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NAPLEX BITCH > Pulm > Flashcards

Pulm Flashcards

1
Q

If a patient is found to be a responder during the diagnosis of PAH. What medications should be tried?

A

CCB - Nifedipine, Diltiazem, and Amlodipine

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2
Q

If a patient is found to be a NON - responder during the diagnosis of PAH what therapies could be trialed?

A

PDE-5
Endothelin Receptor Antag
Soluble Guanylate Cyclase Stimulator
Prostacyclin Analogue

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3
Q

prostacyclin analogues MOA:

A

potent vasodilators and inhibitors of platelet aggregation.

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4
Q

Prostacyclin Analogues ( Remodulin and Veletri) are dosed in:

A

ng/kg/min

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5
Q

Veletri or Flolan:

A

Epoprostenol

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6
Q

Remodulin:

A

Treprostinil

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7
Q

SE of Prostacyclin Analogues

A

hypotension, flushing, jaw pain

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8
Q

Flolan requires ____ for stability

A

ice packs

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9
Q

Endothelin Receptor Antagonist Drugs:

A

-entan
Bosentan
Ambrisentan
Macitentan

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10
Q

Bosentan

A

tracleer

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11
Q

Ambrisentan

A

Letairis

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12
Q

Endothelial receptor antagonists (bosentan, ambrisentan, macitentan) are:

A

teratogenic BBW in place for them. Need pregnancy test prior to starting and monthly thereafter

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13
Q

PDE-5 Inhibitors:

A

increased cGMP concentrations lead to pulmonary vasculature relaxation and vasodilation

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14
Q

Revatio

A

Sildenafil

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15
Q

Adcirca

A

Tadalafil

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16
Q

What are some warnings/se associated with PDE-5’s?

A

headaches, vision loss, hearing loss, NAION (nonarteritic anterior ischemic optic neuropathy)

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17
Q

Soluble Guanylate cyclase stimulator:

A

Riociguat (Adempas)

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18
Q

Adempas MOA:

A

Riociguat is a soluble guanylate cyclase stimulator. It sensitizes sGC to endogenous nitric oxide and directly stimulates the receptor.

Increased cGMP leading to relaxation

19
Q

What is the BBW associated with Adempas?

A

Riociguat is teratogenic!! Has a REMS program in place due to this.
Women must have a negative pregnancy test prior, during, and 1 month after.

20
Q

Other than pregnancy, what is another CI for Adempas (Riociguat)?

A

Use with PDE-5’s or Nitrates

21
Q

What drugs contribute to Pulmonary Fibrosis? (6ish)

A

Amiodarone / Dronedarone
Bleomycin
Busulfan
Carmustine
Lomustine

22
Q

FEV1 =

A

how much air can be forcefully exhaled in one second

23
Q

FVC =

A

After take a deep breath, the maximum volume of air that is exhaled

24
Q

When classifying asthma severity….

When a patient has <2x/month day sx’s and no nighttime symptoms that are:

A

Step 1

25
Q

When classifying asthma severity….

When a patient has >2 day time sx’s a month but less than 4-5 times a week:

A

Step 2

26
Q

When classifying asthma severity….

When a patient has Daytime sx’s most days and Nighttime symptoms >/= 1/wk they are:

A

Step 3

27
Q

When classifying asthma severity….

When a patient has daily day symptoms and over once a weekly night time sx’s they are:

A

Step 4 and 5

28
Q

Step 1 asthma therapy:

A

PRN ICS-Formoterol OR SABA + ICS

29
Q

Step 2 Asthma therapy:

A

PRN ICS-Formoterol pr SABA + Maintenance ICS

30
Q

Step 3 asthma therapy:

A

PRN ics-formoterol

or

SABA + Maintenance ICS- LABA

31
Q

Step 4 asthma therapy:

A

ICS Formoterol + MD ICS Formoterol

OR

SABA + MD ICS -LABA

32
Q

Step 5 asthma therapy:

A

ICS-formoterol + HD ICS-formoterol

OR

SABA + HD ICS-LABA

33
Q

How many doses does an albuterol inhaler contain?

A

200

EXCEPT Ventolin HFA has a 60 dose option

34
Q

What are the SE of SABAs?

A

decreased potassium

Hyperglycemia

Nervousness
Tremor
Tachycardia

35
Q

LABA Name for asthma :

A

Salmeterol (Servant)

36
Q

What is the LABA BBW:

A

Increased risk of asthma related deaths. should only be used in a patient already receiving an ICS.
Also increases hospitalization in pediatric and adolescents

37
Q

SE with ICS:

A

Dysphonia , oral candidiasis, cough

38
Q

Pulmicort Respules should:

A

only be used with a jet nebulizer.

39
Q

QVAR redihaler:

A

Breath activated. DO NOT SHAKE or use with a spacer
DOES NOT NEED PRIMING

40
Q

What LAMA is used in Asthma?

A

Tiotropium (Spiriva)

41
Q

What ICS/LABAs are used in Asthma?

A

Dulera - mometasone/formoterol

Breo Ellipta - fluticasone/vilanterol

Symbicort - budesonide/formoterol

Advair - fluticasone/salmeterol

42
Q

In what type of inhaler can a spacer be used\?

A

MDI- hfs, Respimat!

NO TO DPIs

43
Q

While shaking is not required for DPI’s it is required for MDI’s… EXCEPT

A

QVAR Redihaler, Alvesco, and Respimat Products

44
Q

What is the goal therapeutic range for theophylline?

A

5 - 15 mcg/mL

(dosed off IBW)

NAPLEX BITCH (9 decks)

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