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Module 3: Mali: Pulmonary > pharm chart > Flashcards

pharm chart Flashcards

1
Q

what drug class does fluticasone belong to?

A

anti-inflammatory: inhaled glucocorticoid

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2
Q

what is the MOA of fluticasone?

A

decrease smooth muscle irritability, anti-inflammatory, immunosuppresive, and anti-proliferative activity

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3
Q

what is the indications for fluticasone?

A

asthma primarily, but also COPD

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4
Q

what are SE of fluticasone?

A

thursh, URI, throat irritation

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5
Q

what are contras for fluticasone?

A

latent TB
gluacoma
cataracts

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6
Q

what interesting thing do you need to monitor in fluticasone?

A

growth in children

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7
Q

what is the long term prophylaxis use of fluticasone?

A

bronchspasm

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8
Q

what is interesting about the use of fluticasone in children?

A

may cause slow 1st growth year, but they can catch up if they discontinue use, and risne mouth after to prevent thrush

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9
Q

what is the benefit of using budesonide (pulmocort inhalers) [I think a subset of fluticasone]?

A

it is less systemically absorbed

this was in the interesting column of the drug table under fluticasone and blessington said it was something we should know…so KNOW IT

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10
Q

what drug class does prednisone belong to?

A

anti-inflammatory: oral glucocorticoid

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11
Q

what is the MOA of prednisone?

A

decrease smooth muscle irritability and anti-inflammatory

decreases migration of WBC, reverses capillary permeability, immunosuppressany

later onset of inhibition of protein synthesis in nucleus of cell

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12
Q

what is the indication for prednisone?

A

adjunct therapy in exacerbation of bronchospasm; many others…duh, its prednisone

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13
Q

when do you worry about systemic side effects from prednisone?

A

10-14 days of use

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14
Q

what are contras for prednisone?

A

latent TB, glaucoma, catarcts

duh, same as fluticasone because they are both anti-inflammatory gluccocorticoid, one is inhalled and one is PO

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15
Q

what can the oral or IV prednisone be used as a “short burst” treatment for? (3 things)

A

bronchospasm
asthma
COPD

DONT USE LONG TERM!!!

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16
Q

what drug class does cromolyn MDI belong to?

A

anti-inflammatory mast cell stablizer

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17
Q

what is the MOA of cromolyne MDI?

A

decrease smooth muscle irritability, stabalizes the mast cell membrane to prevent degranulation and release of histamine, leukotrienes

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18
Q

what is the indication for cromolyn MDI?

A

childhood asthma

this works better in children that adults….so use for children! duh

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19
Q

what are the SE of cromolyn MDI?

A

headache, unpleasent taste

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20
Q

what is the contraindications for cromolyn MDI?

A

acute asthma

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21
Q

what is the PO route of cromolyn MDI being investigated for?

A

food allergy, IBD

Not there yet, just investigating

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22
Q

what is the drug class for zafirlukast?

A

anti-inflammatory oral leukotriene receptor antagonist

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23
Q

what is the MOA for zafirlukast?

A

decrease smooth muscle irritability, selective and competitive antagonist of leukotriene receptors D4 and E3, slow reacting substance of anaphylaxsis

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24
Q

what is the indication of zafirlukast?

A

asthma

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25
Q

what are contra associated with zafirlukast?

A

caution with alocholic cirrosis

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26
Q

what should you not take with zafirlukast?

A

FOOD

it decreases the bioavaliabiltiy by 40%

wow thats a lot

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27
Q

when should you not start this medication?

A

don’t start during an acute exacerbation, but can continue it if already on it

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28
Q

how is zafirlukast used?

A

as a long term prophylatic type of med

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29
Q

what is the drug class for salmeterol?

A

bronchodilators: inhaled long acting Beta2 adrenergic agonists

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30
Q

what is the MOA of salmeterol (LABA)?

A

selective, long-acting beta2 adrenergic agonist

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31
Q

what are 3 side effects experience by those on salmetrol (LABA)l?

A

muscle pain, anxiety, insomnia

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32
Q

what are the drug to drug intereactions with salmetrol (LABA)?

A

increases diuretics,
CYP34A inhibitors
decreased bet beta blockers

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33
Q

salmetrol has a ______

A

BLACK BOX WARNING!!!! AHHHH

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34
Q

what are the two LABA drugs?

A

salmeterol

formoterol

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35
Q

what form is salmeterol administered in?

A

DRY POWDER INHALER

make sure to rinse mouth after*

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36
Q

what should you consider or know about with LABA drugs?

A

asthma deaths
CVD outcomes
discouraged in excercise induced bronchospasm

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37
Q

what is the drug class for formoterol?

A

bronchodilators: inhaled long acting beta2 adrenergic agonist

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38
Q

what is the MOA of formoterol?

A

long acting beta2 agonist

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39
Q

what is the indication for formoterol?

A

long term control of COPD, asthma with steroid meter inhaler

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40
Q

what are SE of formoterol? (6)

A 
tremors
chest pain
palpitations
anxiety
insomnia
muscle cramps
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41
Q

what are the drug-drug interactions of formoterol?

A

increase loop diuretics

decreased by beta2 blockers

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42
Q

what do you need to monitor in LABA drugs?

A

glucose

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43
Q

what two inhaled forms does this come in?

A

dry powder inhaler and nebulizer

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44
Q

what do you not want to use formoterol in?

A

asthma deaths
CVD
exercise induced bronchospasm

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45
Q

what is the drug class for albuterol?

A

bronchodilators: inhaled short-acting beta2 adrenergic agonist SABA

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46
Q

what is the MOA of albuterol?

A

bronchial smooth muscle beta2 (sympathetic) receptor stimulation, racemic mixture with active R isomer

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47
Q

what is the indication for albuterol?

A

acute bronchospasm in asthma and COPD, pre-exercise excercise induced bronchospams

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48
Q

what are the SE of albuterol? (7)

A 
angina
BP changes
arrythmias
palpations
CNS stimulation
restless,wakefulness
angioedema
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49
Q

what patient disorders do you need to be cautious in when prescribing albuterol? (7)

A

HTN, CHF, seizure disorder, diabetes, glaucoma, LOW serum K, hypothyroidism

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50
Q

what is contraindicated for in patient taking albuterol?

A

Beta blockers

dont’ use these two together

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51
Q

what formulations does albuterol come in?

A

oral, nebulizer, IV, spacer

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52
Q

when using albuterol in prohphylaxis, what other drug do you want to combine it with?

A

anti-inflammatory agent for long term use other than mild asthma

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53
Q

does asthma tolerance develop when using albuterol?

A

YES….

so remember that!!

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54
Q

what drug class does theophyline belong to?

A

bronchodilators: PDE inhibitor/methlxanthine

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55
Q

what is the MOA of theophyline?

A

PDE blockade causes increased levels of cAMP which produces bronchdilation, diuresis, DNA and cardiac stimulation, and release of epinephrine

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56
Q

what is the indication of theophyline?

A

reversal of bronchospasm

57
Q

what are three SE of theophyline?

A

tachy, insomnia, seizuers

58
Q

what are four contraindications for theophyline?

A

CVD, HTZ, HYPERTHYROIDSM, peptic ulcer disorder and seizure disorder

59
Q

what are contras for theophyline? (2…thing systems)

A
  1. CYP1A2 (increases level)

2. CYP34A drugs

60
Q

what do you need to measure when taking theophyline?

A

theophyline levels!

woah thats hard

61
Q

what is a caution when using theophyline? what can the toxicity of this include?

A

NARROW therapeutic index, if toxic amounts are reached can cause persistent vomiting and agitations

62
Q

what is the drug class for levalbuterol?

A

bronchodilators: inhaled beta2 adrenergic agonist (SABA)

63
Q

what ist eh MOA of levalbuterol? which form of the drug do we use?

A

rapid acting selective beta2 receptor agonist counteracts bronchospasm, PURE R ISOMER FORM

64
Q

what are the SE of levalbuterol?

A

temors
rhinitis
VIRAL INFECTION
PHARYNGITIS

65
Q

what should you not use levalbuterol in?

A

active heart disease!

66
Q

what are the drug interactions with levalbuterol? (4)

A

increase loop diuretics
sympathmimetics
decreased by beta blockers
combination alpha/beta blocker

67
Q

what forms does levalbuterol come in?

A

nebulizer and inhaler forms

68
Q

is levalbuterol more or less expensive than albuterol?

A

MORE EXPENSIVE!!!

69
Q

what do you use levalbuterol in conjunction with?

A

anti-inflammatory agent for long term use for other than mild asthma or exercise induced bronchospasm (EIB)

70
Q

what is the drug class for ipratropium?

A

bronchodilators: inhaled anticholinergic

71
Q

what is the MOA of ipratropium?

A

blocks acetylcholine cholinergic receptors in bronchial smooth muscle to reduce bronchospasm (short term)

72
Q

what is the indication for ipratropium?

A

acute and maitenance TX of bronchospasm in COPD or asthma those that haven’t responded to beta 2 adenergic agents for asthma control

73
Q

what are the SE of ipratropium?

A

URI, chest pain, dyspepsia, xerostomia, FLU-like syndrome

74
Q

what are the contraindications for ipratropium?

A

NARROW ANGLE glaucoma
paradoxical bronchspasms,
URINARY TRACT OUTFLOW OBSTRUCTION

75
Q

what does ipratropium decrease the effects of?

A

acetylcholinesterase inhibitors

76
Q

what is the dose for the ipratropium?

A

17 mcg/inh

77
Q

what is ipratropium the first line treatment for?

A

COPD

78
Q

what is the drug class for tiotropium?

A

bronchodilators: inhaled long acting anticholinergic

79
Q

what is the MOA of tiotropium?

A

blocks acetylcholine at parasympathetic receptors in bronchial smooth muscle producing bronchodilation

80
Q

what is the indication of tiotropium?

A

maitenance TX in bronchospasm in COPD, asthma

81
Q

what are the SE of tiotropium?

A

URI, chest pain, palpitations, dyspneia, xerostoma, flu-like symptoms

82
Q

what are the contra indications of tiotropium?

A

bronchospasm, narrow angle glaucoma, urinary tract flow obstruction

83
Q

what does tiotropium interact with for drugs?

A

decreases effect of acetylcholinesterase inhibitors

84
Q

how many more times potent is tiotropium than ipratropium?

A

10 times as strong!!!

85
Q

what is tioptropium used for first line treatment? when is this treatment appropriate?

A

first line treatment of COPD when its not reacting to Beta2

86
Q

what is the drug class for umeclidinium and vilanterol?

A

combination inhaled long-acting anticholingeric and LABA

87
Q

what is the MOA of umeclidinium and vilanterol?

A

combination of bronchodilating agents, anti-muscarinic and beta2 agonism

88
Q

what is the indication ofr umeclidinium and vilanterol?

A

COPD!!!

89
Q

what patients should you not prescrive umeclidinium and vilanterol?

A

SEVERE MILK PROTEIN ALLERGY
prostatic hyperplasia
low K
diabetes

90
Q

what do you need to monitor when taking umeclidinium and vilanterol? (3)

A

FEV1 peak flow, CNS stimulation, eye changes

91
Q

what is the half life of umeclidinium and vilanterol?

A

11 hours

92
Q

what is the drug class for fluticasone/salmeterol HFA MDI

A

combination product inhaled glucocorticoid and LABA (beta2 agonist)

93
Q

what is the MOA of fluticasone/salmeterol HFA MDI?

A

anti-inflammatory action of steroid and bronchodilation actvitiy of Beta2 agonist

94
Q

what is the indication for fluticasone/salmeterol HFA MDI?

A

asthma (maitenance of bronchodilation)

95
Q

what is a interesting thing you need me measure when a patient is on fluticasone/salmeterol HFA MDI

A

growth velocity in children

96
Q

what is a real caution with fluticasone/salmeterol HFA MDI?

A

BLACK BOX WARNING re asthma-related death

97
Q

what is the drug class of ipratropium/albuterol

A

combination product inhaled anticholingeric/beta2 adrenergic agonist (SABA) bronchodilators

98
Q

what is the MOA of ipratropium/albuterol ?

A

anticholingeric and beta2 agonist bronchodilating mechanisms

99
Q

what is the indication for ipratropium/albuterol

A

COPD patients requiring two bronchodilators?

100
Q

what is the drug class for budesonide/formterol?

A

inhaled corticosteroid/beta2 adrenergic agonist (LABA) bronchodilators

101
Q

what is the MOA of budesonide/formterol?

A

anti-inflammatory steroid and bronchodilation activity of Beta2 agonist

102
Q

what is the indication for budesonide/formterol?

A

maitenance of asthma and COPD

103
Q

what do you need to monitor when taking budesonide/formterol?

A

growth velocity in children/

104
Q

what is the advantage of taking budesonide/formterol over fluticasone?

A

it is less systemically absorbed

105
Q

what do you need extreme caution when using budesonide/formterol

A

BLACK BOX WARNING, ASTHMA RELATED DEATHS

106
Q

what is the drug class for roflumilast?

A

phosphodiesterase-4 inhibitor antiinflammatory

107
Q

what is the MOA of roflumilast? (4 unique things0

A

inhibits BDE4 increasing cAMP in inflammation and cells

supress cytokine release

inhibit lung infiltration by WBC

decreases pulmonary remodeling in COPD

108
Q

what is the indication for roflumilast?

A

adjunct therapy in COPD (chronic bronchitis)

109
Q

what drug interactions do you need to caution in roflumilast?

A

CYP34A inducers decrease [ ]

cipro increase [ ]

rifampin decreases [ ]

110
Q

when do you ONLY use roflumilast?

A

ADJUNCT TO BRONCODILATOR ONLY, NOT USED ON ITS OWN!!!

111
Q

do you take roflumilast with or without food

A

EITHER….happy day

112
Q

what is the drug class for omallizumab?

A

antibody agents: anti IgE antibody; immunomodulator

113
Q

what is the MOA of omallizumab?

A

binds IgE antibody receptors on mast cells, blocks IgE antibody from activating it and degranulating

114
Q

what is the indication for omallizumab?

A

maitenance tx allergic asthma not controlled by inhaled steroids

115
Q

what is one thing you need to be cautious of when using omallizumab?

A

ANAPHYLAXSIS

116
Q

how is omallizumab administered?

A

SQ ONLY Q 2-4 WEEKS

117
Q

what are the four forms that nictoteine replacement can come in?

A

nicroderm patch
nicroette gum
nictrol inhaler
nicotrol nasal spray

118
Q

what is the MOA of nicoteine replacements? what is the difference between the low and high dose treatment?

A

Biphasic CND and ANS nicotine receptor stimulant

low dose: stimulation ANS ganglia

Large dose: stimulation folowed by blockage of transmission

119
Q

what is the indication of nicotine replacement?

A

tabacco cessation aid

120
Q

what is the SE of nicotine replacement? (7)

A 
mucosal irritation
cough
rhinitis
tremors
respiratory EXCITATION
convulsions
RESPIRATORY FAILURE
121
Q

what are 4 contras for nicotine replacement?

A

AMI
life threatening arrythmias
T1DM
TMJ disorder

122
Q

what drug increases the effect of nicotine replacement?

A

cimetidine

123
Q

what do you want to monitor in a patient takine nicotine replacement?

A

insomnia

124
Q

can you use more than one formulation of nicotine replacement?

A

YES

125
Q

what is the drug class for varenicline?

A

partial nicotine agonist oral

126
Q

what is the MOA for varenicline?

A

prevents nicotine stimulation of the mesolimbic dopamine system

127
Q

what is the indication for varenicline?

A

smoking cessation aid

128
Q

what is the SE of varenicine?

A

ABNORMAL DREAMSS!!!! nausea

129
Q

what are the contras for varenicline? (3)

A

psychiatric disorders, decreased renal function, active CVD

130
Q

what should you monitor when taking varenicline?

A

psych changes

131
Q

what is one major caution of varenicline?

A

BLACK BOX WARNING; psychiatric events, depression, suicide, and agitation

be reall careful who you prescribe this in!

132
Q

what is the dosing regiment for varenicline?

A
  1. mg 1x daily
    1 mg 2x daily

for 11 weeks with addition 12 weeks if needed

133
Q

what is the drug class for bupropion?

A

atypical antidepressant, oral dopamine reuptake inhibitor

134
Q

what two other names is bubpropion called for marketing purposes?

A

wellbrutin

zyban

135
Q

what is the MOA bupropion?

A

unknown MOA

woah that’s werid, but it just works!!

136
Q

what are four contraindications for a patient taking bupropion?

A
  1. BIPOLAR DISORDER
  2. SEIZURE DISORDER
  3. active CVD
  4. uncontrolled HTZ
137
Q

what do you not want to take bupropion with?

A

ethanol

138
Q

what is a major caution when taking bupropion?

A

BLACK BOX WARNING FOR DREPRESSION AND SUICIDAL THOUGHTS!!!

139
Q

what is the order of drugs you want to use when trying to help a patient quit smoking?

A
  1. nicotine replacement
  2. bupropion
  3. varenicline

Module 3: Mali: Pulmonary (3 decks)

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