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Winter 2021 Finals > Pharm - Respiratory > Flashcards

Pharm - Respiratory Flashcards

1
Q

Anticholinergics mechanism (respiratory fluid)

A

Reduce production of fluid

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2
Q

Mucokinetic (expectorants) mechanism

A

increase production of fluid to prevent drying and aid in productiveness

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3
Q

Mucokinetic (expectorant) exemplar

A

Guaifenesin

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4
Q

Mucolytic mechanism

A

Liquefy mucous through breaking disulfide bonds

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5
Q

Mucolytic exemplar

A

NAC

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6
Q

NAC side effects

A

stomatitis, rhinorrhea, bronchospasm - infrequently used d/t these

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7
Q

Opioids exemplar

A

Codeine

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8
Q

Opioids mechanism

A

act within cough centres of the brain

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9
Q

Opioids side effects

A

development of tolerance and physical dependence, respiratory depression

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10
Q

Non-opioid exemplar

A

Dextromethorphan

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11
Q

Other antitussives

A

Menthol, honey (anything sweet)

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12
Q

Selective beta 2 adrenergic receptor agonists mechanism

A

causes muscle relaxation

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13
Q

Selective beta 2 adrenergic receptor agonists exemplars

A

Salbutamol, Salmeterol

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14
Q

Only drug to show beneficial effect in non-specific treatment of cough

A

Dextromethorphan, only in adults

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15
Q

Salbutamol info

A 
Short acting
Administered via MDI
Treats acute bronchospasm - rescue
Oral doses have slower onset, more side effects
4-5 hours duration of action
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16
Q

Salmeterol info

A

Long acting
Administered via accuhaler
Prevents bronchospasm (asthma, COPD)
Lipophilicity improves duration of action (10-12 hrs)

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17
Q

Anticholinergics mechanism (bronchodilation)

A

Bind to M3 receptors (in smooth muscle) and blocks cholinergic stimulation from the vagus nerve –> blocks rise in intracellular calcium and prevents bronchoconstriction

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18
Q

Anticholinergic exemplar

A

Tiotropium

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19
Q

Tiotropium adverse effects

A
  • HA, GI motility issues, dizziness, dry mouth

- Use in caution in pts w/ glaucoma prostatic hyperplasia, urinary retention and bladder neck obstruction

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20
Q

Methylxanthine mechanism

A

nonspecific inhibition of phosphodiesterase enzymes, complex mechanism

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21
Q

Methylxanthine exemplar

A

Theophylline

22
Q

Theophylline used for?

A

Inpatient method to control COPD, asthma, apnea, when others have failed

23
Q

Theophylline adverse effects

A
  • Narrow therapeutic index (5-15 mg/L), CYP3A family
  • GI distress at lower doses, CNS stimulation at higher
  • Cardiac stimulation
  • seizures and dysrhythmias
24
Q

Glucocorticoid exemplars

A

Fluticasne, prednisone, triamcinolone

25
Q

Glucocorticoid mechanism

A

alter gene expression

  • increase transcription of beta 2 receptors and anti-inflammatory cytokines
  • decrease transcription of pro-inflam cytokines
  • induce apoptosis in pro-inflam cells
26
Q

Glucocorticoids indications

A

prophylactic asthma management, COPD

27
Q

Glucocorticoids adverse effects

A

adrenal insufficiency, thinned skin/ poor wound healing (long term), fungal infections, reduced growth velocity, cataracts and glaucoma, bone density loss

28
Q

Glucocorticoids contraindications

A
  • primary treatment of status asthmaticus or acute asthma episodes
  • Tb or untreated infection of respiratory system
  • abrupt discontinuation
29
Q

Mast cell stabilizers (cromolyns) exemplar

A

Cromolyn sodium

30
Q

Cromolyns mechanism

A
  • inhibits release of inflammatory mediators

- inhibits immediate allergic response

31
Q

Cromolyns indications

A

Solely prophylactic treatment of asthma and allergic rhinitis

32
Q

Cromolyns safety profile

A

better than any other asthma medication, w/ minimal systemic absorption (>98% swallowed excreted in feces)

33
Q

Cromolyns adverse effects

A

Remarkably non-toxic

throat irritation and cough, horrible taste

34
Q

Leukotriene receptor inhibitors exemplar

A

Montelukast

35
Q

Leukotriene receptor inhibitors mechanism

A

interact with receptors that cause smooth muscle contraction, eosinophil migration, and edema

36
Q

Monteleukast indications

A

Adult and pediatric prophylactic and chronic asthma treatment
additive to beta agonists and inhaled corticosteroids

37
Q

Monteleukast adverse effects

A

Generally none, rare reports of liver injury, post marketing reports of neuropsych issues

38
Q

Leukotriene formation inhibitors exemplar

A

Zileuton

39
Q

Leukotriene formation inhibitors adverse effects

A
  • CI liver disease d/t increase liver enzymes in 2%
  • possible sleep disorders/ behavioral changes
  • flu sydrome, HA, drowsiness, dyspepsia
40
Q

Leuktriene formation inhibitors effects

A

same as monteleukast

41
Q

H1 receptor antagonists mechanism

A

higher affinity for inactive receptor conformation –> block signal transduction
mediates smooth muscle contraction and increases capillary permeability

42
Q

H1 receptor antagonist first generation exemplar

A

Dipenhydramine

43
Q

Dipenhydramine uses

A

allergic rhinoconjunctivitis, urticaria, atopic dermatitis, anaphylaxis, motion sickness/ nausea, sedation

44
Q

Diphenhydramine adverse effects

A

Sedation, antiACh effects

45
Q

H1 receptor antagonist 2nd gen exemplar

A

Cetirizine (most likely to cause drowsiness)

46
Q

Cetirizine uses

A

allergic conjunctivitis, urticaria

47
Q

Cetirizine adverse effects

A

dizziness, HA, insomnia, nervousness, drowsiness – compounded with pseudoephedrine which can intensify

48
Q

Quercetin

A

“Mast cell stabilizer”
Reduces/ block histamine release for IgE eosinophils and basophils
Urticaria and allergic rhinoconjunctivitis

49
Q

Rhinitis drugs

A
  • H1 receptor antagonists
  • inhaled corticosteroids (triamcinolone)
  • alpha adrenergic receptor agonist
50
Q

Alpha adrenergic receptor agonist exemplar (decongestants)

A

pseudoephedrine

51
Q

alpha adrenergic receptor agonists mechanism

A

Sympathomimetic agent, constricts arterioles in nasal mucosa

52
Q

Pseudoephedrine adverse effects

A

Rhinitis medicamentosa, nervousness/ anxiety, tremor, dizziness, insomnia, tachycardia

Winter 2021 Finals (6 decks)

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