Pulmonary Flashcards
Drug class for Fluticasone
Anti-inflammatory: inhaled glucocorticoid
MoA for Fluticasone
anti-inflammatory, immunosuppresive, anti-proliferative activity
Indications for Fluticasone
asthma, COPD
SE/ADRs for Fluticasone
HA, oral thrush, URI, throat irritation, cough
Contra-indications for Fluticasone
hypersensitivity, acute bronchospasm, latent TB, glaucoma, cataracts
DX-DX interactions for Fluticasone
via inhalation minimal
Monitoring for Fluticasone
spirometry (peak flow meter)
PG category for Fluticasone
PG C
How might Fluticasone affect children?
possibly growth slowing but ‘catch up’
Drug class for Prednisone
Anti-inflammatory: oral glucocorticoid
MoA for Prednisone
anti-inflammatory early after admin by decreasing migration of WBC, reversal of capillary permeability, immunosuppressant; later onset of inhibition of protein synthesis
Indications for Prednisone
adjunct therapy in exacerbation of bronchospasms; multiple others
SE/ADRs for Prednisone
short term: minimal
longer than 10-14 days: multiple systemic
Contra-indications for Prednisone
hypersensitivity, acute bronchospasm (unless as adjunct), latent TB, glaucoma, cataracts
DX-DX interactions for Prednisone
tNSAIDs
anti-diabetic meds
anti-HTN meds
Monitoring for Prednisone
spirometry
PG category for Prednisone
caution in PG
Drug class for Cromolyn MDI
Anti-inflammatory: mast cell stabilizer
MoA for Cromolyn MDI
stabilizes mast cell membrane to prevent degranulation & release of histamine, leukotrienes, slow-rxn substance of anaphylaxis
Indications for Cromolyn MDI
childhood asthma
SE/ADRs for Cromolyn MDI
HA, unpleasant taste, hoarseness, cough
Contra-indications for Cromolyn MDI
hypersensitivity, acute asthma
DX-DX interactions for Cromolyn MDI
none
Monitoring for Cromolyn MDI
spirometry
PG category for Cromolyn MDI
PG B
Drug class for Zafirlukast
Anti-inflammatory: oral leukotriene receptor antagonist
MoA for Zafirlukast
selective & competitive antagonist of leukotriene receptors D4 & E4, SRSA
Indications for Zafirlukast
asthma
SE/ADRs for Zafirlukast
HA, N/D, hepatitis
Contra-indications for Zafirlukast
hypersensitivity
acute exacerbation of asthma
caution in alcoholic cirrhosis
DX-DX interactions for Zafirlukast
concomitant food decreases bioavailability by 40%
Monitoring for Zafirlukast
spirometry, LFT
PG category for Zafirlukast
PG B
Drug class for Salmeterol
Bronchodilator: inhaled long-acting Beta2 Adrenergic Agonist (LABA)
MoA for Salmeterol
selective, long-acting Beta2 adrenergic agonist
Indications for Salmeterol
long term control of COPD, asthma control; EIB
SE/ADRs for Salmeterol
HA, muscle pain, anxiety, insomnia
Contra-indications for Salmeterol
acute asthma/COPD; seizure d/o; CVD; diabetes, hyperthyroidism
DX-DX interactions for Salmeterol
increase levels of loop diuretics, sympathomimetics; levels increased by CYP3A4 inhibitors; impact decrease by Beta Blockers
Monitoring for Salmeterol
spirometry, HR, BP, glucose
PG category for Salmeterol
PG C
Drug class for Formoterol
Bronchodilators: inhaled long-acting Beta2 adrenergic agonist (LABA)
MoA for Formoterol
long acting Beta2 agonist
Indications for Formoterol
long term control COPD, asthma w/ steroid MDI
SE/ADRs for Formoterol
tremor, chest pain, palpitations, anxiety, insomnia, muscle cramps
Contra-indications for Formoterol
acute asthma/COPD, active CVD
DX-DX interactions for Formoterol
increase levels of loop diuretics, sympathomimetics, effect decreased by Beta Blockers
Monitoring for Formoterol
spirometry, HR, BP, glucose
PG category for Formoterol
PG C
Drug class for Albuterol
Bronchodilators: inhaled short-acting Beta2 adrenergic agonist (SABA)
MoA for Albuterol
bronchial smooth muscle Beta2 (sympathetic) receptor stimulation; racemic mix w/ R isomer active & S isomer inactive
Indications for Albuterol
bronchospasm in asthma & COPD, EIB
SE/ADRs for Albuterol
angina, increase/decrease BP, arrhythmias, palpitations, CNS stimulation, angioedema, restlessness, wakefulness
Contra-indications for Albuterol
caution w/ HTN, CHF, arrhythmias, seizure d/o, diabetes, glaucoma, hyperthyroidism, low serum K+
DX-DX interactions for Albuterol
beta blockers
Monitoring for Albuterol
spirometry
PG category for Albuterol
PG C
Drug class for Theophyline
Bronchodilators: Oral/IV PDE inhibitor/ methylxanthine
MoA for Theophyline
PDE blockade causes increased levels of cAMP which produces bronchodilation, diuresis, CNS & cardiac stimulation, release of epi
Indications for Theophyline
reversal of bronchospasm
SE/ADRs for Theophyline
tachycardia, HA, insomnia, seizures
Contra-indications for Theophyline
CVD, HTN, hyperthyroidism, peptic ulcers, seizure d/o