Pulmonary Meds Flashcards
what are the 3 characteristic findings with acute bronchospasm?
Smooth muscle constriction
Mucous prod
Vascular engorgement
muscarinic receptor stimulation
-Inc cGMP
-Enhanced bronchoconstriction
-Parasympathetic input
adrenergic (B2) receptor stimulation
-Inc cAMP
-Enhanced bronchodilation
-Sympathetic input
π½-Adrenergic agonists may be given to inc ____ and thereby promote ____
cAMP, bronchodilation
Ι-Adrenergic antagonists may be given to inhibit ____ and support ____
cGMP, bronchodilation
Cholinergic/muscarinic (PNS) antagonism = dec ____, inc ____
cGMP, bronchodilation
Primary factors that mediate bronchoconstriction in emphysema and bronchitis appears to be inc in ____ tone and ____ release
vagal tone, ACh release
What are the top 2 drug choices for asthma?
- Steroid
- π½-2 agonist
MOA of xanthine derivatives
Inhibition of phosphodiesterases, resulting in increased cAMP (bronchodilation) along with an anti-inflammatory response
What should you keep in mind regarding xanthine derivatives?
low toxicity (monitor pt closely!)
What are the 3 types of antitussives?
-Topical anesthetic: block receptors
-Nonnarcotic: inc threshold of cough center in medulla
-Narcotic: inc threshold of cough center in medulla
How do Codeine (and other opioid derivatives) act as antitussives?
-Dec brain threshold for coughing
-Act to suppress cough reflex centrally
How do antihistamines (i.e. Benadryl) act as antitussives?
-Dec tickling, allergic feeling
-Inhibit irritating effects of histamines on resp mucosa or acts as local anesthetic on resp epithelium
most decongestants are in what drug class?
alpha 1 adrenergic agonists
how do alpha 1 adrenergic agonists work?
-Cause vasoconstriction
-Reduce blood flow and hence outflow from capillaries (dec pressure in sinuses, lungs, throat)
what are some things to keep in mind with alpha 1 adrenergic agonists?
-Can mimic effects of inc SNS activity (can raise BP and HR)
-Can cause serious CV and CNS excitation
-AEs: HA, dizziness, nervousness, nausea, palpitations, inc BP
-Rebound effects occur if too much β nasal congestion get progressively worse
what other pathology can antihistamines be used for?
-PD
-Dec brain activity to help with motor control
Histamines are prod by ____ and ____
basophils, mast cells
what are the 3 main actions of histamines?
- Sneezing d/t histamine-assoc sensory neural stimulation
- Hypersecretion from glandular tissue β inc mucus (swelling and permeability)
- Nasal congestion d/t vascular engorgement assoc with vasodilation and inc capillary permeability
Where are the H1 receptors located?
-Vascular smooth muscle (vasodilation)
-Vascular endothelial cells (inc vascular permeability)
-CNS tissue throughout body
What are the primary AEs of antihistamines?
Sedation (due to crossing BBB), fatigue, dizziness, blurred vision, incoordination
What is good about 2nd generation antihistamines?
-Donβt easily cross BBB
-May be used in pts with asthma bc they wonβt dry up the airways
quick relief asthma drugs (rescue inhaler)
-SABA
-Anticholinergics
-Systemic corticosteroids
LT asthma meds
-LABA
-Leukotriene modifiers
-Mast cell stabilizers
-Theophylline
when is a LABA indicated?
when pt needs SABA > 2x/week
important things to know about LABAs
-Take 20 mins to begin working
-Duration of action: 12 hrs (2x/day puffs)
-Formulation of agonist protects them against degradation
-Reduce dosage of glucocorticoids used
LABA AEs
-Palpitations, shakiness and cramping of hands/legs/feet
-Often caused by improper administration
