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Pulmonary Flashcards

1
Q

Drug class for Fluticasone

A

Anti-inflammatory: inhaled glucocorticoid

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2
Q

MoA for Fluticasone

A

anti-inflammatory, immunosuppresive, anti-proliferative activity

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3
Q

Indications for Fluticasone

A

asthma, COPD

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4
Q

SE/ADRs for Fluticasone

A

HA, oral thrush, URI, throat irritation, cough

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5
Q

Contra-indications for Fluticasone

A

hypersensitivity, acute bronchospasm, latent TB, glaucoma, cataracts

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6
Q

DX-DX interactions for Fluticasone

A

via inhalation minimal

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7
Q

Monitoring for Fluticasone

A

spirometry (peak flow meter)

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8
Q

PG category for Fluticasone

A

PG C

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9
Q

How might Fluticasone affect children?

A

possibly growth slowing but ‘catch up’

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10
Q

Drug class for Prednisone

A

Anti-inflammatory: oral glucocorticoid

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11
Q

MoA for Prednisone

A

anti-inflammatory early after admin by decreasing migration of WBC, reversal of capillary permeability, immunosuppressant; later onset of inhibition of protein synthesis

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12
Q

Indications for Prednisone

A

adjunct therapy in exacerbation of bronchospasms; multiple others

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13
Q

SE/ADRs for Prednisone

A

short term: minimal

longer than 10-14 days: multiple systemic

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14
Q

Contra-indications for Prednisone

A

hypersensitivity, acute bronchospasm (unless as adjunct), latent TB, glaucoma, cataracts

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15
Q

DX-DX interactions for Prednisone

A

tNSAIDs
anti-diabetic meds
anti-HTN meds

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16
Q

Monitoring for Prednisone

A

spirometry

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17
Q

PG category for Prednisone

A

caution in PG

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18
Q

Drug class for Cromolyn MDI

A

Anti-inflammatory: mast cell stabilizer

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19
Q

MoA for Cromolyn MDI

A

stabilizes mast cell membrane to prevent degranulation & release of histamine, leukotrienes, slow-rxn substance of anaphylaxis

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20
Q

Indications for Cromolyn MDI

A

childhood asthma

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21
Q

SE/ADRs for Cromolyn MDI

A

HA, unpleasant taste, hoarseness, cough

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22
Q

Contra-indications for Cromolyn MDI

A

hypersensitivity, acute asthma

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23
Q

DX-DX interactions for Cromolyn MDI

A

none

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24
Q

Monitoring for Cromolyn MDI

A

spirometry

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25
Q

PG category for Cromolyn MDI

A

PG B

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26
Q

Drug class for Zafirlukast

A

Anti-inflammatory: oral leukotriene receptor antagonist

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27
Q

MoA for Zafirlukast

A

selective & competitive antagonist of leukotriene receptors D4 & E4, SRSA

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28
Q

Indications for Zafirlukast

A

asthma

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29
Q

SE/ADRs for Zafirlukast

A

HA, N/D, hepatitis

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30
Q

Contra-indications for Zafirlukast

A

hypersensitivity
acute exacerbation of asthma
caution in alcoholic cirrhosis

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31
Q

DX-DX interactions for Zafirlukast

A

concomitant food decreases bioavailability by 40%

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32
Q

Monitoring for Zafirlukast

A

spirometry, LFT

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33
Q

PG category for Zafirlukast

A

PG B

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34
Q

Drug class for Salmeterol

A

Bronchodilator: inhaled long-acting Beta2 Adrenergic Agonist (LABA)

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35
Q

MoA for Salmeterol

A

selective, long-acting Beta2 adrenergic agonist

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36
Q

Indications for Salmeterol

A

long term control of COPD, asthma control; EIB

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37
Q

SE/ADRs for Salmeterol

A

HA, muscle pain, anxiety, insomnia

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38
Q

Contra-indications for Salmeterol

A

acute asthma/COPD; seizure d/o; CVD; diabetes, hyperthyroidism

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39
Q

DX-DX interactions for Salmeterol

A

increase levels of loop diuretics, sympathomimetics; levels increased by CYP3A4 inhibitors; impact decrease by Beta Blockers

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40
Q

Monitoring for Salmeterol

A

spirometry, HR, BP, glucose

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41
Q

PG category for Salmeterol

A

PG C

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42
Q

Drug class for Formoterol

A

Bronchodilators: inhaled long-acting Beta2 adrenergic agonist (LABA)

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43
Q

MoA for Formoterol

A

long acting Beta2 agonist

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44
Q

Indications for Formoterol

A

long term control COPD, asthma w/ steroid MDI

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45
Q

SE/ADRs for Formoterol

A

tremor, chest pain, palpitations, anxiety, insomnia, muscle cramps

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46
Q

Contra-indications for Formoterol

A

acute asthma/COPD, active CVD

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47
Q

DX-DX interactions for Formoterol

A

increase levels of loop diuretics, sympathomimetics, effect decreased by Beta Blockers

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48
Q

Monitoring for Formoterol

A

spirometry, HR, BP, glucose

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49
Q

PG category for Formoterol

A

PG C

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50
Q

Drug class for Albuterol

A

Bronchodilators: inhaled short-acting Beta2 adrenergic agonist (SABA)

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51
Q

MoA for Albuterol

A

bronchial smooth muscle Beta2 (sympathetic) receptor stimulation; racemic mix w/ R isomer active & S isomer inactive

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52
Q

Indications for Albuterol

A

bronchospasm in asthma & COPD, EIB

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53
Q

SE/ADRs for Albuterol

A

angina, increase/decrease BP, arrhythmias, palpitations, CNS stimulation, angioedema, restlessness, wakefulness

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54
Q

Contra-indications for Albuterol

A

caution w/ HTN, CHF, arrhythmias, seizure d/o, diabetes, glaucoma, hyperthyroidism, low serum K+

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55
Q

DX-DX interactions for Albuterol

A

beta blockers

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56
Q

Monitoring for Albuterol

A

spirometry

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57
Q

PG category for Albuterol

A

PG C

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58
Q

Drug class for Theophyline

A

Bronchodilators: Oral/IV PDE inhibitor/ methylxanthine

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59
Q

MoA for Theophyline

A

PDE blockade causes increased levels of cAMP which produces bronchodilation, diuresis, CNS & cardiac stimulation, release of epi

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60
Q

Indications for Theophyline

A

reversal of bronchospasm

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61
Q

SE/ADRs for Theophyline

A

tachycardia, HA, insomnia, seizures

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62
Q

Contra-indications for Theophyline

A

CVD, HTN, hyperthyroidism, peptic ulcers, seizure d/o

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63
Q

DX-DX interactions for Theophyline

A

levels increased by multiple CYP1A2, CYP3A4 inhibitor drugs

64
Q

Monitoring for Theophyline

A

Theophylline level, spirometry, HR, BP, glucose

65
Q

PG category for Theophyline

66
Q

Drug class for Levalbuterol

A

Bronchodilators: inhaled Beta2 adrenergic agonist (SABA)

67
Q

MoA for Levalbuterol

A

rapid acting selective Beta2 receptor agonist counteracts bronchospasm; pure R-isomer of drug

68
Q

Indications for Levalbuterol

A

TX or prevention of bronchospasm in reversible airway disease (asthma, EIB, COPD

69
Q

SE/ADRs for Levalbuterol

A

tremor, rhinitis, viral infection, HA, pharyngitis

70
Q

Contra-indications for Levalbuterol

A

active cardiac disease

71
Q

DX-DX interactions for Levalbuterol

A

increase levels of loop diuretics, sympathomimetics; levels decreased by beta blockers, combination alpha/beta blockers

72
Q

Monitoring for Levalbuterol

A

spirometry, HR, BP

73
Q

PG category for Levalbuterol

74
Q

Drug class for Ipratropium HFA

A

Bronchodilators: inhaled anticholinergic

75
Q

MoA for Ipratropium

A

blocks acetylcholine cholinergic receptors in bronchial smooth muscle to reduce bronchospasm

76
Q

Indications for Ipratropium

A

acute & maintenance tx of bronchospasm in COPD, asthma

77
Q

SE/ADRs for Ipratropium

A

URI, chest pain, palpitations, dyspepsia, xerostomia, dyspnea, flu-like syndrome

78
Q

Contra-indications for Ipratropium

A

narrow angle glaucoma, paradoxical bronchospasm, acute asthma except in conjunction w/ SABA drug; urinary outflow obstruction

79
Q

DX-DX interactions for Ipratropium

A

decrease effect of acetylcholinesterase inhibitors

80
Q

Monitoring for Ipratropium

A

spirometry, HR

81
Q

PG category for Ipratropium

82
Q

Drug class for Tiotropium

A

Bronchodilators: inhaled long-acting anticholinergic

83
Q

MoA for Tiotropium

A

blocks acetylcholine at parasympathetic receptors in bronchial smooth muscle producing bronchodilation

84
Q

Indications for Tiotropium

A

maintenance tx bronchospasm in COPD, asthma

85
Q

SE/ADRs for Tiotropium

A

URI, chest pain, palpitations, dyspepsia, xerostomia, dyspnea, flu-like syndrome

86
Q

Contra-indications for Tiotropium

A

paradoxical bronchospasm, acute bronchospasm, narrow angle glaucoma, urinary tract outflow obstruction

87
Q

DX-DX interactions for Tiotropium

A

decreases effect of acetylcholinesterase inhibitors

88
Q

Monitoring for Tiotropium

A

spirometry, HR

89
Q

PG category for Tiotripium

90
Q

Drug class for Roflumilast

A

Phosphodiesterase 4 inhibitor

91
Q

MoA for Roflumilast

A

drug & active metabolite inhibit PDE4 increased cAMP in inflammatory & structural cells; suppress cytokine release; inhibit lung infiltration by WBCs; decreases pulmonary remodeling

92
Q

Indications for Roflumilast

A

adjunct therapy in COPD (chronic bronchitis)

93
Q

SE/ADRs for Roflumilast

A

HA, wt loss, diarrhea, nausea

94
Q

Contra-indications for Roflumilast

A

moderate to severe liver impairment

95
Q

DX-DX interactions for Roflumilast

A

CYP3A4 inducers decrease serum concentration; Cipro increases serum concentration; Rifampin decreases concentration

96
Q

Monitoring for Roflumilast

A

spirometry

97
Q

PG category for Roflumilast

A

avoid use in PG

98
Q

Drug class for Omalizumab

A

antibody agents

99
Q

MoA for Omalizumab

A

binds to IgE antibody receptors on mast cells, blocking attachment of IgE antibody & preventing degranulation release of histamines & leukotrienes

100
Q

Indications for Omalizumab

A

maintenance tx of allergic asthma not controlled by inhaled steroids

101
Q

SE/ADRs for Omalizumab

A

HA, injection site rxn, URI, pain, anaphylaxis

102
Q

How is Omalizumab administered?

A

Sub-Q every 2-4 weeks

103
Q

Drug class for Nicoderm patch, Nicorette gum, Nicotrol inhaler/nasal spray

A

Nicotine replacement

104
Q

MoA for Nicotine replacement

A

biphasic CNS & ANS nicotine receptor stimulant; low dose- stimulations ANS ganglia; large dose- stimulation follows by blockade of transmission

105
Q

Indications for Nicotine replacement

A

tobacco cessation aid

106
Q

SE/ADRs for Nicotine replacement

A
  • HA, mucosal irritant, cough, rhinitis

- toxicity= tremors, respiratory excitation, convulsions, respiratory failure

107
Q

Contra-indications for Nicotine replacement

A

recent AMI, life-threatening arrhythmias, severe angina, TMJ d/o, hyperthyroidism, T1DM, bronchospastic d/o

108
Q

DX-DX interactions for Nicotine replacement

A

concentration increased by Cimetidine

109
Q

Monitoring for Nicotine replacement

A

HR, BP, insomnia

110
Q

PG category for Nicotine replacement

A

PG D (for nasal spray)

111
Q

Drug class for Varenicline

A

partial nicotine agonist oral

112
Q

MoA for Varenicline

A

prevents nicotine stimulation of the mesolimbic dopamine system

113
Q

Indications for Varenicline

A

tobacco cessation aid

114
Q

SE/ADRs for Varenicline

A

insomnia, HA, abnormal dreams, nausea

115
Q

Contra-indications for Varenicline

A

psychiatric disorders, decreased renal function, active CVD

116
Q

DX-DX interactions for Varenicline

A

none known

117
Q

Monitoring for Varenicline

A

psych changes, tobacco use

118
Q

PG category for Varenicline

119
Q

Drug class for Bupropion

A

atypical antidepressant: oral dopamine reuptake inhibitor

120
Q

MoA for Bupropion

121
Q

Indications for Bupropion

A

tobacco cessation; depression

122
Q

SE/ADRs for Bupropion

A

tachy, HA, insomnia, nausea, xerostomia, wt loss, palpitations, agitation, constipation, diarrhea

123
Q

Contra-indications for Bupropion

A

biopolar disorder, seizure disorder, active CVD, uncontrolled HTN

124
Q

DX-DX interactions for Bupropion

A

MAO inhibitors, ethanol

125
Q

Monitoring for Bupropion

A

psych sxs, tobacco use, BP

126
Q

PG category for Bupropion

127
Q

Drug class for Umeclindinium & Vilanterol

A

combination inhaled long-acting anticholinergic & LABA

128
Q

MoA for Umeclidinium & Vilanterol

A

combination of 2 agents with different bronchodilating action (anti-muscarinic & beta2 agonism)

129
Q

Indications for Umeclidinium & Vilanterol

130
Q

SE/ADRs for Umeclidinium & Vilanterol

A

paradoxical bronchospasm, chest pain, limb pain, pharyngitis

131
Q

Contra-indications for Umeclidinium & Vilanterol

A

severe milk protein allergy, caution w/ glaucoma, comorbid thyrotoxicosis, seizure disorder, prostatic hyperplasia, low K+, diabetes

132
Q

DX-DX interactions for Umeclidinium & Vilanterol

A

multiple but lower risk of occurrence

133
Q

Monitoring for Umeclidinium & Vilanterol

A

FEV1, peak flow, BP, HR, CNS stimulation, eye changes

134
Q

PG category for Umeclidinium & Vilanterol

135
Q

Drug class for Fluticasone/Salmeterol

A

combination product inhaled glucocorticoid & LABA

136
Q

MoA for Fluticasone/Salmeterol

A

anti-inflammatory action of steroid & bronchodilation activity of beta2 agonist

137
Q

Indications for Fluticasone/Salmeterol

A

asthma (maintenance of bronchodilation), asthma

138
Q

SE/ADRs for Fluticasone/Salmeterol

A
  • combo of both drugs

- increased risk of death

139
Q

Contra-indications for Fluticasone/Salmeterol

A

actue exacerbation of bronchospasm, status asthamticus

140
Q

DX-DX interactions for Fluticasone/Salmeterol

A

combo of both

141
Q

Monitoring for Fluticasone/Salmeterol

A

spirometry, HR, BP, CNS stimulation, frequency of use of SABA, growth velocity in children

142
Q

PG category for Fluticasone/Salmeterol

143
Q

Drug class for Ipratropium/Albuterol

A

combination product inhaled anticholinergic & beta2 adrenergic agonist (SABA) bronchodilators

144
Q

MoA for Ipratropium/Albuterol

A

anticholinergic & beta2 agonist bronchodilators

145
Q

Indications for Ipratropium/Albuterol

A

COPD patients requiring 2 bronchodilators

146
Q

SE/ADRs for Ipratropium/Albuterol

A

combo of drugs

147
Q

Contra-indications for Ipratropium/Albuterol

A

see individual drugs

148
Q

Monitoring for Ipratropium/Albuterol

A

spirometry, HR, BP, frequency of use

149
Q

PG category for Ipratropium/Albuterol

150
Q

Drug class for Budesonide/Formoterol

A

combination product inhaled corticosteroid & beta2 adrenergic agonist (LABA) bronchodilators

151
Q

MoA for Budesonide/Formoterol

A

anti-inflammatory action of steroid & bronchodilation activity of beta2 agonist

152
Q

Indications for Budesonide/Formoterol

A

asthma (maintenance of bronchodilation), COPD

153
Q

SE/ADRs for Budesonide/Formoterol

A
  • combo of both drugs

- increased risk of death

154
Q

Contra-indications for Budesonide/Formoterol

A

acute exacerbation of bronchospasm, status asthmaticus

155
Q

DX-DX interactions for Budesonide/Formoterol

A

combo of both

156
Q

Monitoring for Budesonide/Formoterol

A

spirometry, HR, BP, CNS stimulation, frequency of use of SABA, growth velocity in children

Pharmacology (16 decks)

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