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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
Q

Tiotropium dosing

A

once daily

26
Q

Inhaled anticholinergics side effects

A
  1. nosebleeds
  2. nasal irritation
  3. sore throat
  4. can worsen angle closure glaucoma
  5. can worsen urinary retention
27
Q

Inhaled anticholinergics cautions

A

glaucoma
urinary retention
(very drying)

28
Q

Leukotriene Receptor Antagonists Indications

A
  1. prevention of persistent asthma (not first line)
  2. exercise induced bronchospasm
  3. allergic rhinitis
29
Q

Leukotriene Receptor Antagonists CI

A
  1. acute liver disease or any impaired liver function

2. not used for acute asthma

30
Q

Leukotriene Receptor Antagonists MOA

A

blocks inflammatory response –> reduces bronchoconstriction, decreases inflammation

31
Q

Leukotriene Receptor Antagonists Examples

A

Montelukast (Singulair)

32
Q

dosing for Montelukast

A

once a day

33
Q

Leukotriene Receptor Antagonists S/E

A

headache
gastritis/GI upset
Rare but serious: Churg-Strauss syndrome

34
Q

Methylxanthine Examples

A

Theophylline

35
Q

Methylxanthine MOA

A

relax smooth muscle in bronchial airways and relax pulmonary blood vessels

36
Q

Methylxanthine Indications

A

like 10th line for asthma and COPD

37
Q

Methylxanthine CIs

A
  1. active or symptomatic coronary heart disease
  2. smokers
  3. geriatric patients
38
Q

Methylxanthine S/E

A
  1. N/V
  2. headache
  3. insomnia
  4. tremor
  5. seizure
  6. restlessness
  7. irregular heartbeat
  8. palpitations
  9. tachycardia
39
Q

Disadvantage of theophylline

A

narrow therapeutic index

need ongoing serum levels every 6-12 months

40
Q

Mast Cell Stabilizers indications

A
  1. conditions with allergy component (asthma, rhinitis, conjunctivitis)
  2. systemic mastocytosis
  3. adjunct therapy (NOT acute therapy)
41
Q

Mast Cell Stabilizers CI

42
Q

Mast Cell Stabilizers MOA

A

prevents degranulation of mast cells which blocks release of proinflammatory factors

43
Q

Mast Cell Stabilizers Example

A

Cromolyn sodium (Nasal Crom)

44
Q

Mast Cell Stabilizers S/E

A

generally well tolerated
cough from throat irritation
nasal irritation

45
Q

When would you consider Mast Cell Stabilizers for asthma pt

A

if not getting good control with regular progression and you think there is an allergy component

46
Q

Considerations with Mast Cell Stabilizers

A
  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
Q

Monoclonal Antibodies indications

A

add on maintenance treatment of patients with severe asthma with an eosinophilic phenotype

48
Q

Intranasal steroids examples

A
  1. Fluticasone (Flonase/Veramyst)

2. Mometasone (Nasonex)

49
Q

disadvantage of intranasal steroids

A

sometimes takes weeks to get benefits, requires continuous dosing to see response

50
Q

Intranasal steroids indications

A
  1. allergic rhinitis

2. nasal congestion

Pharmacology (27 decks)

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