Pulmonary, Pneumonia, Pulmonary HTN Flashcards by Sarah Gillen

abbreviation for receptor ligand thought to contribute to the pulmonary arterial hypertension caused by anorexigens such as dexfenfluramine

5-HT

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prototypical short-acting beta2-agonist used in asthma rescue inhalers and for asthma prophylaxis

albuterol

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orally active endothelin antagonist that selectively blocks ET-A subset of receptors, pregnancy category X but lacks other significant adverse effects of bosentan

ambrisentan

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routine therapy for pulmonary arterial hypertension to minimize in situ thrombosis

anticoagulants

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class of drugs that reduce the itching, sneezing and rhinorrhea associated with allergic rhinitis, appear to be inverse agonists rather than antagonists

antihistamines

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macrolide with 15-atom ring, does not block cytochrome P450 and has unusual pharmacokinetics in that a single dose becomes concentrated in cells and is then slowly released at bacteriostatic levels over several days

azithromycin

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category of antibiotics that generally should not be administered at the same time as bactericidal drugs

bacteriostatic

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value is very low for second-generation inhaled glucocorticoids that end up in GI tract

bioavailability

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risk of this is increased by some cephalosporins

bleeding

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refers to COPD patients in which chronic bronchitis causes alveolar hypoxia, leading to pulmonary arterial vasoconstriction, erythrocytosis, and eventually cor pulmonale

blue bloater

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orally active nonselective blocker of endothelin receptors; has hepatotoxicity as significant adverse effect, pregnancy category X necessitates use of two forms of birth control, and alters metabolism of several drugs including oral contraceptives

bosentan

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especially important during the initial phase of an asthma attack, less so in the later phases as eosinophils, etc., migrate into the lungs

bronchoconstriction

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notable among the “cefs” for being ~only agent eliminated by the liver rather than the kidneys

ceftriaxone

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constructed from peptidoglycan in bacteria, crosslinking component of synthesis is blocked by beta-lactam antibiotics

cell wall

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beta-lactam-containing antibiotics divided into 4 generations

cephalosporins

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has less epigastric pain than erythromycin, but does block cytochrome P450

clarithromycin

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a drug of choice for aspiration pneumonia due its spectrum of activity that includes most anaerobic bacteria; frequent cause of C. difficile colitis

clindamycin

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an opioid, it is the most effective agent to suppress chronic non-productive cough

codeine

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3rd leading cause of death in the US, a combination of emphysema and chronic bronchitis

COPD

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enlargement of the right side of the heart due to high blood pressure in the pulmonary circulation

cor pulmonale

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will block mast cell degranulation if you take it before exposure to an asthma trigger, and several times per day during peak allergy season

cromolyn

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abbreviation for the agents initially characterized as the ‘slow-reacting substances of anaphylaxis’

cyslt

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use of these causes a phenomenon known as rebound congestion, where ever increasing dosages are required to see benefit while increasing side effects

decongestant

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widely used non-opioid antitussive agent

dextromethorphan

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a prototypical first-generation antihistamine

diphenhydramine

administered as needed to control peripheral edema in patients with right-sided heart failure

diuretics

one of the bacterial enzymes blocked by fluoroquinolones

DNA gyrase

recombinant deoxyribonuclease used to reduce the viscosity of sputum in cystic fibrosis, utility in other pulmonary diseases with excessive mucus secretion is uncertain

dornase alfa

a tetracycline useful for community-acquired pneumonia

doxycycline

abbreviation for inhaler requiring brisk inhalation to deliver powered medication to the lungs

DPI

an early sign of pulmonary arterial hypertension when associated with physical exertion

dyspnea

lacking for infections caused by adenovirus, parainfluenza and RSV

effective drugs

exceptionally potent vasoconstrictor produced by endothelial cells

endothelin

prostacyclin analog administered by central IV line for treatment of pulmonary arterial hypertension, has 6 min half-life and must be kept refrigerated

epoprostenol

macrolide that is a frequent substitution for penicillin; causes epigastric pain and a well-known inhibitor of cytochrome P450

erythromycin

mnemonic for the multidrug resistant bacteria of greatest concern, members are responsible for ~80% of ventilator-associated pneumonia

ESKAPE

broad-spectrum orally active class of drugs with activity against gram-negative bacteria; current agents now also target gram-positive bacteria

fluoroquinolones

widely-used inhaled glucocorticoid for persistent asthma therapy, intranasal glucocorticoid that is drug of first choice for chronic allergic rhinitis

fluticasone

getting the annual version of this is the best protection against the influenza virus

flu vaccine

essential for life, but too much--endogenous or exogenous-- causes symptoms of Cushing's syndrome

glucocorticoids

adding activity against these bacteria is what makes ampicillin and amoxicillin 'broad-spectrum' penicillins

gram negative

purported to be an expectorant and common ingredient in OTC cold remedies, little evidence of benefit for any pulmonary disease

guaifenesin

prostacyclin analog with intermediate half-life, administered by inhalation 6-9 times per day

iloprost

short-acting anticholinergic drug, blocks muscarinic receptors causing bronchoconstriction caused by parasympathetic tone, drug of first-choice for COPD

ipratropium

among the respiratory fluoroquinolones

levofloxacin

having these turn blue in association with near-syncope and swelling in legs and ankles is a sign of progressing pulmonary arterial hypertension

lips

a prototypical second-generation antihistamine, does not cross the blood-brain barrier

loratadine

bacteriostatic drug class that includes erythromycin, clarithromycin and azithromycin, works by binding to bacterial 50S ribosomal subunit and blocking peptide chain elongation

macrolides

blocks leukotriene receptors responsible for bronchoconstriction and nasal congestion

montelukast

treatment for acetaminophen toxicity, thins mucus but causes bronchoconstriction, so generally contraindicated in asthma and COPD

N-acetylcysteine

penicillinase-resistant penicillin

nafcillin

convenient way of delivering inhaled medicines to those who are young or physically incapacitated

nebulizer

characteristic of second-generation antihistamines

non-sedating

anti-IgE antibody, useful in asthma therapy but expensive

omalizumab

not the preferred route for taking glucocorticoids when treating asthma

oral

reduces duration and severity of influenza infection if taken within 48 hrs of symptom onset

oseltamivir

reason gram-negative cells are gram-negative and barrier to many antibiotics

outer membrane

administering this as necessary to maintain saturation levels > 90% is an important component of pulmonary arterial hypertension therapy

oxygen

abbreviation for a finding of mean pulmonary arterial pressure greater than 25 mm Hg at rest and PCWP <= 15 mm Hg

PAH

among the safest antibiotics, allergic reactions are the biggest problem

penicillins

whether mild, moderate or severe, this main category of asthma severity requires daily medication

persistent

alpha1-agonist increasingly being substituted into remedies for allergic rhinitis as the decongestant

phenylephrine

enzyme responsible for cleaving arachidonic acid from the cell membrane for eicosanoid synthesis, its activity is blocked by lipocortin-1 expressed by cells in response to glucocorticoids

phospholipase A2

refers to COPD patients in whom emphysema predominates; see less hypoxemia so less pulmonary vasoconstriction and erythrocytosis, and less severe pulmonary hypertension

pink puffer

characterized as an extended spectrum penicillin because of its activity against P. aeruginosa

piperacillin

lesions that are pathognomonic of PAH

plexiform

vaccine against a broader range of S. pneumoniae serotype, but does not elicit a satisfactory immune response in those younger than age 2 yrs

pneumovax 23

formed by tetracycline in the presence of calcium, magnesium, etc.

precipitate

example of an orally administered glucocorticoid used to treat severe asthma

prednisone

S. pneumoniae vaccine administered to newborns at 2, 4, 6 and 12-15 mo of age

prevnar 13

agent with long history of use as decongestant, being replaced since a precursor for methamphetamine synthesis

pseudoephedrine

syndrome caused by infusing vancomycin too fast

red man

ideal status of respiratory fluoroquinolones I the treatment of community-acquired pneumonia

reserve

phosphodiesterase inhibitor used to treat asthma, beneficial effects are modest

roflumilast

flushing the nasal passages with this is an effective treatment for allergic rhinitis

saline

prototypical long-acting beta2-agonist used for persistent asthma, not appropriate for rescue therapy and may increase asthma-related death

salmeterol

orally active prostacyclin analog that is in late stage clinical trials for the treatment of pulmonary arterial hypertension

selexipag

orally active phosphodiesterase type V inhibitor used to treat pulmonary arterial hypertension

sildenafil

use of this can dramatically increase delivery of inhaled drugs from MDI to the lungs

spacer

name given to bacterial pulmonary infections that develop secondary to viral infections

superinfection

tetracyclines turn them gray/brown while developing

teeth

can rupture during fluorquinolone therapy, especially in the young, old and in others who subject them to significant stress

tendons

drug with a long history of use for treating asthma, has significant toxicities that diminish its use in the US

theophylline

generally well-tolerated anticholinergic drug that can be administered once daily to the lungs to improve airflow in patients with symptomatic COPD

tiotropium

prostacyclin analog with longer half-life that does not require refrigeration, administered IV, subQ and via inhalation for treatment of pulmonary arterial hypertension

treprostinil

smoke, dust mite feces, mold, pets and physical exercise are among these for an asthma attack

triggers

MRSA and resistant C. difficile infections are reasons to use this antibiotic

vancomycin

performed during right heart catheterization by infusion of a short-acting vasodilator to assess the likelihood that CCB could be effective therapy for the pulmonary arterial hypertension

vasopressor test

seen more often in the very young, elderly and in its more severe forms in those who are immunocompromised

viral pneumonia

definition of asthma in in which no more than 2 daytime symptoms per week, no more than 2 nighttime symptoms per month, rescue inhaler needed < 2 times per week, no interference with normal activity, peak flow ~ normal, no more than 1 urgent care visit per year

well controlled

blocks a key enzyme in leukotriene synthesis

zileuton