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Pharmacology > Pulmonary Pharmacology > Flashcards

Pulmonary Pharmacology Flashcards

1
Q

Inhaled bronchodilator for symptom relief and acute bronchodilation

A

Short-acting B agonists (SABAs)

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2
Q

Can be used in asthma, COPD and exercise-induced bronchospasm

A

Albuterol (salbutamol)

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3
Q

Inhaled dose of albuterol )salbutamol

A

180 ug (2 puffs) every 4 to 6 hrs as needed

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4
Q

Nebulized dose of albuterol (salbutamol)

A

2.5 mg via oral inhalation every 6-8 hrs as needed over 5-15 mins

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5
Q

Oral dose of albuterol (salbutamol)

A

2-4 mg by mouth every 6-8 hrs

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6
Q

Albuterol(salbutamol) can be inhaled as

A

Levalbuterol (active isomer so half the dose)

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7
Q

SABA bronchodilator that is inhaled through MDI nebulizer

A

Levalbuterol

L-albuterol

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8
Q

SABA which is similar to albuterol given via MDI nebulizer

A

Pirbuterol

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9
Q

Dose of pirbuterol

A

400 ug (2 puffs) every 4-6 hrs

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10
Q

Examples of SABAs

A

Albuterol (salbutamol)
Levalbuterol (L-albuterol)
Pirbuterol

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11
Q

Add on therapy to ICS in asthma and can be used alone in COPD

A

Long-acting B agonists (LABAs)

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12
Q

Examples of LABAs

A 
Formoterol
Arformoterol
Salmeterol
Indacaterol
Olodaterol
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13
Q

LABAs for Asthma add-on to ICS

A

Formoterol

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14
Q

LABA used for maintenance and treatment of severe COPD

A

Formoterol

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15
Q

Inhaled dose of formoterol

A

12 ug every 12 hr

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16
Q

Nebulized dose of formoterol

A

20 ug in 2 ml twice per day

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17
Q

LABA used as reliever of bronchospasm

A

Formoterol

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18
Q

LABA used for severe COPD

A

Arformoterol

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19
Q

LABA used in maintenance for treatment for COPD

A

Salmeterol

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20
Q

Inhaled dose of arformoterol

A

15 ug in 2 ml twice daily

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21
Q

Inhaled dose of salmeterol

A

50 ug twice daily

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22
Q

Inhaled dose of indacaterol

A

Inhaled (DPI) 75 cetazolamide once daily

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23
Q

Inhaled dose olodaterol

A

2.5 cetazolamide once daily

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24
Q

Muscarinic receptor antagonists inhaled as bronchodilators

A

Anticholinergics

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25
Q

Examples of anticholinergics

A 
Ipratropium bromide
Albuterol/ipatropium combination
Tiotropium bromide
Umeclidinium bromide
Aclidium bromide
Glycopyrrolate
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26
Q

Inhaled dose of ipratropium bromide

A

2 puffs (17 ug/puff) 3-4x a day

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27
Q

Dose of albuterol/ipratropium combination

A

Albuterol 103 ug/ipratropium 18 ug/puff

2 puffs 4 times daily

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28
Q

Ipratropium bromide are replaced by

A

LAMAs

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29
Q

Anticholinergics that should be avoided spraying in the eyes

A

Ipratropium bromide

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30
Q

Adverse effects of ipratropium

A

Dry mouth, Tachycardia, urinary retention, glaucoma

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31
Q

Dose of tiotropium bromide

A

2.5 ug via oral inhalation (2 puffs of 1.25 ug/actuation) once daily

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32
Q

Anticholinergics that should be a caution in patients with urinary retention or glaucoma history

A

Tiotropium bromide

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33
Q

Inhaled dose (DPI) of umeclidinium bromide

A

6.25 ug (1 puff) once daily

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34
Q

Inhaled dose (DPI) of aclidinium bromide

A

400 ug (1 puff) once daily

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35
Q

Inhaled dose (DPI) of glycopyrrolate

A

1 capsule (15.6 ug) inhaled twice daily

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36
Q

Combination inhalers for the maintenance treatment of COPD

A

LAMA-LABA combination inhalers

37
Q

Examples of LAMA-LABA combination inhalers

A

Glycopyrrolate/
Umeclinium/Vilanterol
Tiotropium/olodaterol

38
Q

Maintenance treatment for asthma

A

Inhaled corticosteroids

39
Q

Examples of corticosteroids

A
  1. Beclomethasone (dipropionate) BDP
  2. Fluticasone propionate
  3. Budesonide
  4. Ciclesonide
40
Q

Inhaled dose of beclomethasone

A

MDI/PDI 88 ug (1 spray= 44 ug) twice daily

41
Q

Has more systemic than any other ICS

A

Beclomethasone dipropionate

42
Q

Local effects of Beclomethasone

A

Hoarse voice

Candidiasis

43
Q

Systemic effects of Beclomethasone

A

Growth suppression
Bruising
Adrenal suppression

44
Q

Beclomethasone dipropionate should not exceed

A

440 ug twice daily

45
Q

Inhaled dose of fluticasone propionate

A

MDI/DPI

50, 100, 250 ug 2 puffs, twice daily

46
Q

Dose of fluticaosne should exceed

A

1000 ug daily

47
Q

ICS that has fewer systemic effects than BDP

A

Fluticasone propionate

48
Q

Inhaled dose of budesonide

A

Inhaled via jet nebulizer either once daily or divided into 2 doses (maximum daily dose 0.5 mg/d

49
Q

ICS that is used in children less than 8 who cannot use PDI

A

Budesonide

50
Q

Inhaled dose of ciclesonide

A

MDI 80 ug twice daily

51
Q

Has the least-systemic effects of all ICS and maybe effective once daily

A

Ciclesonide

52
Q

Maintenance treatment in asthma and COPD

A

ICS/LABA Combination inhalers

53
Q

Examples of ICS/LABA combination

A

Fluticasone propionate/salmeterol
Budesonide/formoterol
Fluticasone furoate/vilanterol

54
Q

ICS/LABA combination where the starting dose should be based on the asthma severity

A

Fluticasone propionate/salmeterol

55
Q

Inhaled dose of budesonide/formoterol

A

Inhaled MDI 80 ug budesonide and 4.5 ug formoterol per inhalation twice daily

56
Q

Inhaled dose of fluticasone furoate/vilanterol

A

Inhaled DPI 1 inhalation

Fluticasone furoate 100 ug/vilanterol 25 ug once daily

57
Q

ICS/LABA combi that Uses lowest-dose that maintains asthma control

A

Fluticasone propionate/salmeterol

58
Q

ICS/LABA combination that is used only in severe COPD or asthma-COPD overlap

A

Fluticasone propionate/salmeterol

59
Q

Short course or oral maintenance for asthma and COPD

A

Systemic corticosteroids

60
Q

Examples of systemic corticosteroids

A

Prednisone
Prednisolone
Hydrocortisone succinate
Methyprednisolone

61
Q

Oral dose of prednisone

A

40-80 mg once daily or divided dose for 3-10 days for acute exacerbation

62
Q

Systemic corticosteroids that has minimal dose for maintenance

A

Prednisone

63
Q

Dose of hydrocortisone succinate

A

IM/IV: 100-500 mg every 12 h for acute severe asthma

64
Q

Systemic corticosteroids for patients not able to take oral steroids

A

Hydrocortisone succinate

65
Q

Dose of methylprednisolone

A

IV: 100-1000 mg for acute severe asthma

66
Q

Systemic corticosteroids that is rarely indicated because of steroids side effects

A

Methyprednisolone

67
Q

Antileukotrienes for Asthma Maintenance

A

Montelukast
Zafirlukast
Zileuton

68
Q

Oral dose of montelukast

A

10 mg/day

69
Q

Oral dose of Zafirlukast

A

20 mg twice per day

70
Q

Oral dose of Zileuton

A

600 mg four times/d or 1200 mg twice/d

71
Q

Antileukotrienes that causes hepatic dysfunction

A

Zileuton

72
Q

Adverse effects of antileukotrienes

A

Headache

Churg-Strauss syndrome

73
Q

Add-on maintenance for SEVERE asthma and COPD

A

Methylxanthines

74
Q

Examples of methylxanthines

A

Theophylline (oral)

Aminophylline (IV)

75
Q

Methylxanthines used for severe exacerbation that does not respond to nebulized B agonists

A

Aminophylline (IV)

76
Q

Maintenance for severe COPD

A

Phosphodiesterase 4 Inhibitor

77
Q

Example of PDE4 Inhibitor

A

Roflumilast

78
Q

Oral dose of roflumilast

A

500 ug once daily

79
Q

Maintenance treatment for severe asthma

A

Omalizumab

80
Q

Administration of Omalizumab

A

Subcutaneous administration

81
Q

Dose of Omalizumab

A

Dose depends on total IgE: given every 2-4 weeks

82
Q

Adverse effects of Omalizumab

A

Occasional headache and anaphylaxis

83
Q

PDE4 inhibitor added to maximal inhaled therapy if severe disease with acute exacerbations and chronic bronchitis

A

Roflumilast

84
Q

ICS with reduced oral bioavailability thus reduced adverse effects (BFMC)

A

Budesonide
Fluticasone
Mometasone
Ciclesonide

85
Q

Preferred ICS in patients who need high doses of ICSs in children

A

> 1000 ug

Budesonide
Fluticasone propionate

86
Q

ICS with longest duration of action and suitable for once-daily dosing

A

Fluticasone furoate

87
Q

Reverses reduction in HDAC2 expression that reduces corticosteroids responsiveness in severe asthma

A

Low-dose theophylline

Nortriptyline

88
Q

PDE subfamily important for anti-inflammatory effects

A

PDE4B

Pharmacology (4 decks)

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