Pharma

Question 1

Aerosol delivery drugs

Answer 1

Metered dose - has a spacer for drug expansion Nebulizer - face mask if physical capability is diminished Dry inhaler

Question 2

brochondialtors

Answer 2

B2 adrenergic - activate camp Muscarinic - prevents Methylzanthine

Question 3

B2

Answer 3

Targets Lung smooth muscle, many secondary effects Epi - Isoproteranol SABAs Albuterol Terbutaline - only sub q drug Metropoterenol LABA Salmeterol 50 x more selective than Alb Formoterol Patient compliance over time with not taking anti inflammatory concurrent with beta 2

Question 4

Anti cholenergic asthma drugs

Answer 4

Competitive muscarinic antagonists Ipratropium Tiotropium

Question 5

Methylxanthines

Answer 5

Aminophylline Act on the lung adp receptors Very narrow therapeutic index High drug interaction i

Question 6

Corticosteroids for asthma

Answer 6

Most potent inflammation reducers available Not direct broncho dialators Activation of the glucocorticoid receptors reduces three inflammatory pathways. Oral Prednisone High rate of side fx Inhaled Beclomethasone Fluc Ciclesimide Aerosolized, inactivated if ingested

Question 7

leukotriene pathway receptor

Answer 7

Aspirin and exercise induced asthma Can be combined with glucocorticoids to reduce steroid use Can be hepatotoxic so levels must be monitored. Aspirin causes increased leukotriene by blocking transformation of arachadonic acid to cox

Question 8

Omalizumab

Answer 8

Leukotriene inhibitor !,,

Question 9

Smoking cessation

Answer 9

Nicotine replacement, Dopaminergic!!!@@@@

Question 10

roflumilast

Answer 10

phosphodiesterase 4!inhibitor that preserves cAMP in lung tissue to maintain airways

Question 11

drug interactions

Answer 11

salmeterol & cyp3a4 drugs

Question 12

Filtration requirement of diuretics

Answer 12

Most diuretics must be filtered into the kidney by way of the glomerulus, so if you have renal failure, diuretic efficacy is reduced… Higher doses are required, therefor risk of toxicity is higher.

Question 13

Acetazolimide

Answer 13

prevents high altitude sickness. Prevents carbonic anhydase action, therefore h2co3 doesn’t break down, doesn’t feed the NHE3 transporter, doesn’t allow Na resorption in the proximal tube… Effects will be counteracted later on in the kidney by ambitious Na exchangers later on. Very specific uses

Question 14

mannitol

Answer 14

creates a false glycouria, creates osmotic pressure in the urine, pulls H2o out

Question 15

loop diuretics

Answer 15

More potent because they are acting further down the nephron and less compensatory effect is possible. .. Poisons the Cl portion of the NKCC2 transporter This has the secondary effect of keeping K in the lumen, thus allowing K to be excreted. Tertiary effects Keeps Mg and Ca in the lumen

Question 16

diuretic dose response

Answer 16

the first dose of a loop or thiazide agent is most effective, because within a fairly short period of time the Rest of the kidney will modify its resorption over time

Question 17

thiazide diuretics

Answer 17

act in the distal tube, disrupts the NCC transporter which keeps both NaCl in the lumen… Has the secondary effect of increasing calcium resorption. See first aid page 508. Looks like low intra cellular Na boosts the function of the baso lateral Na Ca exchanger, increasing Ca reabsorption.

Question 18

dosing diuretics for BP

Answer 18

thiazides are credited for high BP reduction. Looks like its actually a thiazide drug…. Turns out the lowest effective does is all that is required to dump BP.

Question 19

complications of diuretics

Answer 19

populate this list

Question 20

interconnected ions

Answer 20

Mg and K are linked. If one is low