Pharm Exam 4 Flashcards
1
Q
Inhaled Corticosteroid Med Names
A
Beclomethasone
Budesonide
Fluticasone
Mometasone
Ciclesonide
2
Q
Short Acting Beta2 Agonist Med Names
A
Albuterol
Levalbuterol
Terbutaline
3
Q
Leukotriene Receptor Agonists Med Names
A
Zafirlukast
Montelukast (Singulair)
4
Q
Methylxanthines Med Name
A
Theophylline
5
Q
Long-Acting Beta2 Agonists Med Names
A
Salmeterol (powder)
Formoterol (powder)
Olodaterol - COPD ONLY
Indacaterol - COPD ONLY (powder)
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
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
8
Q
Inhaler Edu
A
- 1 minutes between puffs
- 5 minutes before other inhalers
9
Q
Anticholinergic/Antimuscarinics - LAMA med names
A
Tiotropium
Aclidinium - COPD ONLY
Umeclidinium - COPD ONLY
10
Q
Anticholinergic/Antimuscarinics - SAMA med names
A
Ipratropium (Atrovent)
11
Q
SAMA/SABA medication
A
Ipatropium/Albuterol (Combivent)
12
Q
First Generation Antihistamine Meds
A
Chlorpheniramine
Diphenhydramine
Hydroxyzine (Atarax)
Promethazine
13
Q
2nd Generation Antihistamines
A
Olopatadine
Azelastine
Cetirizine
Fexofenadine
Loratadine
14
Q
Inhaled Corticosteroids: MOA
A
Prevent transcription of genes that contribute to the inflammatory process
15
Q
Inhaled Corticosteroids: SE
A
r/t immune suppression; thrush, cough, bad taste, hoarseness, congestion, pain/HA, visual dist., voice changes, cataracts
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
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)
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)
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
20
Q
Monitoring with SABA
A
Digoxin – albuterol increases dig levels - get ECG
DM – can cause hyperglycemia
Diuretics - can cause hypo K+
21
Q
What are first line drugs in Asthma?
A
SABAs – act quickly to dilate bronchioles
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
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
24
Q
What does Inhaled Corticosteroids Treat?
A
- Chronic inflammation in asthma
- Slow down airway remodeling in COPD
25
Inhaled Corticosteroids:
- MOA
- SE
- How often are they taken?
- 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
26
Inhaled Corticosteroids:
- C/I
- Caution
- Patient teaching
- 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
Theophylline
- MOA
- Monitoring
- MOA: Inhibit phosphodiesterases > increase cAMP > bronchial smooth muscle and pulmonary vessel relaxation
- Monitoring: serum theophylline levels
28
LABA
- MOA
- SE
- Pt Edu
- 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
LAMAs and SAMAs
- Indication
- MOA
- SE
- 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
Which LAMAs are for COPD and which are for ASTHMA
Tiotropium: COPD and Asthma
Aclidinium: COPD only
Umeclidinium: COPD only
31
Ipratropium:
- SAMA or LAMA?
- COPD or Asthma?
- SAMA
- Both
32
Intranasal Corticosterois: Med Names
- Mometasone (Nasonex)
- Fluticasone (Flonase)
33
Intranasal Corticosteroids:
- Allergic Rhinitis
- MOA
- SE
- Patient Edu
- 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
Antihistamines (H1 Antagonists)
- 1st vs 2nd
- MOA
- SE
- Avoid in what ages
- 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
Diphenhydramine:
- SE
- 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
Decongestants
- Use
- MOA
- SE
- Contraindications
- Pt Edu
- 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
Expectorants
- Use
- MOA
- SE
- Pt Edu
- 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
Antitussive med names
Benzonatate (Tessalon Perles)
Dextromethorphan
Opioids: Codeine, Hydrocodone
39
Benzonatate (Tessalon Perles)
- MOA
- SE
- C/I
- Pt Edu
- 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
Dextromethorphan
- Indication
- MOA
- SE
- C/I
- Pt Edu
- 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
Opioids: Codeine, Hydrocodone
--- As antitussives ---
MOA
SE
Monitoring
- 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
H2 antagonists: Med names
Cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac)
43
Cimetidine r/t CYP450
inhibits CYP450 - so build-up of other drugs
44
Cytotec
- is a _____
- Indication
- MOA
- prostaglandin (ester of prostaglandin E)
- prevents ulcers caused by NSAIDS
- inhibits secretion of gastric acid
45
Cytotec SE
GI, vaginal bleeding/spotting, abd pain, diarrhea, gas, indigestion, N/V
46
Name a prokinetic drug
metoclopramide
47
Metoclopramide
- indication
- MOA
- 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
Peptic Ulcer ds with H Pylori
- 1st and 2nd line tx
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
Medication for constipation in children
miralax
50
N/V tx (meds)
- 1st line
- Med for children
1st Line
- B6 & Unisom
Children
- Zofran
51
What can be taken long-term for constipation?
Bulk-forming laxatives
52
Osmotic laxative drug names
Mag Hydroxide (Milk of Mag)
Mag Citrate
Polyethelene Glycol
53
Stimulant laxative drug names
Bisacodyl
Castor Oil
Cascara
Senna
54
Opioid Antidiarrheals
- Drug names
- MOA
Lomotil
Imodium- directly effect intestinal wall nerves
MOA: stimulate mu opioid receptors to decrease intestinal motility
55
Stimulant Laxative
- Indication
-
constipation s/t prolonged bed rest/medications; bowel prep for surgery
- acts on intestinal wall to increase fluid and electrolytes into bowel
56
Bismuth
- drug class
- MOA
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
Kaopectate
Drug class and MOA
Antidiarrheal
decreases water loss by absorbing bacteria & toxins
58
Laxative abuse can cause:
electrolyte imbalance, osteomalacia, protein losing eneteropathy, steatorrhea, liver dis, loss of muscle tone, cathartic colon
59
Antihistamines that work on N/V
- caused by what?
Phenergan, meclazine, dramamine
- vestibular disturbances
60
Zofran
- drug class
- MOA
- Indication
Serotonin Antagonist
MOA:
- block serotonin receptors peripherally and in chemoreceptor trigger zone
Indication:
- prevention of N/V associated with chemotherapy and post-op
61
Zofran SE
diarrhea, constipation, HA
62
Phenothiazine drug name
Compazine
63
Only antiemetic that does NOT cause sedation
zofran
