Pulmonary Meds Flashcards
Albuterol
Levalbuterol
Beta 2 agonists
Levalbuterol – less B 1 activity
Sm.m. relaxation of bronchi
Acute exacerbations
Mild beta 1 agonist at high doses
-> jitteriness, tachycardia
Mild -> persistent
Albuterol used 2x/wk in day, 2x at night /mo
Salmeterol
Long acting b2 agonist
Asthma prophylaxis
SE: tremor, arrhythmia
Corticosteroids in asthma tx
Persistent asthma
Decreased inflammation
Inhaled, oral, IV
Prophylaxis
- Fluticasone
- Budesonide
- Beclomethasone
Inhibit cytokine synthesis
Inhibit TNFa production
Systemic steroids for asthma tx
Severe chronic asthma
w/ inhaled B2 agonist in acute exacerbation
taper gradually off to avoid rebound
Cromolyn
Prevent release of mediators from mast cells
Prevent bronchoconstriction and inflammation
1st generation H1 inhibitors
Reversible
Diphenhydramine
Dimenhydrinate
Chlorpheniramine
Hydroxyzine
Use:
Allergic rhinitis
Motion sickness
Sleed aid
AE:
Very sedating
Antimuscarinic – delirium in elderly
Anti-alpha adrenergic effects
Muscarinic antagonists
Ipatropium
Tiotropium
Block M receptors -decrease overall vagal (parasympathetic) tone in lungs sm.m. relaxation decrease mucus production -more often COPD, can use in asthma
Zileuton
5-lipoxygenase inhibitor
blocks conversion of AA to leukotrienes
Zafirlukast and montelukast
Prevent chemotactic and bronchospastic effects of LTD4 – block receptor
Zafirlukast – over 5 yo
Montelukast over 2 yo
Cyproheptadine
Antihistamine used as appetite stimulant
Antidote for serotonin sn.
Promethazine
Antihistamine used for N/V
Hydroxyzine
Antihistamine used for sedation, itching
Sleep aide
Meclizine
Antihistamine used for vertigo
Methylxanthines – Theophylline
Bronchodilator – inhibits phosphodiesterase
Very narrow TI
Cardiotoxicity – arrhythmia, tachycardia, hypotension
Antidote: beta blocker
Neurotoxicity – seizures
-antiseizure med to tx
CYP450 metabolized
Blocks action of adenosine
Guaifenesin
Expectorant
Thins sputum
Used w/ cough suppressant
N-acetyl cysteine
Acetaminophen overdose
Mucolytic – cleaves disulfide bonds w/in mucous glycoproteins
Used in CF
Prevents contrast induced renal nephropathy
2nd generation H1 blockers
Loratadine
Fexofenadine
Desloratadine
Cetrizine
Used in allergic rhinitis
Sedating at high doses esp cetirizine
Opioids as cough suppressant
CNS to decrease sensitivity of cough receptors
Codeine, hydrocodone
Dextromethorphan
Synthetic derivative of morphine
No analgesic effects
SE: Constipation
Alpha agonists as nasal decongestant
Constrict dilated arterioles in nasal mucosa
-decrease airway resistance
phenylephrine
pseudoephedrine
long term -> rebound congestion
