Pul 9 - Pulmonary Medication Flashcards
What is the side effect of beta2 agonists?
They are mild beta1 agonists:
- Jittetriness.
- Tachycardia.
-Levalbuterol: less beta1-agonist.
What are some inhaled corticosteroids for asthma?
- Fluticasone.
- Budesonide.
- Beclomethasone.
What do corticosteroids do?
- Inhibit the synthesis of cytokines.
2. Inhibit TNF-alpha production.
When are systemic steroids used in asthma?
- Severe chronic asthma.
2. Acute asthma exacerbation w/ inhaled beta2 agonists.
What does Cromolyn do?
- Prevents the release of mediators from mast cells.
2. Prevents bronchoconstriction and inflammation.
What are some beta2 agonists used in asthma and what do they do?
Albuterol and levalbuterol: smooth muscle relaxation in the bronchi. Used for acute asthma exacerbations.
-Salmeterol: long-acting. Used for asthma prophylaxis.
What are some muscarinic antagonists and what do they do in the lungs?
- Tiotropium and ipatropium.
- They are inhaled agents, they decrease the overall vagal or parasympathetuc tone in the lungs, causing smooth muscle relaxation and decrease in mucus production.
What are some antileukotrienes and what do they do?
- Zileuton:
- 5-lipoxygenase inhibitor; blocks the conversion of arachidonic acid into leukotrienes. - Zafirlukast, Montelukast: Prevent chemotactic and bronchospasmic effects of leukotrienes D4.
What are some methylxanthines and what do they do?
- Theophylline: causes bronchodilation by inhibiting phosphodiesterase.
- Metabolized by cytochrome P450.
- Blocks the action of adenosine.
Why are methylxanthines dangerous?
Has a very narrow therapeutic index:
- Cardiotox: tachycardia and hypotension.
- Neurotoxicity: Seizure.
What are some expectorants and what do they do?
- Guaifenesin.
- They loosen up sputum. - N-acetylcysteine.
- Usually used as acetaminophen overdose.
- Has mucolytic protperties: cleaves disulfide bonds within mucous glycoproteins.
- Can also be used to prevent contrast-induces renal nephropathy.
What are some H1 blockers and what do they do?
- H1 blockers: 1st generation.
- Diphenhydramine.
- Dimenhydrinate.
- Chlorpheniramine.
- Hydroxyzine.
- -Used as allergic rhinitis, motion sickness, sleep aids, sedation, antimuscarinic effects. - Second generation:
- Loratadine.
- Fexofenadine.
- Desloratadine.
- Cetirizine.
–far less sedating, but can be if used in high doses like cetirizine.
What is cyproheptadine used for?
Appetite stimulant on pediatric patients.
What is Promethazine used for?
Nausea, vomiting.
What is Chlorpheniramine used for?
OTC allergy/cold.
What is hydroxyzine used for?
Sedation, itching.
What is Meclizine used for?
Vertigo.
What is Dextromethorphan used for?
Synthetic derivative of morphine used as a cough supressant.
-No analgesic affect.
What are psedudoephedrine and phenylephrine and what are they used for?
They are alfa-agonists and they are used as nasal decongestants. They constrict dilated arterioles in the nasal mucosa.
What medication is used for inhaled treatment of choice for chronic asthma?
Inhaled steroids.
What inhaled treatment of choice for acute exacerbations of asthma?
Albuterol or levalbuterol.
What medication has narrow therapeutic index, is the drug of last resort in asthma?
Theophylline.
What medication blocks conversion of arachidonic acid to leukotriene, used in asthma?
Zileuton.
What medication inhibits mast cell release of mediators, used for prophylaxis only in asthma?
Cromolyn.
What medication is used as inhaled treatment that blocks muscarinic receptors used in asthma?
Ipratropium and triotropium.
What medication is an inhlaed long-acting beta2 agonist used in asthma?
Salmeterol.
What medication blocks leukotriene receptors that is used in asthma?
Zafirlukast and montelukast.
Which medication, if taken long term, can result in rebound nasal congestion?
Pseudoephedrine and phenylephrine.
