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Pharmacology > Pharm Exam 4 > Flashcards

Pharm Exam 4 Flashcards

1
Q

Inhaled Corticosteroid Med Names

A

Beclomethasone
Budesonide
Fluticasone
Mometasone
Ciclesonide

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2
Q

Short Acting Beta2 Agonist Med Names

A

Albuterol
Levalbuterol
Terbutaline

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3
Q

Leukotriene Receptor Agonists Med Names

A

Zafirlukast
Montelukast (Singulair)

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4
Q

Methylxanthines Med Name

A

Theophylline

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5
Q

Long-Acting Beta2 Agonists Med Names

A

Salmeterol (powder)
Formoterol (powder)
Olodaterol - COPD ONLY
Indacaterol - COPD ONLY (powder)

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6
Q

Omalizumab (Xolair)
- route of admin
- what age
- MOA

A
  • SQ
  • 6 yo and up with POSITIVE skin test
  • limits binding of IgE to receptors on mast cells and basophils
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7
Q

Omalizumab (Xolair)
- SE
- Monitoring
- Patient Edu

A
  • Side Effects: URI, sinusitis, HA, pharyngitis, allergic reaction
  • Monitoring: monitor for delayed allergic reaction
  • Patient Teaching: used when ICS don’t work
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8
Q

Inhaler Edu

A
  • 1 minutes between puffs
  • 5 minutes before other inhalers
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9
Q

Anticholinergic/Antimuscarinics - LAMA med names

A

Tiotropium
Aclidinium - COPD ONLY
Umeclidinium - COPD ONLY

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10
Q

Anticholinergic/Antimuscarinics - SAMA med names

A

Ipratropium (Atrovent)

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11
Q

SAMA/SABA medication

A

Ipatropium/Albuterol (Combivent)

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12
Q

First Generation Antihistamine Meds

A

Chlorpheniramine
Diphenhydramine
Hydroxyzine (Atarax)
Promethazine

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13
Q

2nd Generation Antihistamines

A

Olopatadine
Azelastine
Cetirizine
Fexofenadine
Loratadine

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14
Q

Inhaled Corticosteroids: MOA

A

Prevent transcription of genes that contribute to the inflammatory process

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15
Q

Inhaled Corticosteroids: SE

A

r/t immune suppression; thrush, cough, bad taste, hoarseness, congestion, pain/HA, visual dist., voice changes, cataracts

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16
Q

Leukotriene Receptor Antagonists:
- MOA
- SE
- Patient edu

A
  • MOA: block leukotriene receptors preventing inflammation and bronchoconstriction
  • Side Effects: anxiety, aggression, depression and/or suicidal thoughts; HA, dizziness, myalgia, N/V
  • Patient Edu: informed of possible psychiatric side effects; avoid grapefruit juice
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17
Q

Theophylline:
- SE
- Patient EDU

A
  • SE: multiple GI, HA, anxiety, irritability, dizziness/ insomnia, tachy/palps, arrhythmias
  • Patient Teaching: smoking will decrease effectiveness of drug; avoid high fat meals (increases risk of toxicity)
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18
Q

LABA BBW

A

BBW: do NOT use as a monotherapy in asthma (↑risk of asthma-related deaths); must use with ICS if using for asthma maintenance drug)

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19
Q

LABA:
- Indication
- Who can not use?

A
  • Indication: SHORT TERM exercise-induced and nighttime cough and wheezing with kids
  • African Americans should NOT use due to prevalence of polymorphism of beta-adrenergic genes which increase risk of decreased airflow and worsening asthma control when using beta-agonists
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20
Q

Monitoring with SABA

A

Digoxin – albuterol increases dig levels - get ECG
DM – can cause hyperglycemia
Diuretics - can cause hypo K+

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21
Q

What are first line drugs in Asthma?

A

SABAs – act quickly to dilate bronchioles

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22
Q

SABAs:
- MOA
- SE

A
  • MOA: activate ß2 receptors in lungs; stimulate airway relaxation
  • Side Effects: similar to “fight-or-flight” mimics sympathetic neurotransmitters; tachycardia, tremors
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23
Q

SABAs:
- Drug interactions
- How can it affect DM

A
  • Digoxin – albuterol increases dig levels – get ECG, DM
  • Diuretics – can cause hypokalemia
  • DM - Can cause hyperglycemia
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24
Q

What does Inhaled Corticosteroids Treat?

A
  • Chronic inflammation in asthma
  • Slow down airway remodeling in COPD
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25
Q

Inhaled Corticosteroids:
- MOA
- SE
- How often are they taken?

A
  • MOA: prevent transcription of genes that contribute to the inflammatory process
  • Side Effects: r/t immune suppression; thrush, cough, bad taste, hoarseness, congestion, pain/HA, visual dist./cataracts, voice changes
  • TAKE DAILY
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26
Q

Inhaled Corticosteroids:
- C/I
- Caution
- Patient teaching

A
  • C/I in cushings syndrome and respiratory infections, can cause adrenal insuffic. if switched from inhaled to oral
  • Caution: Watch growth in children in high dose
  • Patient Teaching: Bronchodilator FIRST, rinse mouth after ICS use
27
Q

Theophylline
- MOA
- Monitoring

A
  • MOA: Inhibit phosphodiesterases > increase cAMP > bronchial smooth muscle and pulmonary vessel relaxation
  • Monitoring: serum theophylline levels
28
Q

LABA
- MOA
- SE
- Pt Edu

A
  • MOA: activate ß2 receptors in lungs; stimulate airway relaxation
  • Side Effects: bronchospasm, tachy/palps, HTN, tremors
  • Patient Teaching: do not use for acute attacks
29
Q

LAMAs and SAMAs
- Indication
- MOA
- SE

A
  • Indication: Very good for COPD; 6 yo and older new use in asthma
  • MOA: suppress M3 receptor response (airway smooth muscles); prevent activation by acetylcholine - bronchodilator effect
  • Side Effects: COUGH, decreased rest, decreased peristalsis, nervous, tachy, N/V, dry mouth, bronchospasm
30
Q

Which LAMAs are for COPD and which are for ASTHMA

A

Tiotropium: COPD and Asthma
Aclidinium: COPD only
Umeclidinium: COPD only

31
Q

Ipratropium:
- SAMA or LAMA?
- COPD or Asthma?

A
  • SAMA
  • Both
32
Q

Intranasal Corticosterois: Med Names

A
  • Mometasone (Nasonex)
  • Fluticasone (Flonase)
33
Q

Intranasal Corticosteroids:
- Allergic Rhinitis
- MOA
- SE
- Patient Edu

A
  • Use: allergic rhinitis
  • MOA: interrupts inflammation by inhibiting the synthesis of inflammation mediators
  • Side Effects: drying/burning of nasal mucosa
  • Monitoring:
  • Patient Teaching: Avoid nasal mucosa
34
Q

Antihistamines (H1 Antagonists)
- 1st vs 2nd
- MOA
- SE
- Avoid in what ages

A
  • 1st generation more anticholinergic than 2nd generation
  • 1st generation cross BBB more thoroughly (more sedation)
  • MOA: competitive antagonism of histamine binding to cellular receptors (H1) present in nerve endings, smooth muscles, & glandular cells
  • Side Effects: anticholinergic sx., caution in patients with prostate problems & glaucoma
  • Avoid 1st gen. in patients >60 or <1
35
Q

Diphenhydramine:
- SE

A
  • SE: anticholinergic (can’t eat/see/poop/pee)
  • Hallucinations and delirium
  • Rare: ataxia, flushed skin, blurred vision, light sensitivity, irregular breathing, dizziness, irritability, ED, N/V
36
Q

Decongestants
- Use
- MOA
- SE
- Contraindications
- Pt Edu

A
  • Use: relieve nasal congestion & improve eustachian tube function
  • MOA: stimulate alpha receptors of vascular smooth muscle, constrict dilated arterioles in nasal mucosa
  • Side Effects: bronchospasm, drowsiness, N/V, runny nose, stomatitis
  • Contraindications: do not use in children <4 and patients with HTN or cardiac disease
  • Patient Teaching: No more than 3 days in a row to prevent rebound nasal congestion
37
Q

Expectorants
- Use
- MOA
- SE
- Pt Edu

A
  • Use: cough associated with bronchitis, colds, sinusitis, etc.
  • MOA: increase output of respiratory tract by decreasing adhesiveness & surface tension (reduces viscosity)
  • Side Effects: N/V, diarrhea, abdominal pain, drowsiness, HA, hives, rash
  • Patient Teaching: not an antitussive—they will continue to cough (it will just be easier to expectorate)
38
Q

Antitussive med names

A

Benzonatate (Tessalon Perles)
Dextromethorphan
Opioids: Codeine, Hydrocodone

39
Q

Benzonatate (Tessalon Perles)
- MOA
- SE
- C/I
- Pt Edu

A
  • MOA: anesthetizes stretch receptors in the lungs
  • Side Effects: dizziness, sedation, HA, nasal congestion, burning eyes, GI constipation, rash, chills, chest numbness
  • C/I: lidocaine allergy
  • Patient Teaching: swallow whole; do not crush/chew
40
Q

Dextromethorphan
- Indication
- MOA
- SE
- C/I
- Pt Edu

A
  • Indication: Cough
  • MOA: acts on cough center in the medulla to suppress cough
  • Monitoring: avoid concurrently with MAOIs
  • Patient Teaching: is not associated with sedation, respiratory depression or addiction
41
Q

Opioids: Codeine, Hydrocodone
— As antitussives —

MOA
SE
Monitoring

A
  • MOA: act on the cough center in the medulla to suppress cough
  • Side Effects: N/V, sedation, dizziness, constipation
  • Monitoring: use with caution in patients with addiction hx., asthma or COPD
42
Q

H2 antagonists: Med names

A

Cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac)

43
Q

Cimetidine r/t CYP450

A

inhibits CYP450 - so build-up of other drugs

44
Q

Cytotec
- is a _____
- Indication
- MOA

A
  • prostaglandin (ester of prostaglandin E)
  • prevents ulcers caused by NSAIDS
  • inhibits secretion of gastric acid
45
Q

Cytotec SE

A

GI, vaginal bleeding/spotting, abd pain, diarrhea, gas, indigestion, N/V

46
Q

Name a prokinetic drug

A

metoclopramide

47
Q

Metoclopramide
- indication
- MOA

A
  • manage GERD, diabetic gastroparesis, post-op & chemotherapy N/V – when GI isn’t moving well

MOA: dopamine 2-receptor agonist & 5-HT4-receptor stimulant
——-↑ LES tone & force of gastric contractions; improve coordination of gastroduodenal contractions; enhances gastric emptying

48
Q

Peptic Ulcer ds with H Pylori
- 1st and 2nd line tx

A

1st line (Triple Tx)
- PPI, Amoxicillin, & Clarithromycin
- Cont PPI for 8-12 weeks
- If PCN allergy – use flagyl

2nd line (Quadruple Tx)
- PPI, Flagyl, Tetracycline, and Pepto

49
Q

Medication for constipation in children

A

miralax

50
Q

N/V tx (meds)
- 1st line
- Med for children

A

1st Line
- B6 & Unisom

Children
- Zofran

51
Q

What can be taken long-term for constipation?

A

Bulk-forming laxatives

52
Q

Osmotic laxative drug names

A

Mag Hydroxide (Milk of Mag)
Mag Citrate
Polyethelene Glycol

53
Q

Stimulant laxative drug names

A

Bisacodyl
Castor Oil
Cascara
Senna

54
Q

Opioid Antidiarrheals
- Drug names
- MOA

A

Lomotil

Imodium- directly effect intestinal wall nerves

MOA: stimulate mu opioid receptors to decrease intestinal motility

55
Q

Stimulant Laxative
- Indication
-

A

constipation s/t prolonged bed rest/medications; bowel prep for surgery

  • acts on intestinal wall to increase fluid and electrolytes into bowel
56
Q

Bismuth
- drug class
- MOA

A

Drug Class:
- anti-diarrheal (absorbent)

MOA:
- decreases flow of fluid/electrolytes into bowel
- broken down by salicylate → produces local anti-inflammatory action—given for travelers diarrhea (take at meals and bedtime)

—do not use for kids (Reyes Synd)

57
Q

Kaopectate
Drug class and MOA

A

Antidiarrheal

decreases water loss by absorbing bacteria & toxins

58
Q

Laxative abuse can cause:

A

electrolyte imbalance, osteomalacia, protein losing eneteropathy, steatorrhea, liver dis, loss of muscle tone, cathartic colon

59
Q

Antihistamines that work on N/V
- caused by what?

A

Phenergan, meclazine, dramamine

  • vestibular disturbances
60
Q

Zofran
- drug class
- MOA
- Indication

A

Serotonin Antagonist

MOA:
- block serotonin receptors peripherally and in chemoreceptor trigger zone

Indication:
- prevention of N/V associated with chemotherapy and post-op

61
Q

Zofran SE

A

diarrhea, constipation, HA

62
Q

Phenothiazine drug name

A

Compazine

63
Q

Only antiemetic that does NOT cause sedation

A

zofran

Pharmacology (2 decks)

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