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Pharm 1 > Pulmonary Pharm > Flashcards

Pulmonary Pharm Flashcards

1
Q

What are the 3 subclasses of bronchodilators

A

Beta 2 Agonists

Anticholinergics

Xanthine derivatives

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2
Q

3 subclasses of anti-inflammatories

A

leukortriene receptor antagonist (LTRAs)

inhlaed glucocoritcoids

mast cell stabilizers

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3
Q

2 Other medication classes

A

omalizumab

roflumilast

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4
Q

Classes for COPD treatment that dilate bronchioles

A

beta 2-adrenergics

inhaled anticholinergics

xanthine derivatives

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5
Q

Classes for COPD treatment that decrease bronchial inflammation

A

glucocorticoids

mast cell stabilizer

LTRAs

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6
Q

MOA of bronchodilators

A

work by relaxing bronchial smooth muscle

Causes dilation of bronchi/bronchioles

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7
Q

3 classes of bronchodilators

A

Beta-Adrenergic Agonists

Anti-cholinergics

Xanthine derivatives

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8
Q

2 beta-adrenergic agonists Short Acting drugs

A

Albuterol (Proventil) PO/Inhalant

Levalbuterol (Xopenex) Inhalant

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9
Q

2 beta-Adrenergic Agonist Long Acting drugs

A

Salmetrol (Servent)

Formoterol (Foradil)

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10
Q

What type of beta-adrenergic agonist should be used in an asthmatic attack

A

Short Acting

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11
Q

What is the timing of short acting beta agonists

A

inhaled q 4-6 hrs

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12
Q

what is the timing of long acting beta agonists

A

inhaled q 12 hours

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13
Q

What type of beta agonists are resuce drugs

A

short acting

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14
Q

what are long acting beta agonists used for

A

prevention

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15
Q

what is the duration of long acting beta agonists

A

12-24 hrs

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16
Q

MOA of beta-adrenergic agonist

A

mic action of SNS flight or flight

Relax and dilate the airways by stimulating the beta2-adrenergic receptors throughout the lungs

Bronchial dilation & increased airflow into and out of the lungs=goal

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17
Q

what are the 3 subtypes of beta-adrenergic agonist

A

Non-selective adrenergic drugs– stimulate both beta-1 AND beta-2 receptors AND alpha receptors (epinephrine)

Non-selective beta-adrenergic– stimulate both beta-1 AND beta-2 receptors (metaproterenol)

Selective beta-2 receptors (albuterol) preferred medication to treat pulmonary conditions

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18
Q

MOA of non-selective drugs

A

stimulate alpha receptors= vasoconstriction
Decreases edema/swelling in mucous membranes, limits amount of secretions

stimulate beta1= cardiovascular effects
What effects would these be?

CNS stimulation also occurs nervousness/tremors occur

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19
Q

Indications for beta adrenergic agonists

A

prevention or relief of bronchospasm related to asthma/bronchitis/other pulmonary conditions

Will see them used for conditions outside the pulmonary system

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20
Q

Contraindications for beta adrenergic agonist

A

uncontrolled hypertension, cardiac dysrhythmias, high risk for stroke

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21
Q

beta-adrenergic agonist should not be given with what other drugs

A

MAOIs and sympathomimetics (ephedrine/sudafed) bc risk of hypertension

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22
Q

What may diabetics need with beta-adrenergic agonist

A

Diabetics may need higher doses of meds because raises blood sugar

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23
Q

What can beta- 2 drugs cause

A

hypertension or hypotension

24
Q

7 Adverse effects of beta-adrenergic agonist

A 
Insomnia
Restlessness
Anorexia
Cardiac stimulation 
Hyperglycemia
Tremor 
Vascular headache
25
Q

What can reverse an overdose of beta agonist

A

beta blockers but beware of bronchospasm

26
Q

T/F Non-selective have the most

adverse effects

27
Q

T/F Most beta-2s have very short half life

28
Q

2 types of inhalers

A

MDI - Metered dose inhaler

DPI - dry powder inhaler

29
Q

Why are meds given through inhalation?

A

Minimizes the systemic side effects

30
Q

which inhaler is not breath activated

31
Q

which inhaler is breath activated

32
Q

Which inhaler is better for patients with cognitive problems or children

33
Q

Albuterol/Probentil onset

34
Q

T/F Albuterol is considered a rescue drug

35
Q

What is the delievery method of Albuterol/Proventil

A

MDI or nebulizer

36
Q

Albuteraol is a first line treatment for what

A

acute asthma attack

37
Q

indications for albuterol/Proventil

A

Treatment of: Asthma, bronchitis, and emphysema

Treatment of: ACUTE episodes of wheezing, chest tightness, SOA

38
Q

Considerations for albuterol

A

Use of more than one canister per month indicates inadequate control of asthma & need for initiating or intensifying anti-inflammatory therapy

200 ACTUATIONS per canister

Regularly scheduled daily use is NOT recommended

  • Also for PREVENTION of EIA (exercise induced asthma)
39
Q

T/F salmeterol is used as a maintenance drug

40
Q

how many times daily is LABA given

A

twice daily (inhalation)

41
Q

What is the warning with LABA - salmeterol

A

has been associated with increased asthma-related deaths

More common in Black/African Americans

42
Q

indications of salmeterol

A

Worsening of COPD

Moderate-severe asthma

Key Point: ALWAYS given with an inhaled corticosteroid, not indicated for monotherapy

43
Q

Functioning of anticholinergics

A

Giving ANTI-cholinergic agents results in
Turning off cholinergic response (PNS) and turning on SNS
SNS dominates = bronchodilation
Thus increasing perfusion to heart, lungs, and brain

44
Q

Key point of anticholinergics Function

A

So, by BLOCKING the effect of acetylcholine (anticholinergic drugs), we INHIBIT the normal physiological response
Bronchoconstriction and increased mucus production

45
Q

MOA of anticholinergics

A

Blocks action of acetylcholine= creates bronchodilation (by preventing bronchoconstriction)

46
Q

indications of anticholinergics

A

Used for PROPHYLAXIS and maintenance therapy

NOT for rescue

47
Q

anticholinergics is often in combination with what

48
Q

anticholinergic drug

A

ipratroprium (Atrovent)

49
Q

Adverse effects of antichlinergic

A 
Dry
Hot
Blind
Red
Mad
50
Q

2 Xanthine Derivative drugs

A

throphylline (TheoDur/Theo-24)

aminophylline

51
Q

MOA of Xanthine Derivatives

A

increasing levels of the cAMP enzyme by inhibiting phosphodiesterase

Stimulates CNS and CVD system

52
Q

What is xanthine derivatives used for

A

Preventative treatment of asthma attacks and COPD exacerbation

second-line treatment because of the high risk of toxicity and drug-drug interactions

53
Q

S/E of xanthine derivatives

A

Toxicity -> N/V/D, insomnia, H/A, tachycardia, dysrhythmias, seizures (more common in elderly)

54
Q

contraindications of xanthine derivatives

A

uncontrolled cardiac dysrhythmias, seizure disorders, hyperthyroid, peptic ulcers

55
Q

interactions with xanthine derivatives

A

Caffeine - may ↑ side effects

Smoking → ↓ absorption

56
Q

Cautions of xanthine derivatives

A

Has a narrow therapeutic index monitor serum levels and watch for toxicity

Lots of drug interactions macrolide antibiotics, allopurinol, cimetidine, quinolones, flu vaccine, oral contraceptives

Pharm 1 (28 decks)

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