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CPR 2 Exam 2 > Pharmocology Asthma And COPD - Dr. Izsard > Flashcards

Pharmocology Asthma And COPD - Dr. Izsard Flashcards

1
Q

3 types of bronchodilators

A
  1. B2 agonist
  2. Muscarinic antagonist (Anticholinergic)
  3. Methylxanthines
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2
Q

2 drugs increasing cAMP to bronchodilate

A

B2 blocker albuterol

Theophylline

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3
Q

Albuterol is what and clinical use

A

SABA

Asthma and COPD, acute bronchitis, Bronchiolitis

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4
Q

Albuterol contraindications

A

Paradoxical bronchospasms
Deterioration of asthma
CV effects
Hypersensitivity reactions

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5
Q

Terbutaline is what and clinical use

A 
SABA
(Oral or subQ*)
1. Prophylaxis bronchospasm from asthma 
2. Bronchitis 
3. Emphysema
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6
Q

Terbutaline not given to what pt

A

Super allergy
Pregnancy
Pre-contractions in pregnancy

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7
Q

Metaproterenol is what and clinical use

A

SABA

  1. Asthma
  2. Bronchospasm from COPD or bronchitis
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8
Q

Metaproterenol side effects

A

Paradoxical bronchospasm

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9
Q

Pirbuterol is what and clinical use

A

SABA

1. Prevent and reverse bronchospasm

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10
Q

Pirbuterol side effects

A

Significant cardiovascular effects* like in HTN pts

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11
Q

Levabuterol is what and clinical use and side effects

A

SABA
1. Tx or prevent bronchospasm is any reversible obstructive airway disease
Can cause paradoxical bronchospasm

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12
Q

Beclomethasone is what and clinical use

A

ICS
= asthma maintenance (before sx)
= can be to help patients get off oral steroids

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13
Q

Beclomethasone side effects

A

Can shrink adrenal gland during oral steroids so need to start Beclomethasone carefully so hypothalamic pituitary pathway can heal

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14
Q

ICS is given how and functions to do what in asthma pts

A
  1. 2 x day usuall
  2. Prevent asthma sx and exercise-induced asthma
  3. Prevent airway changes
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15
Q

Tx asthma persistent

A

ICS

Then LABA if needed

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16
Q

Budesonide is what and clinical use

A

ICS

1. Maintenance asthma (before sx)

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17
Q

Budesonide contraindications

A
  1. Status asthmaticus

2. Acute asthma episode

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18
Q

Ciclesonide is what and clinical use

A

ICS

= maintenance asthma (before sx)

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19
Q

Ciclesonide contraindications

A

= acute bronchospasm

= candida present

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20
Q

Ciclesonide advantage

A

Less candidiasis (PRODRUG activated by bronchial Esterases**)

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21
Q

Flunisonide is what and clinical use

A

ICS
= maintenance asthma
= help eliminate oral steroids slowly

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22
Q

Flunisonide contraindications

A

Asthma attack

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23
Q

Fluticasone is what and clinical use

A

ICS

= maintenance asthma

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24
Q

Fluticasone risks

A

Candida is higher risk

- wash mouth with water

25
Q

Mometasome is what and clinical use

A

ICS

= maintenance asthma

26
Q

Mometasome contraindications

A

Milk hypersensitivity (lactose)

27
Q

Triamcinolone is what and clinical use

A

ICS
= maintenance asthma
= decrease oral steroids

28
Q

Triamcinolone contraindications and warning for risk

A

Acute asthma

Adrenal insufficiency death can happen if not gradual change to this drug from oral steroids

29
Q

Prednisone is what and clinical use

A 
ORAL corticosteroids (OCS)
= WITH SABA to tx  asthma flareup 
= also used for endocrine and other anti inflammatory needed conditions
30
Q

Prednisone can cause

A

Hypothalamic-pituitary adrenal pathway insufficiency

31
Q

Prescribing pt with asthma what

A
  1. ICS everyday.
  2. OCS and SABA when needed
  3. If that doesn’t work add LABA + ICS every day
32
Q

Fomoterol is what and clinical use

A

LABA (used with ICS)

  1. Asthma control
  2. COPD
33
Q

Fomoterol risk

A

Asthma problems if not given with ICS

34
Q

Salmeterol is what and clinical use

A

LABA
= prevent exercise bronchospasm
= maintain COPD

35
Q

Indacaterol and Vilanterol is what and clinical use

A

LABA
= breathing problems from COPD
= bronchitis and emphysema from COPD

36
Q

Olodaterol is what and clinical use

A

LABA

= maintenance 1x day for COPD, chronic bronchitis, emphysema

37
Q

LABA only given with

A

ICS

38
Q

4 anticholinergic drugs used for COPD

A
  1. Atropine (shirt lasting)
  2. Ipratropium (maintenance)
  3. Tiotropium (long term maintenance)
  4. Aclidinium (long term maintenance)
39
Q

Atropine is what and clinical use

A

Anticholinergic

= X life threatening COPD or asthma attacks

40
Q

Atropine max dose

A

No more then 2-3mg

41
Q

Ipratropium is what and clinical use

A

Anticholinergic
=maintenance bronchospasm for COPD
= less systemic effect then atropine

42
Q

Tiotropium is what and clinical use

A

Anticholinergic

= 1x day maintenance bronchospasm from COPD

43
Q

Aclidinium is what and clinical use

A

Anticholinergic

= maintenance bronchospasm long term from COPD

44
Q

3 Methylxanhines (from plants and animals)

A
  1. Theophylline
  2. Theobromine (chocolate)
  3. Caffeine
    = asthma, chronic bronchitis, emphysema (COPD) tx
45
Q

Theophylline does what 2 things and contraindications

A
  1. Bronchodilate by increasing cAMP
  2. Inhibit bronchoconstriction
    = PUD, seizures, cardiac problems cautious use needed
46
Q

Non-hormone anti inflammatory

A

Leukotriene atagonists and Lipoxygenase inhibitors

47
Q

Zafirlukast and Montelukast are what and clinical use

A

Reversible antagonist of Cysteinyl LEUKOTRINE receptors ( CysLT1 receptors)
= bronchodilator not as effective as ICS (ORALLY)

48
Q

Zafirlukast and Montelukast and Pranlukast do what and advantage

A

BLOCK Leukotrienes binding to CysLT1 Rs
Anti-inflammatory and bronchodilator
= no glucocorticoid effects *

49
Q

Zileuton is what and clinical use

A

BLOCK 5-LO (lipoxygenase = making leukotrines that bind to CysLT1 R)

50
Q

Zafirlukast and Monelukast and Pranlukast and Zileuton are used when

A
  1. DM (prevent glucocorticoid effects)
  2. Prophylaxis in asthma
  3. Prevention of asthma prophylaxis (anti-inflammatory + bronchodilator)
    (Except monelukast can tx ongoing prophylaxis however can also tx allergies)
51
Q

Zafirlukast risk

A

Hepatotoxicity

52
Q

Zileuton used when and risks

A

Prophylaxis and chronic asthma

= hepatotoxic

53
Q

Omalizumab is what and clinical use

A

Monoclonal antibody drugs
= severe asthma persistent (with + skin test or no other drug works)
= chronic idiopathic urticaria (even after anti-H1 tx)

54
Q

Omalizumab works how

A
  1. Bind to IgE
  2. Decrease R bound by IgE
  3. Decrease mast cell mediator release
  4. Decreasing allergic inflammation
55
Q

Omalizumab risks

A

Anaphylaxis ** (should be given in hospital only)

56
Q

Asthma tx steps

A

SABA ALWAYS

ICS —> LABA —> LAMA

57
Q

COPD Tx steps

A

SABA ALWAYS

LAMA —> LABA —> ICS

58
Q

Chronic Idiopathic Urticaria

A

Hives from unknown cause usually autoimmune hyperreactive immune system

CPR 2 Exam 2 (12 decks)

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