Pulmonary Pharmacology Flashcards
Who is Asthma most prevalent in?
- Children
- Females
What are reliever drugs used for in asthma cases?
- Short acting
- Less severe cases
What type of drugs are relievers for asthma?
-Beta 2 agonist at a minimum dose and frequency
What are examples of reliever drugs used for asthma?
- Albuterol
- Salmeterol
What do typical Beta 2 adrenergic agonists end in?
-terol
What do corticosteroid drugs typically end in?
-sone
What do anti-muscarinic drugs end in?
-pium
What do reliever drugs do?
-Rapid bronchodilators
If a patient is intolerant of B2 agonists are recommended to use what as a reliever?
-Ipratropium bromide
What is the onset and length of the effect of albuterol as a reliever drug for asthma?
- Rapid onset
- 4-6 hr effect
What is the onset and length of the effect of salmeterol as a reliever drug for asthma?
- Slower onset
- 12 hrs
How do use a controller drug for asthma?
- Take regularly for long-term stable control
- Inhaled
- Must be taken continuously
What is the only true rescue inhaler?
Albuterol
What is the MOA of reliever drugs used for asthma?
-Directly relax airway smooth muscle
What are the side effects of asthma controller drugs?
- Nose bleeds
- Sores in nose, mouth, and tongue that don’t heal
- Oropharngeal candidiasis
What are the drugs of choice for moderate to sever asthma?
-Corticosteroids (fluticasone
What do you often combine with corticosteroid (controller) asthma drugs?
-Beta 2 agonists
What is the MOA for the corticosteroids?
- Not a bronchodilator
- Anti-inflammatory and immune modifier
What is a corticosteroid drugs used for asthma?
-Fluticasone (Flovent)
Do you use corticosteroid for rescue in asthma?
-No
What are methylxanthine drugs used for asthma?
-Theophylline (found in tea)
what is the MOA of Methylxanthine drugs?
- Phosphodiesterase inhibitor and increases cAMP
- Relaxes airway smooth muscle
What are methylxanthine drugs use for in asthma?
-Monotherapy for mild asthma
What do you often combine Methylxanthine drugs with and why?
-Corticosteroids to reduce steroid doses and side effects
What does Theophylline (Elixophyllin) do for COPD?
-Improve diaphragmatic fatigue
What are some antimuscarinics used in asthma?
-Ipratropium
What do antimuscarinics do?
- Reverses contraction of smooth muscle from vagal activity
- Blocks ACh
What is usually a backup for beta 2 agonists used for asthma?
-Antimuscarinics
T/F Ipratropium is effective for COPD
False
-It is not
What are leukotriene modifers drugs used for asthma?
-Montelukast (Singulair)
What is Singulair (Montelukast) used for?
-Prophylaxis for pt who have trouble with inhaled therapies
What is the MOA for Montelukast?
-Block leukotriene
What is especially effective for aspirin-induced asthma?
-Montelukast (singular)
What are Mast Cell stabilizer drugs used for asthma?
-Cromolyn
What does Cromolyn do?
- Prevention by inhibiting the release of inflammatory mediator such as histamine
- Use before exervise and allergen exposure)
What does Omalizumab do?
-Inhibit IgE binding to mast cells
When do you use Omalizumab?
- For severe non-responsive asthma
- Very Expensive
Asthmatics tend to be mouth breathers, what does that lead to?
-Dry mouth
T/F Asthma inhalers irritate mucosa of mouth, especially back of roof of mouth
True
What are the causes of COPD?
- Long smoking history
- Exposure to environmental irritants
- Airflow limitations due to progressive, irreversible airway remodeling
What drugs do you use to treat COPD?
- Tiotropium bromide (Spireva)
- Salmeterol
- Theophylline with glucocorticoids
Does Tiotropium bromide (spireva) cause bronchodilation?
-Yes, it is a longer acting bronchodilator
What is the treatment for Influenza?
- Oseltamivir (Tamiflu)
- Used for prevention of Influenza A and B
What does Oseltamivir do?
-Prevents separation of virus particle from cell receptors stopping viral spread
What are the symptoms of allergic reactions?
- Itching
- Hives
- Sneezing
- Wheezing
- Difficulty breathing
In allergic reactions what does the release of histamine from mast cells and basophils do?
- Contract pulmonary smooth muscles
- Dilate blood vessels lowering BP
- Increase permeability of vessels
- Increases gastric secretion
What antihistamines do you use to treat an allergic reaction?
- Dephnhydramine (Benadryl)
- Chlorpheniramine
Why would you use epinephrine in an allergic reaction?
- It is a potent reversal
- Vasoconstricts and reduces fluid in lungs so breathing improves and swelling reduces
What is an anti-smoking medication?
- Nicotine replacement therapy
- Buproprion (TTC antidepressant)
