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Pharm II > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

meter dosed inhaler

A
  • requires hand-breath coordination
  • inhale before using device
  • can use w spacer
  • 10% of drug reaches lungs
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2
Q

respimats

A

fine mist; no propellant

increased drug deposits in lungs

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3
Q

dry powder inhaler

A

breath activated
NO hand-breath coordination needed
spacers NOT used
20% of drug reaches lungs

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4
Q

nebulizer

A 
aerosolized droplets; use MACHINE to deliver
no hand-breath coordination needed
spacers NOT used
increased drug delivery to lungs
delivers med slowly
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5
Q

pt teaching for oxygenation meds

A
  • how to use inhaler
  • time between puffs (1 min, allows bronchodilation)
  • how long is the inhaler good? (look at actuations)
  • cleaning of inhaler
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6
Q

how much drug reaches lungs, inhaler w NO spacer?

A

9-10%

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7
Q

how much drug reaches lungs, inhaler WITH spacer

A

about 21%

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8
Q

what is GINA?

A

tool that providers use for asthma

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9
Q

diff. types of bronchodilators (3)

A

beta-2 agonists
anticholinergics
methylxanthines

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10
Q

diff. types of anti-inflammatories (5)

A 
glucocorticoids
leukotriene modifiers
mast cell stabilizers
monoclonal antibodies
phosphodiesterase inhibitor
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11
Q

beta-2 adrenergic agonists (naming, MOA, indication, types, SE, admin, special considerations)

bronchodilator or anti-inflammatory?

A

naming: “-terol”
MOA: relaxes bronchial smooth muscle, results in bronchodilation (sympathomimetic)
indication: bronchoconstriction
type: SABA (short-acting), LABA (long-acting)
SE: tachycardia, tremors, palpitations, angina
admin: start to inhale and activate inhaler; hold the breath for 10 seconds; wait one minute before second inhalation
special considerations: tolerance may develop; becomes systemic if used too often (SABA)

bronchodilator

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12
Q

SABA (prototype, indication, onset)

A

prototype: albuterol
indication: acute bronchoconstriction; asthma attack
onset: immediate; peak: 30-60 min.

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13
Q

LABA (prototype, indication, special considerations)

A

prototype: salmeterol
indication: PREVENT asthma issues
special considerations: NEVER monotherapy; NOT PRN (fixed schedule)

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14
Q

anticholinergic (prototype, MOA, action, SE, contraindications, typical order)

bronchodilator or anti-inflammatory?

A

prototype: ipratropium
MOA: blocks parasympathetic NS
action: onset 30 sec; peak in 3 min; lasts 6H
SE: dry mouth, irritation of pharynx
contraindications: peanut allergy (soy is carrier), glaucoma (can raise IOP)
typical order: ipratropium w albuterol Q6H

bronchodilator

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15
Q

methylxanthines (IV prototype, oral prototype, chemically related to ___)

bronchodilator or anti-inflammitory?

A

IV proto: aminophylline
oral proto: theophylline
chemically related to CAFFEINE

bronchodilator

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16
Q

aminophylline (class, admin considerations)

bronchodilator or anti-inflammatory

A

class: methylxanthine IV
admin considerations: SLOW

bronchodilator

17
Q

theophylline (class, safety considerations)

bronchodilator or anti-inflammatory

A

class: oral methylxanthine
safety considerations: narrow margin of safety, therapeutic levels (10-20 mcg/mL), NO SMOKING, half life varies 2-15H, drug-drug interactions

bronchodilator

18
Q

glucocorticoid, general (prototype, how it’s prescribed)

bronchodilator or anti-inflammatory

A

prototype: beclomethasone
prescribed: sometimes in combo drugs

anti-inflammatory

19
Q

glucocorticoid, inhaled (indication, SE, special considerations)

A

indication: PREVENTION
SE: adrenal suppression, candidiasis, dysphonia (hoarseness)
special considerations: should be last inhaler, then swish and spit (to avoid candidiasis), may take 1-4 weeks for full effect, little to no systemic effects

**no proto provided

20
Q

glucocorticoid, oral/IV (prototype for each, indication, special considerations)

A

oral proto: prednisone
IV proto: methylprednisolone (Dr. K’s notes says methylpredisone = generic. incorrect but perhaps know this)
indication: acute bronchoconstriction, acute asthma (methylprednisolone then oral therapy at home after discharge)
special considerations: to transition from oral to inhaled… have to be on both and can take a few weeks (renal suppression issue)

21
Q

leukotriene modifiers (prototype, MOA, indication, admin, onset, SE, special considerations)

bronchodilator or anti-inflammatory

A

prototype: montelukast
MOA: modifies action of leukotrienes (reduces inflammation)
indication: prophylaxis of chronic asthma
admin: PO daily
onset: maximal effects within 24H of first dose
SE: neuropsychiatric effects
special considerations: not effective for acute attacks

anti-inflammatory

22
Q

what do leukotrienes do?

A

a part of the inflammatory response; result in edema, inflammation, bronchoconstriction

23
Q

mast cell stabilizers (prototype, MOA, indication)

bronchodilator or anti-inflammatory?

A

proto: cromolyn
MOA: inhibits mast cells from releasing histamine and other chemical mediators of inflammation
indication: prevent asthma attacks; ALSO to prevent allergic rhinitis

anti-inflammatory

24
Q

cromolyn (prototype for what?, admin, SE, special consideration)

A

proto of: mast cell stabilizer
admin: nebulizer or inhaler
SE: cough and bronchospasm
special consideration: rebound bronchospasm if stopped abruptly

25
Q

monoclonal antibody (prototype, MOA, indication, admin, SE, special considerations)

bronchodilator or anti-inflammatory?

A

prototype: omalizumab
MOA: binds to IgE
indication: severe, persistent asthma; not controlled by high dose steroids
admin: SQ Q2-4 weeks
SE: viral infections, URI, sinusitis, headache, injection site response, ANAPHYLAXIS
special considerations: super duper $$$

anti-inflammatory

26
Q

PDE4/Phosphodiesterase type 4 inhibitor (prototype, MOA, indication, SE)

bronchodilator or anti-inflammatory

A

prototype: roflumilast
MOA: blocks action of enzyme PDE4 (breaks down cAMP resulting in decreased release of inflammatory mediators)
indication: severe COPD with chronic bronchitis
SE: loss of appetite, weight loss, psychiatric effects (anxiety, depression, suicide)

anti-inflammatory

27
Q

allergic rhinitis: preventers (3 meds)

A

antihistamines
intranasal glucocorticoids
mast cell stabilizers

28
Q

allergic rhinitis: relievers (2 meds)

A

oral and nasal decongestants (sympathomimetics)

29
Q

antihistamines (prototype [2], MOA, indication, route, SE, considerations)

preventer or reliever?

A

prototype: diphenhydramine (first gen), loratadine (second gen)
MOA: blocks the actions of histamine at the H1 receptor
indication: first line therapy for mild/moderate seasonal allergies
route: oral, intranasal
SE: sedation, anticholinergic effects
considerations: should be taken prophylactically

preventer

30
Q

intranasal glucocorticoids (prototype, indication, route, SE, considerations)

preventer or reliever?

A

proto: fluticasone
indication: most effective for seasonal allergies
route: nasal (MDI)
SE: drying/burning sensation, epistaxis
considerations: action and SE limited to nasal passages

preventer

31
Q

sympathomimetics (prototype [2], MOA, route)

preventer or reliever?

A

proto: pseudoephedrine (oral), oxymetazoline (intranasal)
MOA: stimulates sympathetic NS to relieve nasal congestion
route: oral or intranasal

reliever

32
Q

pseudoephedrine (proto of what, SE, contraindications)

A

proto of oral sympathomimetics
SE: HTN, CNS stimulation (insomnia)
contraindications: cardiac patients

33
Q

oxymetazoline (proto of what, special considerations)

A

proto of intranasal sympathomimetics
special considerations: risk for rebound congestion (need more drug to get same results), addictive!, start intranasal glucocorticoid to wean

34
Q

antitussives: opioid (proto, special considerations)

preventer or reliever?

A

proto: codeine
special considerations: low dose needed, usually combination drugs

reliever

35
Q

antitussive: nonopioid (proto)

A

dextromethorphan

36
Q

expectorant (proto, MOA)

A

proto: guaifenesin
MOA: increase bronchial secretions; stimulate flow of secretions

37
Q

mucolytic (proto, MOA)

A

proto: acetylcysteine
MOA: increase bronchial secretions; makes mucus more watery so the cough is more productive

Pharm II (3 decks)

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