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N233 > Resp Meds > Flashcards

Resp Meds Flashcards

1
Q

What is the mechanism of action of a short acting beta 2 receptor agonist?

A

Bronchial smooth muscle relaxation causing bronchodilation through activating beta2-adrenergic receptors

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2
Q

What is the indication of short acting beta 2 receptor agonists?

A

Prevention or relief of bronchospasm in asthma or COPD. Used PRN, inhaled.

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3
Q

What are the side effects of short acting beta 2 receptor agonists?

A

In larger doses, may cause anxiety, nausea, tremors, palpitations, increased heart rate -> tachydysrthythmias, angina, seizures.

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4
Q

What are the contraindications/interactions of short acting beta 2 receptor agonists?

A

Effects may be diminished if pt is taking beta blockers. Avoid use in pts taking MAOIs/other sympathomimetics r/t risk of hypertension.

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5
Q

What is an example of a short acting beta 2 receptor agonist?

A

Salbutamol (Albuterol)

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6
Q

What is the mechanism of action of a long acting beta 2 receptor agonist?

A

Bronchial smooth muscle relaxation causing bronchodilation.

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7
Q

What is the indication of long acting beta 2 receptor agonist?

A

Prevention/long term control of bronchospasm in asthma or COPD. Fixed schedule, not PRN, inhaled.

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8
Q

What are the side effects of long acting beta 2 receptor agonist?

A

May increase risk of death if used monotherapy in asthma.

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9
Q

What are the contraindications/interactions of long acting beta 2 receptor agonist?

A

Effects may be diminished if pt is taking beta blockers. Avoid use in pts taking MAOIs/other sympathomimetics r/t risk of hypertension.

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10
Q

What is an example of a long acting beta 2 receptor agonist?

A

Salmeterol

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11
Q

In asthma, what must be given alongside a long acting beta 2 agonist?

A

A glucocorticoid.

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12
Q

What is the mechanism of action of an anticholinergic?

A

Blocks muscarinic receptors in the bronchi -> reduced bronchospasm

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13
Q

What is the indication of an anticholinergic?

A

Slower onset compared to beta agonist. Used for prevention of bronchospasm. COPD “off label” for asthma. Inhaled.

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14
Q

What are the side effects of an anticholinergic?

A

Dry mouth, throat, nasal congestion. Not readily absorbed systemically, but if it does this can increase intraocular pressure.

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15
Q

What are the contraindications/interactions of an anticholinergic?

A

Caution in pts with acute angle glaucoma or prostate enlargement. Possible addictive toxicity in use with other anticholinergic drugs.

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16
Q

What is an example of an anticholinergic?

A

Ipratropium, tiotropium

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17
Q

What is the mechanism of action of methylxanthines?

A

Bronchodilation by relaxing the smooth muscle of the bronchi. Not firmly established - likely from blocking adenosine receptors.

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18
Q

What is the indication of methylxanthines?

A

Chronic - asthma, decrease frequency and severity of attacks. No longer recommended for COPD.
PO or IV

19
Q

What are the side effects of methylxanthines?

A

Toxicity, nausea, vomiting, diarrhea, insomnia, restlessness.

20
Q

What are the contraindications/interactions of methylxanthines?

A

Caffeine, tobacco, marijuana, many drug interactions.

21
Q

What is an example of methylxanthines?

A

Aminophylline, theophylline

22
Q

What is the mechanism of action of inhaled corticosteroids?

A

Reduces inflammation, decreases edema and results in bronchodilation. Increases responsiveness to beta agonists (eg salbutamol)

23
Q

What is the indication of inhaled corticosteroids?

A

Persistent asthma, often used in conjunction with beta agonists. May also be used in moderate to severe COPD or in exacerbations as they can improve symptoms.

24
Q

What are the side effects of inhaled corticosteroids?

A

Oral-pharyngeal candidiasis, dysphonia, delay growth in children?, long term bone loss.

25
Q

Why is there no serious risk of toxicity when using inhaled corticosteroids?

A

Because there is no adrenal suppression.

26
Q

What are the contraindications/interactions of inhaled corticosteroids?

A

Less contraindications/interactions when inhaled.

27
Q

What is an example of an inhaled corticosteroid?

A

Beclomethasone, budesonide

28
Q

What is the mechanism of action of leukotriene receptor antagonists?

A

Suppress effects of leukotrienes (which promote smooth muscle constriction, vessel permeability, and inflammatory responses directly). Decreases bronchoconstriction.

29
Q

What is the indication of leukotriene receptor antagonists?

A

Maintenance therapy in chronic asthma. Second line therapy (if inhaled glucocorticoids cannot be used). Used for adults and children 5 and above. PO

30
Q

What are the side effects of leukotriene receptor antagonists?

A

Headache, GI, arthralgia, myalgia, neuropsychiatric effects

31
Q

What are the contraindications/interactions of leukotriene receptor antagonists?

A

Interacts with various drugs eg aspirin, erythromycin, warfarin

32
Q

What is an example of leukotriene receptor antagonists?

A

Zafirlukast

33
Q

What are Metered drug inhalers (MDI)?

A
  • Pressurized devices
  • 1 minute in between uses
  • Teaching important!
  • Spacer
34
Q

What is Respimat?

A
  • Fine mist

- Less drug in the mouth and oropharynx

35
Q

What are Dry-powder inhalers (DPI)

A
  • Micronized powder
  • Breath activated
  • Spacers not used
36
Q

What are Nebulizers?

A
  • Mist

- For some this may be more effective

37
Q

Life span considerations for children?

A
  • Special delivery devices
  • SABA - approved over 2 but may be used younger
  • Methylxanthines - all ages
  • Anticholinergics - safety not established under 11
  • Inhaled glucocorticoids preferred
38
Q

Life span considerations for breastfeeding?

A
  • Caution recommended

- Inhaled considered safe - system contraindicated

39
Q

Life span considerations for pregnant?

A

Uncontrolled asthma associated with fetal risks

40
Q

Life span considerations for older adults?

A

Consider benefits vs. risks

41
Q

Low doses of opioids are very effective in decreasing ___________________ (morphine sulphate is used most commonly)

A

The perception of dyspnea

- Exact mechanism unknown

42
Q

What are Antitussives?

A
  • Cough suppressants
  • Should be only given for an ongoing dry, non-productive cough
  • Opioid based (codeine)
43
Q

What are Expectorants used for?

A

To reduce viscosity of secretions for easier removal

44
Q

What are Mucolytics used for?

A
  • Break down chemical structure of mucus for easier removal by coughing
  • Use with caution

N233 (3 decks)

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