Pulm - Pharmacology Flashcards
Besides short-acting beta-2 agonists, what other medication type is useful for quick relief of asthma symptoms (especially for severe cases)?
Anticholinergics
What is the preferred medication type for long-term asthma control?
Inhaled corticosteroids
Besides inhaled corticosteroids, what other four medication types can be used for long-term asthma control?
Long-acting beta-2 agonists,
oral corticosteroids,
anti-IgE antibodies (e.g. omalizumab),
leukotriene antagonists
What are the two first-line medication types you should select from in treating either typical or atypical pneumonia in a patient with no underlying disease?
- Macrolides
- Doxycycline
What medication type(s) should you select from in treating either typical or atypical pneumonia in a patient with underlying comorbidities (e.g. CHF, diabetes, splenectomy, hospitalization, alcoholism, etc.)?
Fluoroquinolones (respiratory)
What medication type(s) should you select from in treating either typical or atypical pneumonia in a patient who has been treated with either macrolides or doxycycline within the past 3 months?
Fluoroquinolones (respiratory)
True/False.
First-line agents in treating pneumonia are always antibiotics that act at the cell wall.
False.
Start with macrolides or doxycycline.
What is the treatment regimen for tuberculosis (ignore timeframes)?
(5 drugs)
RIPE + streptomycin
(rifampin, isoniazid, pyrazinamide, ethambutol)
What is the treatment regimen for infection with MAC (M. avium complex)?
(4 drugs)
Rifabutin, azithromycin, clarithromycin, ethambutol
(RACE)
What is the treatment regimen for Hansen’s disease (infection with M. leprae)?
(4 drugs)
Rifampin, dapsone, clofazimine, thalidomide
(RDCT)
Because beta-2 agonists can worsen ventilation/perfusion mismatch and worsen hypoxemia by increasing blood flow to poorly ventilated areas of the lung, you must use what first in cases of acute asthma exacerbation?
Oxygen therapy
Inhaled corticosteroids have a _________ (rapid/slow) onset of action and have _________ (more/fewer) side effects when compared to oral corticosteroids.
Inhaled corticosteroids have a slow onset of action and have fewer side effects when compared to oral corticosteroids.
What negative side effects are associated with lower doses of theophylline?
Mild cortical arousal
+
deferral of fatigue
What negative side effects are associated with higher doses of theophylline?
Convulsions,
cardiac arrhythmias,
death
True/False.
Beta-2 agonists can be used to increase V/Q matching.
False.
Beta-2 agonists can worsen V/Q mismatch and worsen hypoxemia by increasing blood flow to poorly ventilated areas of the lung.
After being activated by cAMP, PKA phosphorylates the following 3 targets to produce the bronchodilator effect:
After being activated by cAMP, PKA phosphorylates the following 3 targets to produce the bronchodilator effect:
MLCK
PI/Ca2+
KCa channels
Why is cromolyn sodium rarely used in asthma management?
Low efficacy
Patients with asthma need supplemental oxygen if their pO2 gets below _____%.
Patients with asthma need supplemental oxygen if their pO2 gets below 90%.
Oral corticosteroids are only used for asthma management in what two scenarios?
- Severe asthma
- In a blocked airway
Which leukotriene receptor is preferable due to favorable dosing and fewer side effects (e,g, liver toxicity)?
Montelukast
Rescue treatments for asthma are not enough (i.e. control is also needed) if the rescue treatment must be used > ___ times per week.
Rescue treatments for asthma are not enough (i.e. control is also needed) if the rescue treatment must be used > 2 times per week.
What is status asthmaticus?
What medication which acts largely at the level of gene transcription should be administered i.v.?
Severe, acute attack that is resistant to short-acting beta agonists;
corticosteroids
When should leukotriene receptor antagonists be used as monotherapy for asthma?
Never!
(Increased risk of asthma-related death (poorly understood))
Omalizumab (an anti-IgE antibody) has an associated risk of __________.
Omalizumab (an anti-IgE antibody) has an associated risk of anaphylaxis.
