Pharm 4 Resp pt5

Question 1

Someone has Asthma and COPD. What’s the ideal inhaler?

Answer 1

MDI containing Albuterol + Ipratropium Bromide (an anticholinergic)

Question 2

Prototypical Anticholinergic
Example
Indications

Answer 2

Ipratropium Bromide

Indications: Bronchospasm associated with chronic bronchitis and emphysema (COPD)

Question 3

**With the rise of peanut, soy, lecithin allergies rising which drug is contraindicated?

Answer 3

Ipratropium Bromide.

Question 4

What allergies contraindicate Ipratropium Bromide? (3)

Answer 4

soy, peanut, lecithin (a thickening agent used in cooking, baking ..used in chocolate. Ask if they are allergic to chocolate)

Question 5

Indication of ORAL steroids

What patient would go on these?

Answer 5

Bronchial asthma, including status asthmaticus not responsive to inhaled steroids; can be a quick relief medication or for chronic therapy
The patient who goes on these: a 50 pack of cigarettes/year.

Question 6

What does GOLD stand for?

Answer 6

GOLD: global obstructive lung disease guidelines

Question 7

Prototypical Inhaled Corticosteroid
Example
Indication

Answer 7

Fluticasone

Indications: maintenance treatment of asthma as prophylactic therapy; to reduce the need for systemic corticosteroids

Question 8

Fluticasone

Contraindications, Precautions, Side Effects

Answer 8

Not for treatment of primary attack
Caution in drugs that lower K+, maintain regular regimen
If exposed to chicken pox, measles, consider prophylaxis
Avoid MAOIs, TCAs w/in 14 days
Pregnancy Cat. C (breathing takes priority)
Rinse mouth after use
Monitor digoxin, for growth suppression in peds, hypercorticism, HPA axis suppression
Antagonized by -blockers
Adverse reactions include pharyngitis, rhinitis, dysphonia, URI, bronchospasm

Question 9

Prototypical Systemic IV Corticosteroid
Example
Indications

Answer 9

Methylprednisolone (IV)

Indications: steroid responsive disorders, including bronchospasm

Question 10

any acute disease that has an inflammatory/allergic component: __ will likely help it.

Answer 10

Steroids aka Glucocorticoids aka Methylprednisolone

Question 11

*common global long-term side effects of systemic steroids (3)

Answer 11

Cataracts, Osteopenia, Osteoporosis

Question 12

Methylprednisolone’s IV form has no faster onset of action than oral form, but preferable in acute exacerbations because (2)

Answer 12

hazards of vomiting, inability of patient to take PO meds while undergoing continuous nebulizer treatments (if kids are wheezing badly, they can’t swallow a pill)

Question 13

Prototypical Systemic ORAL Corticosteroid

Answer 13

Methylprednisolone
Indications: steroid responsive disorders, including bronchospasm
(same as the systemic iv info)

Question 14

Methylprednisolone

Contraindications, Precautions, Side Effects

Answer 14

Precautions: ocular herpes simplex (they’ll lose their eyesight), renal insufficiency, TB, diabetes (sugar will go up)
Avoid abrupt discontinuation (taper
May cause/worsen glaucoma, electrolyte imbalances, psychic disorders (roid rage

Question 15

Prototypical Leukotriene Receptor Antagonist
Example
Indication

Answer 15

Monoleukast (Singulair®)
Indications: Prophylaxis and chronic treatment of asthma
(taken in the evening)

Question 16

Probably one of the most underused and lowest side-effect profile bronchospastic drugs available as an adjunct therapy

Answer 16

Leukotriene Receptor Antagonist - Monoleukast

Question 17

Leukotriene Receptor Antagonist - Monoleukast

Contraindications, Precautions, Side Effects

Answer 17

Very few drug-drug interactions. The ones that exist are pretty inconsequential.
Not for primary treatment of acute attack, monotherapy in exercise-induced asthma