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pharmacology > pulm moa > Flashcards

pulm moa Flashcards

1
Q

Goal of therapy asthma and bronchitis

A

dec airways resistance by increasing diameter of bronchi and decrease mucous secretion

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2
Q

Early phase response asthma

A

inflammatory mediators such as leukotrienes, histamine, and prostaglandin D2s are released

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3
Q

late phase response asthma

A

fibrin and collagen are deposited in tissue

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4
Q

Mast cells- release

A

histamine and leukotrienes

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5
Q

Eosinophils-

A

release enzymes when foreign cells are encountered

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6
Q

Leukotrienes- cause

A

bronchoconstriction

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7
Q

IL4 and IL5 are

A

cytokines that signal molecules between cells

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8
Q

line of trmt for asthma

A
  1. saba
  2. ics
  3. laba
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9
Q

Albuterol moa

A

B2 agonist in airway smooth muscle causing muscle relaxation and bronchodilation

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10
Q

levalbuterol moa

A

B2 agonist in airway smooth muscle causing muscle relaxation and bronchodilation

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11
Q

saba cautionary

A

paradoxical bronchospasm, hx CV disorders

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12
Q

Primatene Mist moa

A

Same as EPI- activates B1, B2, and A1 causing bronchodilation, inc HR, and vasoconstriction

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13
Q

Ipratropium
Ipratorpium + albuterol
moa

A

Competitive antagonists for ACh at muscarinic receptors- inhibit ACh from constricting the bronchial airways

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14
Q

Ipratropium

Ipratorpium + albuterol se

A

dec sludge

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15
Q

Contraindications
Ipratropium
Ipratorpium + albuterol

A

soy and peanuts

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16
Q

Cautionary
Ipratropium
Ipratorpium + albuterol

A

paradoxical bronchospasm, hx of CV disorders, worsening of urinary retention

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17
Q

Short term asthma: Systemic corticosteroids moa

A

Inhibits release of antiinflammatory mediators- reduces synthesis of Phospholipase A2 so arachidonic acid can’t be made which causes lipoxygenase and cyclooxygenase to not be able to be made. This all causes leukotrienes and PG to be reduced. This means that inflammation is reduced and bronchodilation occurs over time

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18
Q

Short term asthma: Systemic corticosteroids se

A

glucose metabolism and fluid retention

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19
Q

diff btwn systemic and inhaled corticosteroids

A

theyre not systemic… they bypass 1st pass effect

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20
Q

se inhaled corticosteroids

A

candida albicans thrush

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21
Q

Contraindication inhaled corticosteroids

A

acute asthma attack

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22
Q

Caution inhaled corticosteroids

A

NOT a bronchodilator… not used for instant relief

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23
Q

inhaled corticosteroids moa

A

Inhibits release of antiinflammatory mediators- reduces synthesis of Phospholipase A2 so arachidonic acid can’t be made which causes lipoxygenase and cyclooxygenase to not be able to be made. This all causes leukotrienes and PG to be reduced. This means that inflammation is reduced and bronchodilation occurs over time

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24
Q

Salmeterol

A

MOA: B2 agonist in airway smooth muscle causing muscle relaxation and bronchodilation
Same as SABA, but longer duration (12 hrs vs 4-6)

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25
Q

Formoterol

A

MOA: B2 agonist in airway smooth muscle causing muscle relaxation and bronchodilation
Same as SABA, but longer duration (12 hrs vs 4-6)

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26
Q

Contraindication long term asthma LABA

A

asthma trmt with LABA alone

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27
Q

NEVER use____ alone in asthma… it’s a BBW… increased risk of asthma related death

A

LABA

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28
Q

Contraindications Long term asthma meds: Inhaled corticosteroids + LABA

A

acute asthma attacks

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29
Q

Fluticasone/salmeterol moa

A

MOA: dec inflammation and bronchodilation

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30
Q

Postmarketing SE for Mometasone/formoterol and Budesonide/formoterol:

A

angina pectoris, cardiac arrhythmias, and QT prolongation

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31
Q

Long term asthma meds: Inhaled corticosteroids + LABA

cautions

A

candida albicans infection, not bronchodilator

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32
Q

Fluticasone/vilanterol

moa

A

MOA: dec inflammation and bronchodilation

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33
Q

BBW: removed in 2017

A

Long term asthma meds: Inhaled corticosteroids + LABA

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34
Q

Mometasone/formoterol moa

A

MOA: dec inflammation and bronchodilation

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35
Q

Montelukast moa

A

antagonizes leukotriene receptors which prevent airway edema, smooth muscle contractions, and help secretions of thick mucus

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36
Q

Budesonide/formoterol

moa

A

MOA: dec inflammation and bronchodilation

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37
Q

Zafirlukast moa

A

antagonizes leukotriene receptors which prevent airway edema, smooth muscle contractions, and help secretions of thick mucus

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38
Q

Contraindications Montelukast and Zafirlukast

A

not used to acute asthma attacks

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39
Q

Theophylline moa

A

causes bronchodilation either by…

Adenosine receptor antagonist OR inhibiting phosphodiesterase (PDE 3 and PED4)

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40
Q

Zileuton moa

A

inhibits lipoxygenase which converts arachidonic acid to leukotrienes thus inhibiting leukotriene formation

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41
Q

Aminophylline moa

A

causes bronchodilation either by…

Adenosine receptor antagonist OR inhibiting phosphodiesterase (PDE 3 and PED4)

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42
Q

Zileuton se

A

elevates liver enzymes

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43
Q

Structurally similar to caffeine

A

Theophylline and aminophylline

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44
Q

se Theophylline and aminophylline

A

CNS side effects such as HA, insomnia, irritability, restlessness, seizures, tachycardia, difficulty urinating in males (bc its like caffeine)

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45
Q

Long term asthma meds: Methylxanthines

contra

A

not for acute asthma attacks

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46
Q

Narrow therapeutic index!

A

Long term asthma meds: Methylxanthines

47
Q

There are inhibitors and inducers (remember inhibitors dec Cl and inc F)

A

Theophylline

48
Q

Cromolyn sodium

moa

A

mast cell stabilizer- prevents release of histamine, leukotrienes, and cytokines

49
Q

ContraindicationsCromolyn sodium

A

acute asthma attack

50
Q

Omalizumab moa

A

blocks binding of IgE to mast cells, basophils, and other cells associate with allergic response

51
Q

Omalizumab bbw

A

anaphylaxis, bronchospasm, hypotension, syncope, urticaria, angioedema of the tongue or throat… can occur yrs after taking the medication

52
Q

Indacaterol moa

A

MOA: works on B2 to relax bronchial smooth muscle

53
Q

laba 2 cautions

A

can produce paradoxical bronchospasms and cv effects such as inc hr or bp

54
Q

Aclidinium moa

A

MOA: Competitive antagonists for ACh at muscarinic receptors- inhibit ACh from constricting the bronchial airways

55
Q

Arformoterol moa

A

MOA: works on B2 to relax bronchial smooth muscle

56
Q

Reslizumab

A

IL5 receptor antagonists- reduces eosinophils

57
Q

Olodaterol moa

A

MOA: works on B2 to relax bronchial smooth muscle

58
Q

Mepolizumab

A

IL5 receptor antagonists- reduces eosinophils

59
Q

Dupilumab

A

IL 4 receptor antagonist- inhibits release of proinflammatory cytokines, chemokines, and IgE

60
Q

Benralizumab

A

IL5 receptor antagonists- reduces eosinophils

61
Q

BBW Reslizumab:

A

anaphylaxis

62
Q

Glycopyrrolate

A

MOA: Competitive antagonists for ACh at muscarinic receptors- inhibit ACh from constricting the bronchial airways

63
Q

Aclidinium/formoterol

moa

A

MOA: block ACh which leads to bronchodilation; longer acting bronchodilation

64
Q

Umeclidinium/ vilanterol

moa

A

MOA: block ACh which leads to bronchodilation; longer acting bronchodilation

65
Q

Glycopyrrolate/formoterol

moa

A

MOA: block ACh which leads to bronchodilation; longer acting bronchodilation

66
Q

Umeclidinium

A

MOA: Competitive antagonists for ACh at muscarinic receptors- inhibit ACh from constricting the bronchial airways

67
Q

COPD: anticholinergic + LABA

contra

A

Contraindications: contraindicated in asthma pts without use of long term asthma control medication

68
Q

Tiotropium

A

MOA: Competitive antagonists for ACh at muscarinic receptors- inhibit ACh from constricting the bronchial airways

69
Q

Glycopyrrolate/Indacterol

moa

A

MOA: block ACh which leads to bronchodilation; longer acting bronchodilation

70
Q

COPD: anticholinergic + LABA

cautions

A

Cautions: paroxysmal bronchospasms, LABA can cause significant CV effects (inc hr and bp)

71
Q

COPD: anticholinergic + LABA

bbw

A

in risk asthma related death

72
Q

Tiotropium/olodaterol

moa

A

MOA: block ACh which leads to bronchodilation; longer acting bronchodilation

73
Q

Roflumilast moa

A

MOA: Selective inhibitors of phosphodiesterase type 4, an enzyme that metabolizes cAMP; leads to relaxation of bronchial smooth muscles

74
Q

Roflumilast se

A

SE= mental health issues

75
Q

Roflumilast contra

A

moderate to severe liver impairment

76
Q

Mast cells

A

store histamine; highest conc. In nose and eye

77
Q

where are Basophils located

A

blood and deeper tissue

78
Q

Histamine acts on

A

H1 receptor

79
Q

histamine causes

A

Causes vasodilation, sneezing, itching, edema, contraindication of bronchial smooth muscle

80
Q

In the drink Lean or Purple Drank

Commonly combined with codeine cough syrup

A

Promethazine

81
Q

Most OTC sleep aids are ___ generation antihistamines

A

1st

82
Q

Lipophilic and easily cross the BBB

A

1st generation antihistamines

83
Q

SE 1st generation antihistamines

A

SE= sedation and CNS depression, VERY anticholinergic so they dec sludge, can cause paradoxical CNS stimulation in kids

84
Q

Fexofenadine moa

A

selective for H1 receptors;

85
Q

Diphenhydramine moa

A

MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine

86
Q

Cetirizine moa

A

selective for H1 receptors;

87
Q

Bromopheniramine moa

A

MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine

88
Q

Chloropheniramine moa

A

MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine

89
Q

Loratadine moa

A

selective for H1 receptors;

90
Q

Levocetirizine moa

A

selective for H1 receptors;

91
Q

Clemastine moa

A

MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine

92
Q

Desloratadine moa

A

selective for H1 receptors;

93
Q

Doxylamine moa

A

MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine

94
Q

Dimenhydrinate moa

A

MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine

95
Q

Azelastine moa

A

MOA: competes with histamine for H1 receptor sites

96
Q

Hydroxyzine moa

A

MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine

97
Q

Olopatadine moa

A

MOA: competes with histamine for H1 receptor sites

98
Q

Cyproheptadine moa

A

MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine

99
Q

cough assoc with underlying inflammatory process

A

productuve

100
Q

cough stimulated by irritant or inflammation; can damage respiratory structures

A

nonprod

101
Q

Meclizine moa

A

MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine

102
Q

mucinex moa

A

MOA: inc resp tract fluid and reduces viscosity

103
Q

Lipophobic and does NOT cross the BBB; CNS penetration is minimal to none

A

2nd generation antihistamines

104
Q

2nd generation antihistamines se

A

SE= non sedating and non anticholinergic properties

105
Q

Guaifenesin moa

A

MOA: inc resp tract fluid and reduces viscosity

106
Q

Dextromethorphan moa

A

MOA: acts on cough receptor in medulla; interrupts cough impulse transmission

107
Q

Contraindications dxm

A

MAOI- can lead to serotonin syndrome

108
Q

Currently a drug of abuse: robotripping

Drinking excessive amts of _____ and overdose

A

Dextromethorphan

109
Q

Tessalon perles/ Benzonatate

moa

A

MOA: non narcotic antitussive- anesthetizes receptors in resp passages and lungs

110
Q

Codeine/Guaifenesin

moa

A

MOA: narcotic analgesic that acts in the medulla to inc urge to cough

111
Q

Codeine/Guaifenesin/ PSE

moa

A

MOA: narcotic analgesic that acts in the medulla to inc urge to cough

112
Q

hydrocodone/chlorpheniramine

moa

A

MOA: narcotic analgesic that acts in the medulla to inc urge to cough

113
Q

bbw Codeine Cough suppressants/ antitussives

A

BBW: respiratory depression and death have occurred in kids; ultra rapid metabolizers of codeine dt CYP2D6

114
Q

hydrocodone/homatropine

moa

A

MOA: narcotic analgesic that acts in the medulla to inc urge to cough

pharmacology (16 decks)

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