 2 and alpha (epinephrine)
alpha: vasoconstriction (decrease edema/swelling in mucous membranes, limit secretions)
beta 1: CV effects - increased BP and HR
more SE with non selective
CNS stim - nervousness/tremors

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8
Q

non selective beta adrenergic

A

stimulate beta 1 and 2
metaproterenol

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9
Q

selective beta 2

A

albuterol
preferred med to treat pulmonary conditions

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10
Q

beta adrenergic agonist: I

A

prevent or relieve bronchospasm related to asthma/bronchitis/other pulmonary conditions
and conditions outside the pulmonary system
CI: uncontrolled htn, cardiac dysrhythmias, high risk for stroke

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11
Q

beta adrenergic agonist: nc

A

can be given with beta blockers but may diminish effects (prefer inhaled and selective, may need higher dose of BB)
avoid MAOIs and sympathomimetics bc htn (ephedrine)
diabetics may need higher doses of insulin bc raises bp

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12
Q

beta adrenergic agonist: SE

A

non selective have most
beta 2 = htn or hypoT
can reverse overdose with beta blocker but watch for bronchospasm
short half life - effects go away quickly
insomnia, restlessness, anorexia, cardiac stim, hypergly, tremor, vascular HA

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13
Q

why inhaled

A

minimize systemic SE (htn and HR issues)
MDI: inhale slow and deeply
DPI: breath activated, easier to use, better for cognitive issues and younger pt
neb: hospital, acute exacerbation

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14
Q

albuterol

A

selective beta agonists
onset in minutes
inhale q4-6, rescue
MDI or neb, first line for acute asthma
I: asthma, bronchitis, emphysema; acute wheezing, chest tightness, SOA
>1 canister/mo = inadequate control of asthma, need to start or intensify anti inflam therapy, 200 pushes, regular scheduled daily use not recommended
also prevent EIA

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15
Q

salmeterol

A

long acting beta 2 agonist agent
not for acute treatments - maintenance drug
2x/day via DPI
associated with increased asthma related deaths (AA)
I: worsening asthma or COPD
always given with inhaled corticosteroid not given alone

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16
Q

anticholinergics

A

work on acetylcholine receptors
turn off pns and turns on sns (bronchodilates), increase perfusion to heart, lungs, brain
block acetylcholine and inhibit normal phys response - bronchoconstriction and increased mucus

17
Q

ipratroprium

A

anticholinergic
prophylactic and maintenance (not rescue)
usually given in combo with albuterol

18
Q

ipratroprium: SE

A

anticholinergic effects
sedation, dizzy, confusion, hallucinations, urinary retention, dry mouth and throat, constipation, feel hot, decreased sweating, tachy, blurred vision, dry eyes
dry as a bone, hot as a hare, blind as a bat, red as a beet, mad as a hatter

19
Q

xanthine derivatives

A

theophylline and aminophylline
increase levels of cAMP enzyme by inhibiting phosphodiesterase - stimulate CNS and CVD system
second line bc high toxicity and drug interactions
prevent asthma attacks and COPD exacerbation (not rescue)

20
Q

xanthine derivatives: SE

A

toxicity: n/v/d, insomnia, HA, tachy, dysrhythmias, seizures (more common in elderly)

21
Q

xanthine derivatives: CI and interactions

A

CI: uncontrolled cardiac dysrhythmias, seizure disorders, hyperthyroid, peptic ulcers
Interactions: caffeine may increase SE, smoking decreases abs; macrolide abx, allopurinol, cimetidine, quinolones, flu vax, oral contraceptives
narrow therapeutic index: monitor serum levels and watch for tox (reverse with activated charcoal)

22
Q

leuokotriene receptor antagonists

A

montelukast (>12 mo) and zafirlukast (>5yr)
leukotrienes cause inflam, chroncostriction and mucus production
moa: prevent leukotrienes (released from mast cells) from attaching to receptors on immune cells in lungs and prevent inflam
given PO - chewable tablets and granules, improve in 1 wk
prophylaxis and chronic, and allergies, not rescue

23
Q

leuokotriene receptor antagonists: SE

A

HA, n/d, dizzy, insomnia,
M: few drug drug interactions
Z: lots if I

24
Q

inhaled corticosteroids meds

A

beclomethasone diproprionate
budesonide
fluticasone

25
Q

inhaled corticosteroids

A

can be PO for COPD exacerbation and others unless getting worse
limit systemic SE - neb or MDI
moa: reduce inflam and enhance beta agonist (combo therapy)
can take several weeks before full effect if inhaled, PO instant
not rescue
asthma - take on regular schedule, give bronchodilator first to allow more abs of steroid

26
Q

inhaled corticosteroids SE

A

pharyngeal irritation, cough, dry mouth, oral fungal infections - rinse mouth after

27
Q

combos: inhaled glucocorticoid and bronchodilator

A

mod - severe asthma (not acute attack!)
budesonide and formoterol - minutes
fluticasone and salmeterol - longer
both have long half life

28
Q

mast cell stabilizer

A

stabilize membranes of mast cells and prevent release of broncho constrictive inflam substances
used for prevention of attack 15 -20 min before known trigger, still not rescue
cromolyn

29
Q

monoclonal antibody antiasthmatic

A

omalizumab
newest gen of antiasthmatic
add on therapy
moa: selectively binds to immunoglobulin IgE -> limit release mediators of allergic response
given via injection
monitor closely for hypersensitivity reactions (anaphylaxis big risk)

30
Q

selective PDE 4 inhibitor

A

roflumilast
moa: inhibit PDE4 in lung cells - anti inflam
prevent COPD exacerbation - not acute
oral
good for chronic bronchitis w hx of lots of exacerbations
SE: n/v/d, HA, muscle spasms, decreased appetite, uncontrollable tremors

31
Q

long term control meds

A

anticholinergics
xanthine derivative
inhaled corticosteroids
leukotriene modifiers
mast cell stabilizers
LABA

32
Q

rescue meds

A

SABA
albuterol

nur 326 (45 decks)

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