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Emma's NPLEX II Conventional Tx > Pharm Respiratory > Flashcards

Pharm Respiratory Flashcards

Drugs (12), week 1

1
Q

Indications for Albuterol?

A

Acute Asthma Sx
Prevent Exertion-Induced Asthma
COPD

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2
Q

Indications for Beclomethasone?

A

Asthma (not controlled)

Rhinitis

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3
Q

Indications for Budesonide?

A

Asthma (not controlled)

Rhinitis

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4
Q

Indications for Cromolyn?

A

Asthma: prophylaxis (not helpful once begun)

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5
Q

Indications for Epinephrine?

A

Anaphylaxis (IV/IM)
Acute asthma (inhalation)
Ocular HTN, Open-Angle Glaucoma (eye drops)

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6
Q

Indications for Fluticasone?

A

Rhinitis
Nasal polyps
Asthma (prophylactic)
Eosinophillic esophagitis

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7
Q

Indications for Ipratropium?

A

COPD

2nd line for asthma

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8
Q

Indications for Mometasone?

A

Asthma (uncontrolled)
Allergic rhinitis
Nasal polyps

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9
Q

Indications for Montelukast?

A

Asthma (chronic, prophylaxis)

Allergic rhinitis

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10
Q

Indications for Salmeterol?

A

Chronic asthma (mod-severe)

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11
Q

Indications for Tiotropium?

A

COPD

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12
Q

Indications for Triaminolone?

A 
Rheumatic/Arthritic d/o
MS
Dermatitis
Inflammation/Allergy
Asthma (uncontrolled)
Rhinitis
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13
Q

What are contraindications for Albuterol and why?

A

Eclampsia (pre-), intra-uterine infx or fetal death, antepartum hemorrhage, placenta prevue, cord compression, threatened miscarriage
ALL d/t DEC uterine contracility

Cardiac dz, tachycardia

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14
Q

What are contraindications for Beclomethasone and why?

A

Status asthmaticus

Systemic fungal infx

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15
Q

What are contraindications for Budesonide and why?

A

Status asthmaticus

Systemic fungal infx

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16
Q

What are contraindications for Epinephrine and why?

A

HTN, occlusive vascular dz, cardiac arrhythmias, tachycardia
Hyperthyroidism
Cerebrovascular insufficiency
Closed angle glaucoma
Not IM to digits, ears, nose, penis, scrotum

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17
Q

What are contraindications for Fluticasone and why?

A

Status asthmaticus
Systemic fungal infx
Allergy to milk proteins

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18
Q

What are contraindications for Ipratropium and why?

A

Narrow angle glaucoma
Prostatic hypertrophy
Milk/Lactose allergy

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19
Q

What are contraindications for Mometasone and why?

A

Status asthmaticus

Systemic fungal infx

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20
Q

What are contraindications for Montelukast and why?

A

Acute asthma exacerbation

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21
Q

What are contraindications for Salmeterol and why?

A

Status asthmaticus

Acute asthma exacerbation

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22
Q

What are contraindications for Tiotropium and why?

A

Narrow angle glaucoma
Prostatic hypertrophy
Milk/Lactose allergy

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23
Q

What are contraindications for Triamcinolone and why?

A

Status asthmaticus
Systemic fungal infx
Idiopathic thrombocytopenia purpura
Administration of live/attenuated vaccinations

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24
Q

SE of Albuterol?

A

MC: CNS tremor (hands)

Tachy, HTN, angina
Vertigo, unusual taste
Dry/irritation of oropharynx
Vomiting

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25
Q

SE of Beclomethasone?

A

Thrush

Prevents healing of damaged nasal mucosa

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26
Q

SE of Budesonide?

A

Thrush

Prevents healing of damaged nasal mucosa

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27
Q

SE of Cromolyn?

A

Sore throat

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28
Q

SE of EPI?

A

CNS Simulation: urinary retention, SOB, hyperglycemia, sweats, hypersalivation, weakness, tremor, cold extremities, hypokalemia, epigastric pain (GI issues), CV d/o, tachycardia

Gangrene, necrosis to tissue IM

Eyes - blurry vision, photophobia, obstruction of duty, edema, hyperemia, inflammation of eyes

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29
Q

SE of Fluticasone?

A

URI, HA, pharyngitis, cough, rhinitis, nasal congestion
Thrust, prevents healing of damaged nasal mucosa

Topical: pruritus, excess hair growth, dryness, numbness, burning, eruptions, hypo pigmentation, skin atrophy, Cushing’s syndrome

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30
Q

SE of Ipratropium?

A

URI, dry mouth, sinusitis, constipation, cough, tachycardia, urinary retention, UTI, pupil dilation, blurry vision, myalgia, dyspepsia, rash, pharyngitis, rhinitis, epistaxis

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31
Q

SE of Mometasone?

A

Thrush
Prevents healing of damaged nasal mucosa
Burning, itching, rosacea

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32
Q

SE of Montelukast?

A

MC: HA

dizziness, rash, cough, flu like sx, insomnia

INC resp Info in elderly
hepatic eosinophilic infiltration

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33
Q

SE of Salmeterol?

A

Tachycardia, HA, nervousness, nasopharyngitis, cough, INC asthma related death

34
Q

SE of Tiotropium?

A

URI, dry mouth, sinusitis, constipation, cough, tachycardia, urinary retention, UTI, pupil dilation, blurry vision, myalgia, dyspepsia, rash, pharyngitis, rhinitis, epistaxis

35
Q

SE of Triamicinolone?

A

Jt swelling, contusions, sinusitis, cough
Thrush
Prevents healing of damaged nasal mucosa

36
Q

What drug interacts with MAO inhibitors, Tricyclic antidepressants, sympathomimetics.

Is inhibited by beta blockers

Can lead to hypokalemia with diuretics, corticosteroids, and xanthines.

INC absorption of sulfamethoxazole

DEC. serum levels of digoxin?

A

Albuterol

Salmeterol

37
Q

What drug interacts with MAO inhibitors, Tricyclic antidepressants, sympathomimetics, halogenated inhalation anesthetics, B or A blockers, methyldopa, guanethidine, anti-HTN, adrenergic neuron blockers, K depleting drugs, cardiac glycosides, ephedra, yohimbe?

A

Epineprhine

38
Q

What drug has DEC levels in the blood when combined with Phenytoin and Phenobarbitol?

A

Motelukast

39
Q

What respiratory medication should not be combined with Mifepristone?

A

Triamcinolone

40
Q

This asthma-related inhalant should be avoided in diabetes, CVD, angina, and hyperthyroidism

A

Albuterol/Salbutamol

41
Q

The practitioner needs to monitor growth in children while on this inhaler

A

Fluticasone

42
Q

Use of this nasal spray should not exceed 3 days due to risk of rebound congestion or rhinitis medicamentosa?

A

Oxymetazolin

43
Q

Used in combination with dextromethorphan and other antitussives, this medication is an expectorant that may cause kidney stones, with prolonged use

A

Guaifenesin

44
Q

This medication can be used to treat low blood pressure from shock without directly affecting chronotropy and inotropy

A

Phenylephrine

45
Q

Selective Leukotriene receptor antagonist used long-term to reduce asthma attacks

A

Montelukast

46
Q

Used for acute glaucoma, bronchospasms, ventricular fibrillation, and anaphylaxis. It is an alpha & beta 1,2 adrenergic agonist

A

Epinephrine

47
Q

Raises blood pressure by causing vasoconstriction. It may also be used to provide hemorrhoid relief

A

Phenylephrine

48
Q

A long-acting oral asthma medication taken at night that may cause Churg-Strauss Syndrome (vasculitis) with hyper-eosinophilia

A

Montelukast

49
Q

After using this inhaled medication the patient should rinse his mouth out with water

A

Fluticasone

50
Q

Antitussive that potentiates serotonin syndrome risk in people taking an SSRI or MAOI

A

Dextromethorphan

51
Q

Inhaled corticosteroid used to prevent asthma attacks

A

Fluticasone

52
Q

Nasal decongestant spray used to replace pseudoephedrine. This selective alpha-1 agonist does not have an effect on heart rate or its contractility

A

Phenylephrine

53
Q

This topical decongestant is an over the counter nasal spray that can also be used for nosebleeds

A

Oxymetazolin

54
Q

This nasal spray is contraindicated in pregnancy. It is used for nasal congestion and nosebleeds

A

Oxymetazolin

55
Q

Children with a history of atopy should not take this cough suppressant because it may stimulate the release of histamine and lead to an anaphylactic episode

A

Dextromethorphan

56
Q

A long-acting muscarinic receptor antagonist that acts as a bronchodilator.
It is contraindicated in glaucoma because the medication may have anticholinergic side effects that exacerbate glaucoma

A

Tiotropium bromide

57
Q

Eye drops used for mydriasis but contraindicated in glaucoma

A

Phenylephrine

58
Q

Anti-tussive that has shown to be no more effective than placebo but is contained in many cough syrups and lozenges. With very high doses, this medication has been used as a dissociative hallucinogenic agent

A

Dextromethorphan

59
Q

Fluticasone

i.) Clinical Use

A

i. ) Clinical Use
a. ) Allergic Rhinitis
b. ) Prevent asthma attacks (not used in treatment of an attack though)

60
Q

Fluticasone

ii.) Mechanism

A

a.) Inhaled corticosteroid (potent anti-inflammatory)

61
Q

Fluticasone iii.) Side Effects

A

a. ) URI

b. ) Oral candida infection

62
Q

Fluticasone

iv.) Contraindications

A

a. ) Do not use topically when pregnant

b. ) Not to be used as a primary treatment in status asthmaticus

63
Q

Fluticasone

v.) Interactions

A

a. ) Salmeterol improves its response

b. ) Immunostimulant botanicals may antagonize it

64
Q

Montelukast

i. ) Clinical Use
ii. ) Mechanism

A

i. ) Clinical Use
a. ) Especially good for aspirin-induced asthma
b. ) Seasonal Allergies

ii. ) Mechanism
a. ) Selective leukotriene receptor antagonist

65
Q

Montelukast

iii. ) Side Effects iv. ) Contraindications
A

iii. ) Side Effects
a. ) Increased bleeding tendency
b. ) Churg-Strauss Syndrome (eosinophilic granulomatosis vasculitis)
c. ) Hypereosinophilia

iv. ) Contraindications
a. ) NOT used acutely

Oral; Taken in the evening

66
Q

Salmeterol

i. ) Clinical Use
ii. ) Mechanism

iii. ) Side Effects
a. ) Arrhythmia & Tachycardia
b. ) Tremor

iv. ) Contraindications
a. ) Not used for Treating acute asthma attack
b. ) CVD & angina

v. ) Interactions
a. ) Often prescribed with a corticosteroid

A

i. ) Clinical Use
a. ) To prevent asthma attacks & bronchospasms in COPD
* only prescribed to patients with severe persistent asthma.

ii. ) Mechanism
a. ) Long-acting Beta-2-adrenergic agonist

67
Q

Salmeterol

iii. ) Side Effects
iv. ) Contraindications
v. ) Interactions - prescribe w/?

A

iii. ) Side Effects
a. ) Arrhythmia & Tachycardia
b. ) Tremor

iv. ) Contraindications
a. ) Not used for Treating acute asthma attack
b. ) CVD & angina

v. ) Interactions
a. ) Often prescribed with a corticosteroid

68
Q

Tiotropium Bromide

i. ) Clinical Use
ii. ) Mechanism

A

i. ) Clinical Use
a. ) Asthma & COPD

ii. ) Mechanism
a. ) Long-acting (24-hour) Muscarinic receptor antagonist
b. ) Inhalant Bronchodilator

69
Q

Tiotropium Bromide

iii. ) Side Effects
iv. ) Contraindications

A

iii. ) Side Effects
a. ) Anticholinergic effects = Dry eyes, Dry mouth, Mydriasis, Urinary retention, glaucoma, palpitations

iv. ) Contraindications
a. ) Glaucoma

70
Q

Phenylephrine

i. ) Clinical Use
ii. ) Mechanism

A

i.) Clinical Use
a.) Mydriatic Agent *eye drops
b.) Hemorrhoids (symptomatic relief by decreasing swelling)
c.) Increase blood pressure (without affecting heart rate) -> septic shock
d.) Decongestant *nasal spray
(substitute to pseudoephedrine in cases where pseudoephedrine’s positive chronotropy & inotropy is a concern)
(oxymetazolin is a more commonly used nasal spray)

Controversial about whether or not it is an effective decongestant. There has been a push to use it to reduce the abuse of pseudoephedrine

ii. ) Mechanism
a. ) Selective Alpha-1 adrenergic receptor agonist

71
Q

Phenylephrine

iii. ) Side Effects
iv. ) Contraindications
v. ) Interactions

A

iii. ) Side Effects
a. ) HTN & Reflex Bardycardia

iv. ) Contraindications
a. ) Glaucoma (when using eye drops for mydriasis)
b. ) Prostatic Hyperplasia

v. ) Interactions
a. ) Extensively metabolized by MAO

72
Q

Oxymetazoline

i. ) Clinical Use
ii. ) Mechanism

A

i. ) Clinical Use
a. ) Over the counter Topical Decongestant (Nasal Spray)
b. ) Nose bleeds (d/t vasoconstriction from alpha-1 agonistic activity)

ii. ) Mechanism
a. ) Selective alpha-1 agonist & partial alpha-2 agonist
b. ) Vasoconstrictive also

73
Q

Oxymetazoline
iii.) Side Effects
iv.) Contraindications
= Interactions

A

iii. ) Side Effects
a. ) Rhinitis medicamentosa

iv. ) Contraindications
a. ) Use for more than 3 days (to prevent rebound congestion)
b. ) Pregnancy

INTERACTIONS
c.) Concomitant MAOI use

74
Q

Dextromethorphan

i.) Clinical Use (abuse potential?)

A

i. ) Clinical Use
a. ) Antitussive in lozenges, cough syrups, and in pill form (some studies have shown it to be no more effective than placebo)

In large doses, dextromethophan is used recreationally for a dissociative halluginogenic effect and possible euphoria

75
Q

Dextromethorphan

ii. ) Side Effects
iii. ) Contraindications

iv. ) Interactions
a. ) MAOIs & SSRIs (b/c it may potentiate the risk of serotonin syndrome)
b. ) Dextromethorphan is metabolized by P450 and may reach toxic levels with grapefruit juice

A

ii. ) Side Effects
a. ) Nausea, vomiting
b. ) Nervousness, increased energy, and increased confidence
c. ) Hallucinations

iii. ) Contraindications
a. ) Children with a history of atopy (b/c it can trigger histamine release and possible anaphylactic reaction)

76
Q

Dextromethorphan

iv.) Interactions

A

a. ) MAOIs & SSRIs (b/c it may potentiate the risk of serotonin syndrome)
b. ) Dextromethorphan is metabolized by P450 and may reach toxic levels with grapefruit juice

77
Q

Guaifenesin
i.) Clinical Use

ii.) Mechanism

A

i. ) Clinical Use
a. ) Common cold usually combined with pseudoephedrine, phenylephrine, acetaminophen, and/or dextromethorphan

ii. ) Mechanism
a. ) Expectorant (increases volume & decreases viscosity of secretions in the trachea and bronchi)

78
Q

Guaifenesin

iii.) Side Effects

A

a. ) Nausea, vomiting

b. ) Formation of kidney stones (prolonged use)

79
Q

Albuterol/Salbutamol
i.) Clinical Use

ii.) Mechanism

iii. ) Side Effects
a. ) Tremor
b. ) Altered Taste
c. ) Hypotension, Arrhythmias, Tachycardia
d. ) May contain sulfites (which some asthmatics are sensitive to)
e. ) High doses may result in hypokalemia

iv. ) Contraindications
a. ) CVD & angina
b. ) Hyperthyroidism
c. ) Diabetes

v. ) Interactions
a. ) Avoid concomitant use of CNS stimulants

A

i. ) Clinical Use
a. ) Asthma Attack (acute bronchospasm)
* 15 mins to take effect. Lasts 3-4 hours*

ii. ) Mechanism
a. ) Beta-2 agonist. Relaxes bronchial smooth muscle

80
Q

Albuterol/Salbutamol
iii.) Side Effects

iv. ) Contraindications
v. ) Interactions

A

iii. ) Side Effects
a. ) Tremor
b. ) Altered Taste
c. ) Hypotension, Arrhythmias, Tachycardia
d. ) May contain sulfites (which some asthmatics are sensitive to)
e. ) High doses may result in hypokalemia

iv. ) Contraindications
a. ) CVD & angina
b. ) Hyperthyroidism
c. ) Diabetes

v. ) Interactions
a. ) Avoid concomitant use of CNS stimulants

81
Q

Epinephrine
i.) Clinical Use

ii.) Mechanism

A

i. ) Clinical Use
a. ) Anaphylaxis
b. ) Acute bronchospasms
c. ) Glaucoma
d. ) ventricular tachycardia & fibrillation

ii. ) Mechanism
a. ) Alpha & Beta 1,2 adrenergic agonist

82
Q

Epinephrine

SE and CI

A

iii. ) Side Effects
a. ) HTN, Tachycardia, Arrhythmia, Ventricular Fibrillation, Angina

iv. ) Contraindications
a. ) CVD
b. ) DM2
c. ) Hyperthyroidism
d. ) Epilepsy
e. ) Severe Anxiety

Emma's NPLEX II Conventional Tx (8 decks)

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