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Pharm 6 > Resp Drugs > Flashcards

Resp Drugs Flashcards

1
Q

SABA MOA

A

activate B2 receptors

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2
Q

ADR SABA

A 
tachy
bronchospasm
tremor
anxiety
hyperglycemia
hypokalemia
hypomagnesemia
Tolerance with daily use**
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3
Q

ADR LABA

A

SABA + Muscle cramps

BLACK BOX!!! - kids 4-11 asthma

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4
Q

Use of SABA

A

rescue inhaler for SOB

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5
Q

Use of LABA

A

asthma and emphysema

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6
Q

LABA as sole therapy?

A

NO!! must use with corticosteroid

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7
Q

Albuterol

A

SABA

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8
Q

Levalbuterol

A

SABA

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9
Q

Salmeterol

A

LABA*

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10
Q

Metaproterenol

A

SABA

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11
Q

Terbutaline

A

SABA

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12
Q

Formoterol

A

LABA*

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13
Q

Pirbuterol

A

SABA

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14
Q

Fenoterol

A

SABA

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15
Q

Epinephrine

A

non-selective beta agonist

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16
Q

Ephedrine

A

non-selective beta agonist

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17
Q

Isoproterenol

A

non-selective beta agonist

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18
Q

When to use non-selective beta agonist

A

bronchospasm w/ anaphylaxis
hypotensive in shock
INCREASE HR, BP, CP

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19
Q

Methylzanthine MOA

A

relaxes smooth muscles
reduces inflammation
*BRONCHODILATOR

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20
Q

Methylzanthine ADR

A

Get even within range!!
NARROW THERAPEUTIC WINDOW

CNS (insomnia, HA, seizures)
Cardiac (afib, PVC,tachy)
GI (N/V)
reverses diaphragm fatigue

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21
Q

Methylzanthine 1/2 life

A

8hrs norm

4.5 in smokers and kids

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22
Q

how is Methylzanthine taken

A

PO - sustained release

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23
Q

Dosing for Methylzanthines

A

10-15mcg/mL - may still get GI and CNS

> 25 - seizures and arrhythmias

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24
Q

Methylzanthines ending?

A

-phylline

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25
Q

Theophylline

A

Methylxanthine

- more drug interactions

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26
Q

Aminophylline

A

Methylxanthine

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27
Q

When to use Methylxanthine

A

orally for people who cannot tolerate inhaled

COPD mostly, but also asthma

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28
Q

Antimuscarinics MOA

A

bronchodilation

COPD

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29
Q

When to use antimusc

A

COPD

Asthma - can’t use SABA (ipratroprium)

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30
Q

Ipratroprium

A

SA antimusc

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31
Q

Tiotroprium

A

LA antimusc

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32
Q

Aclidinum

A

antimusc

33
Q

Umeclindinium

A

antimusc

34
Q

Antimusc ADR

A

anti SLUDGE

  • dry mouth
  • inc IOP
  • urinary retention
35
Q

When NOT to use antimusc

A

glaucoma
BPH
bladder obstruction

36
Q

Which antimusc in asthma/when

A

ipratroprium

when can’t use SABA

37
Q

ICS - important?

A

MOST EFFECTIVE LONG TERM TREATMENT!!

38
Q

ICS endings

A
  • sone
  • one
  • ide
39
Q

ICS MOA

A

decreases constriction
reduces mucus and edema
decreases exacerbations

40
Q

IV and IM steroids?

A

Depomedrol

Solumedrol

41
Q

Oral steroid?

A

Prednisone

42
Q

Mild to mod asthma ICS use?

A

1-2x day

43
Q

Severe asthma steroid use?

A

ICS + systemic!

44
Q

ADR ICS

A

thrush
dysphonia
reflex cough and bronchospasm

45
Q

tox ICS

A 
thin skin
immunosupress
changes in bone denstiy
cataracts/glaucoma
gland func supression
edema
46
Q

Cromolyn MOA

A

inhibits cough

inhibits mast cells and eosinophil release

47
Q

when to use Cromolyn?

A

PROPHYLACTICALLY!!

antigen or exercised induced asthma!

48
Q

ADR cromolyn

A

bad taste
mouth dry
throat irritation
chest tight and wheeze - b2 inhaler before will help

49
Q

Cromolyn Sodium

A

Cromolyn

50
Q

Nedocromil

A

Cromolyn

51
Q

When to use Leukotriene modifiers

A

Kids who do not want to do ICS
aspirin induced asthma
oral - 1x day

52
Q

which Leukotriene modifiers is best

A

Montelukast - has less ADRs and tox

53
Q

Leukotriene modifiers ADR

A

Zarfilukast and Zileuton - hepatic injury
Zarfilukast - interfere with metabolism of warfarin, felodipine, lovastatine, phenytoin
CHURG STRAUSS - vasculitis and eosinophilia

54
Q

Montelukast

A

Leukotriene modifiers

55
Q

Zarfirlukast

A

Leukotriene modifiers

56
Q

Zileuton

A

Leukotriene modifiers

57
Q

Omalizumab

A

Anti-IgE Monoclonal Antibody

58
Q

Anti-IgE Monoclonal Antibody MOA

A

prevents release of inflamm mediators after allergen exposure

59
Q

How to use Anti-IgE Monoclonal Antibody (Omalizumab)

A

SQ 2-4 weeks in office b/c possible allergic reaction/anaphylaxis

60
Q

When to use Anti-IgE Monoclonal Antibody (Omalizumab)

A

mod-severe asthma NOT CONTROLLED on ICS w/ sensitization to airborne allergen
>12 y.o.
EXPENSIVE!

61
Q

Romfluilast

A

Phosphodiesterase Inhib

62
Q

Phosphodiesterase Inhib (Romfluilast) MOA

A

relax smooth muscle in lungs

decrease inflamm reaction

63
Q

When to use Phosphodiesterase Inhib (Romfluilast)

A

orally 1x day for COPD
*more selective than thephylline

** NOT FOR ACUTE - NOT BRONCHODILATOR

64
Q

ADR Phosphodiesterase Inhib (Romfluilast)

A

N/D
weight loss
anxiety
insomnia

65
Q

Short term goals for asthma

A

make symptoms better, improve func

66
Q

long term asthma goals

A

prevent exaccerbation and loss of pulm func

67
Q

Best/most often asthma treatment??

A

SABA and ICS

68
Q

when should a ashtma pt have SABA

A

ALWAYS - always have with them!

69
Q

When pt on SABA, when should you add ICS

A

> 2x week use of SABA

70
Q

Not controlled of low does ICS and SABA?

A

increase dose OR add LABA

71
Q

Acute Asthma in ER

A 
O2
SABA - combine with ipratroprium(?)
           - nebulizer
severe?? - add oral/iv steroids
obstruction?? - perenteral steroids and inhaled
72
Q

When to use antimusc in ashtma?

A

NOT 1st LINE!!
pts who cannot tolerate SABA

use ipratroprium

73
Q

When/ how to use Cromolyn or Leukotriene modifiers

A

use like a low dose steroid

Cromolyn - clear cut inciting event –> take before the event, seasonal

LTM - more compliance, easier to use (kids)

74
Q

exercise induced bronchoconstriction tx

A

SABA prior to exercise (2-3hrs)
LABA prior (up to 12 hrs)
Montelukast prior (up to 24 hours)
start on ICS if EIB occurs due to poor control of asthma

75
Q

Asthma in preg??

A

SABA - albuterol

ICS - budesonide

76
Q

Asthma in kids

A

1 - SABA

2- ICS or Montelukast

77
Q

Acute COPD

A

SABA or SA anticholinergic

*can use combo

78
Q

Chronic COPD

A

1- LABA/ LA anticholinergic OR Methyxanthines (intolerant to inhaled theraphy)
2- ICS

Pharm 6 (5 decks)

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