Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiopulmonary > Pulmonary Medications > Flashcards

Pulmonary Medications Flashcards

1
Q

Medications that affect the pulmonary system can be classified by mechanism of action:

A
  • Bronchodilation and/or mitigation of bronchoconstriction
  • Facilitation of mucociliary/secretion clearance
  • Increased alveolar ventilation and/or improved oxygenation
  • Improved control of the breathing pattern
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Structures of the respiratory system that respond to pharmacologic intervention:

A
  • Bronchi and bronchioles: function to maintain airflow
  • Alveoli: responsible for gas exchange
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

_______________ are the most frequently used drugs in the treatment of pulmonary disease

A
  • Bronchodilators
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Normal tone is a balance between constrictive and dilatational stimuli that results from equal ____________ and _____________ (muscarinic) influences.
Disruption of normal bronchomotor tone by an outside stimulant leads to _____________

A
  • Adrenergic and cholinergic
  • Bronchospasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In what two ways do bronchodilators influence the ANS

A
  • cAMP—facilitates smooth muscle relaxation and inhibits mast cell degranulation, causing bronchodilation
  • cGMP—facilitates smooth muscle constriction and enhances mast cell release of histamine, causing bronchoconstriction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In the lungs, the effects of cAMP and/or cGMP can be attributed to any of the following:

A
  • Muscarinic receptor stimulation→ increased cGMP→enhanced bronchoconstriction
  • Adrenergic β2 receptor stimulation→ increased cAMP→ bronchodilation
  • α1 receptor stimulation results in a decrease in cAMP and facilitates bronchoconstriction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the 3 different adrenergic receptors

A
  • α receptors— distributed within peripheral/bronchial smooth muscle, myocardium, mucosal blood vessels
  • β1 receptors— found in cardiac tissue, mucosal blood vessels
  • β2 receptors— found in bronchial smooth muscles, peripheral smooth muscle, and skeletal muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Adrenergic agonists bronchodilators

A
  • Epinephrine (adrenaline): Short duration of action, Acts directly on all receptor types, Drug of choice (intramuscular or subcutaneous) for treating acute bronchospasm and acute anaphylactic reaction
  • Ephedrine increases norepinephrine synaptic concentrations on all receptor types.
  • β2-specific agents produce bronchiolar dilation by relaxing the bronchial smooth muscle through facilitation of increased cAMP levels.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Shot versus long acting beta 2 adrenergic agonists

A
  • Short-acting beta2-adrenergic agonists (SABAs): Work quickly (generally within 3–5 minutes), but last for relatively short periods (4–6 hours), Often prescribed as quick-reliever medications because of their fast relief of shortness of breath, Used to prevent or decrease symptoms of bronchospasm triggered by specific situations (e.g., exercise, cold weather)
  • Long-acting β2-adrenergic agonists (LABAs): Considered maintenance drugs because of long-lasting features; Help provide stable airways on a day-to-day basis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 2 methods of providing bronchodilator meds by inhalation

A
  • Metered dose inhaler (MDI)—device that delivers a specific amount of medication to the lungs in the form of a short burst of aerosolized drug
  • Nebulizer—device used to administer medication in the form of a mist inhaled into the lung
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe adrenergic antagonists bronchodilators

A
  • These medications inhibit adrenergic receptors.
  • α-receptor stimulation produces both vasoconstriction and bronchoconstriction.
  • α-adrenoceptor antagonists reduce α-adrenergic activity in the bronchi of patients with pulmonary disease.
  • α-Antagonists prevent the decrease of cAMP, causing bronchodilation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do beta adrenergic bronchodilators end in

A
  • End in -terol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Sympathetic/adrenergic is to parasympathetic/muscarine (True/False)

A
  • True
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe muscarinic antagonists bronchodilators

A
  • These drugs inhibit cholinergic receptors.
  • Vagus nerve (tenth cranial nerve) provides parasympathetic innervation to the lungs.
  • Muscarinic antagonists that reduce vagal tone are used to manage bronchoconstriction in COPD.: Include ipratropium (Atrovent) and tiotropium (Spiriva); Given by inhalation; not absorbed as well into the systemic circulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe Methylxanthines

A
  • enhance intracellular level of cAMP through the inhibition of the enzyme phosphodiesterase (PDE)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe corticosteroids

A
  • reduce the inflammatory response, decrease mucosal swelling, and increase bronchial lumen and airflow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe mast cell stabilizers

A
  • work to stabilize mast cells and prevent the release of histamine and other inflammatory mediators
18
Q

Describe leukotriene inhibitors

A
  • strong inflammatory mediators that promote neutrophil–endothelial interactions, induce bronchoconstriction, and increase airway hyperresponsiveness
19
Q

Describe anti-IgE monoclonal antibodies

A
  • laboratory-created antibodies that bind specifically to IgE antibodies and prevent their action (usually for patients with severe asthma)
20
Q

Possible new anti-inflammatory treatments in development:

A
  • Protease inhibitors
  • Inhibitors of neutrophil elastase
  • Cathepsins
  • Matrix metalloproteases
21
Q

New drug development for pulmonary disease focuses on

A
  • Identifying specific genetic mutations
  • Targeting the action of specific cell receptors to achieve desired effects
  • Issues related to cost, accessibility, and FDA approval
22
Q

Pirfenidone (Esbriet) and Nintedenab (Ofev) are the two antifibrotic medications for IPF.

A
  • Shown to reduce the decline in pulmonary functions and clinical status in patients with IPF.
  • Patients should continue taking the drug for the rest of their life or until undergoing lung transplant.
23
Q

What are the 2 main causes/pathophysiology of pulmonary artery HTN (PAH)

A
  • Vasculopathy of small pulmonary arteries
  • Imbalance of signals
24
Q

_____________ are the primary medications for pulmonary arterial hypertension (PAH).

A
  • Vasodilators
25
Q

How is cystic fibrosis transmembrane conductance regulator (CFTR) protein made

A
  • DNA contains instructions for formation
  • RNA transcribes the instructions
  • Ribosomes translate the instructions for creation
  • Once made the CFTR protein moves through the cell to the cell surface (trafficking)
  • Once at the surface the CFTR protein acts as a chloride channel
26
Q

Describe Ivacaftor (Kalydeco)

A
  • first therapeutic agent to target the defective protein made by CFTR gene mutation
27
Q

Describe Trikafta (Elexacaftor/tezacaftor/ifacaftor)

A
  • combination of three drugs approved for patients with CF at least 12 years old with at least one F508del mutation
28
Q

Describe decongestants

A
  • Treat symptoms of “runny nose and stuffy head” associated with the common cold, allergies, and respiratory infections
  • Symptoms are caused by vasodilation and “leaky” blood vessels, leading to mucosal swelling and fluid leaks.
  • Alpha-adrenergic sympathomimetics are most common decongestants.
  • Stimulate α receptors and cause vasoconstriction, reducing or preventing the underlying pathology
  • End in -rine/-line
29
Q

Describe antihistamines

A
  • Mostly used to treat respiratory allergic responses associated with seasonal allergies
  • Interact with two receptor types: H1 and H2 receptors
30
Q

Describe antitussives

A
  • Indicated for short-term treatment of cough
  • Should only be used to suppress an ineffective, dry hacking cough; not indicated for coughs caused by retained secretions
  • Act to block the overly active receptors or to increase the threshold of the cough center in the medulla portion of the brain
  • End in -adine/-amine
31
Q

Describe mucoactive agents

A
  • Promote mobilization and removal of secretions from the respiratory tract
  • Four basic types: mucolytics, expectorants, wetting agents, and surface-active agents
32
Q

Describe expectorants

A
  • Facilitate expectoration of respiratory secretions by increasing hydration of the airway or the volume of secretions
  • Most prevalent expectorants are simple hydration (via aerosol, i.e., 3% saline or orally, iodinated glycerol, and glyceryl guaiacolate)
33
Q

Describe respiratory stimulants

A
  • Analeptics cause central respiratory excitation with subsequently increased respiratory activity.
  • Doxapram (Dopram) is most widely used analeptic.: When administered intravenously, prevents a rise in partial pressure of arterial carbon dioxide with oxygen therapy in acute ventilatory failure; Also used to prevent respiratory depression in high-risk postoperative patients
34
Q

Describe respiratory depressants

A
  • Include sedatives, tranquilizers, and narcotic analgesics
  • Should generally be avoided in patients with pulmonary disease because they suppress ventilatory drive
  • Respiratory depressants may be indicated for some mechanically ventilated patients.
  • May be prescribed if anxiety or agitation contributes to increased work of breathing
  • Can include intravenous morphine, midazolam (Versed), Propofol (Diprivan), Fentanyl, or diazepam (Valium)
35
Q

Describe neuromuscular blocking drugs

A
  • Used with lighter general anesthesia to produce a desired degree of immobilization for surgery
  • Used to facilitate endotracheal intubation, control laryngeal spasm, treat diseases that cause neuromuscular hyperactivity
36
Q

Describe antimicrobial agents

A
  • Used to combat unicellular organisms (bacteria, viruses, fungi)
  • Antibacterial drugs may be classified as bactericidal (killing or destroying bacteria) or bacteriostatic (limiting growth and proliferation of bacteria)
37
Q

Reserve antimicrobials includes drugs reserved for treatment of confirmed or suspected infections caused by _________________________

A
  • Multidrug resistant organisms
  • Considered last resort drugs to be used when all alternatives have failed
38
Q

Antibiotics in the reserve group include

A
  • Colistin
  • Polymyxin B
  • Fosfomycin
  • Linezolid
  • Meropenam
39
Q

What is the most common indication for oxygen therapy

A
  • Arterial hypoexmia
  • PaO2 <60
40
Q

The therapeutic administration of oxygen can elevate the arterial oxygen tension and increase the arterial oxygen content shifting the oxyhemoglobin dissociation curve to the _______ and improving _______________ oxygenation

A
  • Right
  • Peripheral tissue oxygenation
41
Q

What are the roles of Nitrous Oxide (NO)

A
  • Regulating blood circulation
  • Diffuses to the vascular smooth muscle cells
  • Endotoxic shock
  • Pulmonary HTN
  • Adult respiratory distress syndrome (ARDS)
  • HTN in various disease states

Cardiopulmonary (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions