Pulm & Heme Drugs Flashcards
1
Q
Albuterol Class
A
SABA
2
Q
Terbutaline Class
A
SABA
3
Q
Salmeterol Class
A
LABA
4
Q
Chromolyn sodium Class
A
mast cell stabilizer
5
Q
Omalizumab Class
A
immunodilator
6
Q
Zafirlukast Class
A
leukotriene modifier (LTRA)
7
Q
Montelukast Class
A
leukotriene modifier (LTRA)
8
Q
Zileuton Class
A
leukotriene modifier (LTRA)
9
Q
Prednisone Class
A
oral glucocorticoid
10
Q
Beclomethasone Class
A
inhaled glucocorticoid (ICS)
11
Q
Budesonide Class
A
inhaled glucocorticoid (ICS)
12
Q
Fluticasone Class
A
inhaled glucocorticoid (ICS)
13
Q
Ipratropium Class
A
Short-acting anticholinergic
14
Q
Tiotropium Class
A
Long-acting anticholinergic
15
Q
Nicotine patch, lozenge, gum, inhaler, spray Class
A
nicotine replacement
16
Q
Varenicline Class
A
nicotine partial agonist
17
Q
Buproprion Class
A
antidepressant
18
Q
Diltiazem Class
A
calcium channel blocker
19
Q
Verapamil Class
A
calcium channel blocker
20
Q
Epoprostenol Class
A
prostacyclin analog
21
Q
Bosentan Class
A
endothelin receptor antagonist
22
Q
Sildenafil Class
A
phosphodiesterase inhibitor
23
Q
Roflumilast Class
A
phosphodiesterase inhibitor
24
Q
Unfractionated heparin (UFH) Class
A
antithrombin agent
25
Low molecular weight heparin (LMWH) Class
antithrombin agent
26
Fondaparinux Class
antithrombin agent
27
Warfarin Class
oral anticoagulant
28
Pirfenidone Class
drugs in IPF
29
Nintenadib Class
drugs in IPF
30
Albuterol, terbutaline, Salmeterol mechanism
bronchodilator
31
Chromolyn sodium mechanism
prevents the release of histamine, etc, from mast cells
32
Omalizumab mechanism
IgE binding in circulation
33
Zafirlukast, Montelukast mechanism
leukotreine D4 (LTD4) receptor antangonist
34
Zileuton mechanism
inhibits 5-lipoxygenase
35
Prednisone, Beclomethasone, Busesonide, Fluticasone mechanism
upregulate expression of anti-inflammatory genes & genes that increase gluconeogenesis, downregulates proinflammatory genes
36
Ipratropium, Tiotropium mechanism
blocks muscarinic acetylcholine receptors in lung smooth muscle, allowing bronchi to stay open
37
Nicotine patch, lozenge, gum, inhaler, spray mechanism
delivers nicotine so pt. does not have to smoke
38
Varenicline mechanism
oral partial agonist of alpha4beta2 subunit of nicotinic ACh receptor, stimulates receptor (decreases withdrawal), and blocks nicotine from binding (reduces reward)
39
Buproprion mechanism
non-competitive nicotinic antagonist, increased dopamine transmission in brain
40
Diltiazem, Verapamil mechanism
block L-type calcium channel receptors in smooth muscle, resulting in vasodilation
41
Epoprostenol mechanism
mimics prostacylin in the prostacyclin pathway, stimulares adenylate cyclase, causing increased cAMP and vasodilation, antiproliferation, and antiplatelet aggregation
42
Bosentan mechanism
blocks endothelin A & B receptors on smooth muscles, cardiac myocytes, and endothelial cells (B only), preventing sustained vasoconstriction and proliferation of vascular smooth muscle cells
43
Sildenafil mechanism
Inhibits PDE-5, thus inhibiting deactivation of cGMP in NO pathway, causes vasodilation and antiproliferation
44
Roflumilast mechanism
oral PDE-4 inhibitor, decreases airway inflammation and promotes airway smooth muscle relaxation
45
Unfractionated heparin (UFH) mechanism
complexes with antithrombin to inactivate thrombin
46
Low molecular weight heparin (LMWH), Fondaparinux mechanism
complexes with antithrombin to inactivate factor Xa
47
Warfarin mechanism
inhibits vit. K dependent gamma-carboxylation of factors II, VII, IX, and X
48
Pirfenidone mechanism
inhibits release of proinflammatory cytokines, attentuates fibroblast proliferation, inhibits release of TGF-beta, and inhibits collagen synthesis
49
Nintenadib mechanism
growth factor/angiokinase inhibitor at the vascular endothelial growth factor, fibroblast growth factor, and platelet derived growth factor receptors
50
Albuterol, Terbutaline indications
Step 1 asthma (intermittent); used in emergency situations to reduce/eliminate SOB, coughing, and wheezing, Symptom relief and increase FEV1 for COPD, acute COPD exacerbation
51
Salmeterol indications
Used in combination with ICS in persistent asthma, steps 3-6, Controller medication for COPD (decreases symptoms and acute exacerbation rate, increases FEV1)
52
Chromolyn sodium indications
Used to prevent wheezing, SOB, and trouble breathing caused by asthma
53
Omalizumab indications
Used in cases of allergic asthma triggers, particularly in steps 5 & 6 persistent asthma
54
Zafirlukast, Montelukast, Zileuton indications
Alternate treatment in cases of persistent asthma, steps 2 and in combination with ICS in steps 3 & 4
55
Prednisone indications
Used as both emergency and long-term controller situations for asthma
56
Beclomethasone, Budesonide, Flucasone indications
Used in combination with LABA, LTRA, or theophylline for persistent asthma, steps 2-6; Controller medication for COPD (decreases symptoms and acute exacerbation rate, increases FEV1)
57
Ipratropium indications
Symptom relief and increases FEV1 for COPD (slower than SABA), acute COPD exacerbation
58
Tiotropium indications
Controller medication for COPD (decreases symptoms and acute exacerbation rate, increases FEV1)
59
Nicotine patch, lozenge, gum, inhaler, spray indications
Smoking cessation
60
Varenicline indications
Smoking cessation – can quit smoking 1 week after initiating therapy
61
Buproprion indications
Smoking cessation – reduces severity of nicotine cravings and withdrawal symptoms
62
Diltiazem, verapamil indications
PAH for patients who are highly vasoreactive (robust acute responder)
63
Epoprostenol indications
Improves hemodynamics, functional capacity, and survival in patients with pulmonary artery hypertension, high and lower risk patients
64
Bosentan indications
Improve hemodynamics and functional capacity in PAH patients
65
Sildenafil indications
Improves hemodynamics and functional capacity in patients with pulmonary artery hypertension, high and lower risk patients
66
Roflumilast indications
Improves FEV1 and decreases exacerbation rate in COPD
67
Unfractionated heparin (UFH) indications
Initial therapy for DVT
68
Low molecular weight heparin (LMWH) indications
Initial therapy for DVT, but reduces VTE and bleeding compared to UFH, for PE in unstable pts. and those w/high bleeding risk, VTE prevention (also Heparin)
69
Fondaparinux indications
initial therapy for DVT, equal to LMWH, PE in hemodynamically stable pts
70
Warfarin indications
prevention of recurrent DVT and PE
71
Pirfenidone indications
slows the course of disease progression in IPF
72
Nintenadib indications
may have efficacy in IPF
73
Albuterol, terbutaline side effects
Tachycardia, palpitations, tremor, hypokalemia
74
Salmeterol side effects
Tachycardia, palpitations, tremor, hypokalemia, increased risk of COPD exasperation, asthma death?
75
Chromolyn sodium side effects
Sore throat, bad taste, stomach pain, cough, stuffy nose, itching or burning in nasal passages, sneezing, headache
76
Omalizumab side effects
possible anaphylaxis (rare)
77
Zafirlukast side effects
Cough or hoarseness, fever, chills, lower back or side pain, pain, pain or difficult urination
78
Montelukast side effects
GI disturbances, headaches, hypersensitivity reactions, sleep disorders, bleeding tendency
79
Zileuton side effects
Sinusitis, nausea, pharyngolaryngeal pain
80
Prednisone side effects
Adrenal suppression, growth suppression, osteoporosis, muscle weakness, hypertension, weight gain, diabetes, cataracts, Cushing’s syndrome, dermal thinning
81
Beclomethasone, budesonide, Fluticasone side effects
Oropharyngeal thrush, cataracts, osteoporosis, increased risk of pneumonia in COPD patients?
82
Ipratropium, tiotropium side effects
dry mouth
83
Nicotine patch, lozenge, gum, inhaler, spray side effects
Headache, nausea and GI problems, difficulty getting to sleep (with patch especially), may not be safe in pregnancy
84
Varenicline side effects
nausea, headache, insomnia, abnormal dreams; depression, suicidal thoughts and actions; small increased risk of adverse events in pts with cardiovascular disease
85
Buproprion side effects
insomnia, headache, changes in behavior: hostility, agitation, depressed mood and suicidal thought
86
Diltiazem side effects
Dizziness, headache, flushing, weakness, bradycardia, GI sx, coughing
87
Verapamil side effects
Don’t take verapamil with beta blockers due to risk of severe bradycardia
88
Epoprostenol, Sildenafil side effects
Headache, dizziness, flushing, nasal congestion; jaw pain, delivery system problems; cautious use in hypotensive pts, intrinsic lung disease, elevated LA pressure. ALWAYS WEAN to avoid withdrawal
89
Bosentan side effects
Teratogenic, peripheral edema, anemia
90
Roflumilast side effects
diarrhea, weightloss
91
Unfractionated heparin (UFH) side effects
bleeding
92
Low molecular weight heparin (LMWH), Fondaparinux side effects
Caution in specific populations, such as pregnant women, elderly, obese, renal disease
93
Warfarin side effects
interaction with diet, genetics, multiple drugs. Teratogenic
94
Albuterol, Terbutaline notes
Oral has more side effects than inhaled. For COPD, albuterol is used with ipratropium
95
Salmeterol used with what in COPD?
used with a steroid for COPD, use only with another controller (such as ICS)
96
Chromolyn sodium no longer available as?
no longer available as inhalation (replaced by LTRAs)
97
Omalizumab, Montelukast associated with
possibly associated with Churg-Strauss (allergic granulomatosis)
98
Prednisone oral unless
oral preferred to IV for pts w/o altered mental status
99
Beclomethasone, Budesonide, Flucasone not used where?
| Used with what for COPD?
not used in ED, sometimes used with LABA from COPD
100
Ipratropium used with what for COPD
for COPD, sometimes used with albuterol
101
Nicotine patch, lozenge, gum, inhaler, spray quit rate
6mo quit rate: 25%
102
Varenicline quit rate
6mo quit rate: 24%
103
Buproprion quit rate
6mo quit rate: 33%
104
Epoprostenol administered
IV only
105
Bosentan is old or new?
newer drug
106
Sildenafil administered
Oral, IV
| roflumilast is oral
107
Roflumilast has not been studied in combination with
ICS
108
Unfractionated heparin (UFH):
administeration and window?
reverses with?
crosses the placenta?
IV, narrow therapeutic window, reversible with protamine, does not cross placenta
109
Low molecular weight heparin (LMWH):
| administration
subcutaneous injection
