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Pharmacology > Pulm Drugs > Flashcards

Pulm Drugs Flashcards

1
Q

Examples of short acting beta agonists

A

Albuterol (Ventolin, ProAir, Proventil)

Levalbuterol (Xopenex)

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2
Q

onset and Duration of short acting beta agonists

A

~5 minutes

3-4 hours

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3
Q

Examples of long acting beta agonists

A

Salmeterol (Serevent)

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4
Q

Onset and Duration of long acting beta agonists

A

15-20 minutes, >12 hours

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5
Q

Formulation os beta 2 agonist

A
  1. inhaler

2. solution for nebulizer

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6
Q

beta 2 agonist MOA

A

stimulates beta 2 receptors in bronchial smooth muscle –> relaxation of bronchial smooth muscle –> larger diameter airway

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7
Q

side effects of long term use of beta 2 agonists

A
  1. tachycardia
  2. anxiety
  3. tremor
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8
Q

Indications of beta 2 agonists

A

Relief of bronchospasm in asthma, COPD, anaphylaxis

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9
Q

Indications for beta 2 agonists in asthma

A
  1. prevention of exercise induced asthma
  2. rescue for acute bronchospasm
  3. long acting beta agonist for prevention in combo w/ inhaled steroid
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10
Q

beta 2 agonist contraindications

A

caution with conditions in which tachycardia is undesirable (severe CAD, aortic stenosis)

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11
Q

Beta 2 agonists side effects

A 
tachycardia!
palpitations!
tremor!
headache
dizziness
nausea (back to back treatments)
hypokalemia
hyperglycemia
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12
Q

when do you need to something in addition to SABA

A

using SABA more than 8 days a month or more than 2 times a week

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13
Q

medication given after SABA

A

daily inhaled corticosteroid

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14
Q

Inhaled corticosteroid examples

A

Budesonide (Pulmicort)
Mometasone (Asmanex)
Fluticasone (flovent, Arnuity Ellipta)

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15
Q

Inhaled corticosteroid MOA

A

decreases inflammation, decreases eosinophils

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16
Q

Inhaled corticosteroid route of administration

A
  1. aerosol
  2. dry power
  3. liquid for nebulizer
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17
Q

Inhaled corticosteroid Indications

A

asthma (long term control)
COPD
off label for Eosinophilic esophagitis

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18
Q

Inhaled corticosteroid Contraindications

A

No major CIs

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19
Q

Inhaled corticosteroid side effects

A
  1. oral candidiasis
  2. dysphonia/hoarseness
  3. sore throat
  4. dry mouth
  5. high doses –> osteoporosis, cataracts, same as systemic steroids
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20
Q

Inhaled anticholinergics examples

A
  1. Ipratropium (Atrovent Nasal Inhibitor)
    - Ipratropium+albuterol/Combivent
  2. Tiotropium/Spiriva
  3. Umeclidinium
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21
Q

Inhaled anticholinergics MOA

A

block muscarinic receptors –> bronchodilation and reduced nasal secretions

22
Q

Inhaled anticholinergics Indications

A

COPD
treatment of acute asthma flare associated with respiratory infection (not first line)
Bronchitis

23
Q

Ipratropium route of administration

24
Q

Ipratropium onset and duration of action

A

30-90 minutes, ~6 hours

25
Tiotropium dosing
once daily
26
Inhaled anticholinergics side effects
1. nosebleeds 2. nasal irritation 3. sore throat 4. can worsen angle closure glaucoma 5. can worsen urinary retention
27
Inhaled anticholinergics cautions
glaucoma urinary retention (very drying)
28
Leukotriene Receptor Antagonists Indications
1. prevention of persistent asthma (not first line) 2. exercise induced bronchospasm 3. allergic rhinitis
29
Leukotriene Receptor Antagonists CI
1. acute liver disease or any impaired liver function | 2. not used for acute asthma
30
Leukotriene Receptor Antagonists MOA
blocks inflammatory response --> reduces bronchoconstriction, decreases inflammation
31
Leukotriene Receptor Antagonists Examples
Montelukast (Singulair)
32
dosing for Montelukast
once a day
33
Leukotriene Receptor Antagonists S/E
headache gastritis/GI upset Rare but serious: Churg-Strauss syndrome
34
Methylxanthine Examples
Theophylline
35
Methylxanthine MOA
relax smooth muscle in bronchial airways and relax pulmonary blood vessels
36
Methylxanthine Indications
like 10th line for asthma and COPD
37
Methylxanthine CIs
1. active or symptomatic coronary heart disease 2. smokers 3. geriatric patients
38
Methylxanthine S/E
1. N/V 2. headache 3. insomnia 4. tremor 5. seizure 6. restlessness 7. irregular heartbeat 8. palpitations 9. tachycardia
39
Disadvantage of theophylline
narrow therapeutic index | need ongoing serum levels every 6-12 months
40
Mast Cell Stabilizers indications
1. conditions with allergy component (asthma, rhinitis, conjunctivitis) 2. systemic mastocytosis 3. adjunct therapy (NOT acute therapy)
41
Mast Cell Stabilizers CI
none
42
Mast Cell Stabilizers MOA
prevents degranulation of mast cells which blocks release of proinflammatory factors
43
Mast Cell Stabilizers Example
Cromolyn sodium (Nasal Crom)
44
Mast Cell Stabilizers S/E
generally well tolerated cough from throat irritation nasal irritation
45
When would you consider Mast Cell Stabilizers for asthma pt
if not getting good control with regular progression and you think there is an allergy component
46
Considerations with Mast Cell Stabilizers
1. do not provide bronchodilation so not useful in acute asthma attack or allergy symptoms that have already started 2. delivered topically. low oral bioavailability
47
Monoclonal Antibodies indications
add on maintenance treatment of patients with severe asthma with an eosinophilic phenotype
48
Intranasal steroids examples
1. Fluticasone (Flonase/Veramyst) | 2. Mometasone (Nasonex)
49
disadvantage of intranasal steroids
sometimes takes weeks to get benefits, requires continuous dosing to see response
50
Intranasal steroids indications
1. allergic rhinitis | 2. nasal congestion

Pharmacology (27 decks)

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