Pulmonary, Pneumonia, Pulmonary HTN Flashcards
abbreviation for receptor ligand thought to contribute to the pulmonary arterial hypertension caused by anorexigens such as dexfenfluramine
5-HT
prototypical short-acting beta2-agonist used in asthma rescue inhalers and for asthma prophylaxis
albuterol
orally active endothelin antagonist that selectively blocks ET-A subset of receptors, pregnancy category X but lacks other significant adverse effects of bosentan
ambrisentan
routine therapy for pulmonary arterial hypertension to minimize in situ thrombosis
anticoagulants
class of drugs that reduce the itching, sneezing and rhinorrhea associated with allergic rhinitis, appear to be inverse agonists rather than antagonists
antihistamines
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
category of antibiotics that generally should not be administered at the same time as bactericidal drugs
bacteriostatic
value is very low for second-generation inhaled glucocorticoids that end up in GI tract
bioavailability
risk of this is increased by some cephalosporins
bleeding
refers to COPD patients in which chronic bronchitis causes alveolar hypoxia, leading to pulmonary arterial vasoconstriction, erythrocytosis, and eventually cor pulmonale
blue bloater
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
especially important during the initial phase of an asthma attack, less so in the later phases as eosinophils, etc., migrate into the lungs
bronchoconstriction
notable among the “cefs” for being ~only agent eliminated by the liver rather than the kidneys
ceftriaxone
constructed from peptidoglycan in bacteria, crosslinking component of synthesis is blocked by beta-lactam antibiotics
cell wall
beta-lactam-containing antibiotics divided into 4 generations
cephalosporins
has less epigastric pain than erythromycin, but does block cytochrome P450
clarithromycin
a drug of choice for aspiration pneumonia due its spectrum of activity that includes most anaerobic bacteria; frequent cause of C. difficile colitis
clindamycin
an opioid, it is the most effective agent to suppress chronic non-productive cough
codeine
3rd leading cause of death in the US, a combination of emphysema and chronic bronchitis
COPD
enlargement of the right side of the heart due to high blood pressure in the pulmonary circulation
cor pulmonale
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
abbreviation for the agents initially characterized as the ‘slow-reacting substances of anaphylaxis’
cyslt
use of these causes a phenomenon known as rebound congestion, where ever increasing dosages are required to see benefit while increasing side effects
decongestant
widely used non-opioid antitussive agent
dextromethorphan
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
