Pulmonology - Pharmacology Flashcards
2 Mechanisms to Reduce Inhaler Side Effects
1) Poorly absorbed from GI Tract
2) Rapidly cleared by first pass metabolism
Salmeterol - Class + Use
Class - Long Acting B2 Agonist
Use - Asthma Prophylaxis - Combo with Fluicasone
B2 Selective Agonists - Categories (2) + Names (5) + Uses + Toxicity (2)
1) Short Acting - SABA - Albuteral + Terbutaline + Metaproterenol
Use - Acute Exacerbation
2) Long Acting - Salmeterol + Formoterol
Use - Long Term Prophylaxis
Toxicity = Tremor + Arrhythmia
Albuteral - Class + Use
Class - Short Acting B2 Agonist
Use - Acute Asthma Exacerbation
Tiotropium Bromide - Class + Use
Class -M3 Receptor Antagonist
Use - Prevents bronchoconstriction in asthma and COPD - COPD = Primary
Inhaled Corticosteroids - Names (3) + Use + Mechanism + Toxicity (1)
Names - Fluticasone + Budesonide + Beclomethasone
Use - Combination therapy to reduce asthma induced inflammation
Mechanism - Inactivates NF-Kappa-Beta transcription factor reducing TNF-Alpha and inflammatory factors
Toxicity - Increased Candida Infection - No real risk for growth etc.
Zafirlukast - Class + Use
Class - Antileukotrine - LTD4 Receptor Inhibition
Use - Asthma
2 Major B2 Agonist/Steroid Therapies
CLASS ONLY
Salmeterol-Fluticasone (Advair)
Formoterol-Budesonide (Symbicort)
Fluticasone - Class + Use
Class - Inhaled Corticosteroid
Use - Asthma Prophylaxis - Combo with Salmeterol
When to Add Asthma Prophylaxis (3)
Class Only
1) Rescue Needed > 2x Weekly
2) Noctornal Symptoms >2x Monthly
3) FEV1 < 80% Predicted
Budesonide - Class + Use
Class - Inhaled Corticosteroid
Use - Asthma Prophylaxis - Combo with Formoterol
Aminophylline - Class + Use
Class - Inhaled Methylxanthiine Drug
Use - Asthma - Limited (Narrow Theuroputic Window)
Inhaled M3 Receptor Antagonists - Name (2) + Use + Mechanism + Toxicity
Name - Ipratropium Bromide (Asthma) + Tiotropium Bromide (COPD - Very Long Long Lasting)
Use - Asthma + COPD - B2 Agonist Synergy
Mechanism - Prevents M3 Bronchoconstriction - Not absorbed by GI Tract
Toxicity - None
Terbutaline - Class + Use
Class - Short Acting B2 Agonist
Use - Acute Asthma Exacerbation
Formoterol - Class + Use
Class - Long Acting B2 Agonist
Use - Asthma Prophylaxis - Combo with Budesonide
Theophylline - Class + Use
Class - Inhaled Methylxanthiine Drug
Use - Asthma - Limited (Narrow Theuroputic Window)
Antileukotriene Drugs - Names (3) + Use + Mechanism (2) + Toxicity
Names - Montelukast + Zafirlukast + Zileuton
Use - Asthma - Long Term Therapy - Leukotrienes are bronchoconstrictors that causes mucous hypersecretion
Effects/Response not equal in all people
Mechanism - Montelukast/Zafirlukast - Block LTD4 Luekotrine Receptors
Zileuton - Block 5-Lipoxygenase Production)
Toxicity - Zileuton = Hepatotoxicity + Oral
Zileuton - Class + Use
Class - Antileukotrine - 5-Lipoxyganse Inhibition
Use - Asthma - Oral
Omalizumab - Class + Use
Class - Monoclonal Anti-IgE
Use - Asthma - Severe refractory allergic asthma
Anti-IgE Antibodies - Name + Use + Mechanism + Toxicity
Name - Omalizumab
Use - Asthma - Severe refractory allergic asthma
Mechanism - Prevent inflammation via serum IgE inhibition - No cross linking
Toxicity - Anaphylaxis + Neoplasms
COPD Specific Steroid Therapies (4)
1) Tiotropium-Bromide - COPD M3 Antagonist
2) Formaterol - LABA
3) Arformaoterol - LABA
4) Fluicaseon-Vilanterol - Specific Combo
Ipratropium-Bromide - Class + Use
Class -M3 Receptor Antagonist
Use - Prevents bronchoconstriction in asthma and COPD - Asthma = Primary
Metaproterenol - Class + Use
Class - Short Acting B2 Agonist
Use - Acute Asthma Exacerbation
Methylxanthine Drugs - Names (2) + Use + Mechanism + Toxicity
Names - Theophylline + aminophyliline
Use - Asthma - No Longer Used (Narrow Therapeutic Window) - Requires blood monitoring
Mechanism - Inhibits phosphodiesterase - Increaes cAMP and bronchodilation
Toxicity - Super narrow theuraputic window + CYP450 - Cardiotoxicity + Neurotoxicity
Montelukast - Class + Use
Class - Antileukotrine - LTD4 Receptor Inhibition
Use - Asthma
