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Pharmacology > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Decongestant contraindications

A

narrow angle glaucoma
severe uncontrolled HTN
CAD
Tx with MAOI in past 14 days

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2
Q

Decongestants with MAOI medication

A

HTN crisis

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3
Q

Antitussive contraindication

A

MAOI in past 14 days

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4
Q

Acute and chronic rhinosinusitis

A

Acute lasts for less than 4 wks

Chronic lasts for more than 12 wks

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5
Q

Abt prescribing for rhinosinusitis

A

Most cases are viral but abt is still prescribed in most cases

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6
Q

Abts for tx on ARS

A 
Amoxicillin/Augmentin
doxycycline
levofloxacin/moxifloxacin
clindamycin
cefpodoxime/cefixime
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7
Q

contraindications to amoxicillin/augmentin

A

hepatic dysfunction/jaundice

ER contraindicated with CrCl <30mL/min

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8
Q

Amoxicillin/Augmentin interactons

A

may increase methotrexate and warfarin
may be increased by probenecid
taking allopurinol can cause increased risk of allergy to amoxicillin

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9
Q

1st line therapy for ABRS

A

Augmentin unless PCN allergic then use:
doxycycline, levofloxacin, or moxifloxacin
Levofloxacin in children with PCN allergy

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10
Q

2 or less symptoms/wk
2 or less night awakening/mo
use of emergency SABA 2x or less/wk
exacerbations requiring corticosteroids 0-1/yr

A

intermittent asthma age 12 and older

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11
Q

symptoms more than 2 days/wk but not daily
3-4 night awakenings/mo
SABA use >2 days/wk but not more than once daily
2+ exacerbations requiring corticosteroids/yr

A

mild persistent asthma 12 yrs and older

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12
Q

symptoms daily
more than 1 night awakening per week but not nightly
SABA daily
2+ exacerbations/yr

A

moderate persistent asthma age 12 and older

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13
Q

symptoms throughout the day
often 7 night awakening/wk
SABA several times/day
2+ exacerbation/yr

A

severe persistent asthma in 12 and older

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14
Q

what should all persons with asthma have

A

SABA for quick relief of symptoms

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15
Q

preferred tx for intermittent asthma

A

SABA prn

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16
Q

preferred tx for mild persistent asthma

A

Low dose ICS

Alternative: Cromolyn, LTRA, theophylline

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17
Q

Preferred tx for moderate persistent asthma (step 3)

A

Low dose ICS + LABA
OR
medium-dose ICS

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18
Q

preferred tx for moderate persistent asthma (step 4)

A

Med dose ICS + LABA

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19
Q

preferred tx for severe persistent asthma (step 5)

A

High dose ICS + LABA
AND
consider omalizumab for those with allergies

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20
Q

preferred tx for severe persistent asthma (step 5)

A

High dose ICS + LABA + oral CS
AND
consider omalizumab for those with allergies

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21
Q

SABA drugs

A 
albuterol (Proventil HFA, Ventolin HFA, ProAir HFA)
Albuterol neb (Accuneb)
22
Q

ICS drugs

A 
beclomethasone (QVAR)
budesonide (Pulmicort)
ciclesonide (Alvesco)
fluticasone (Flovent)
mometasone (Asmanex)
23
Q

combo ICS/LABA drugs

A

formoterol/budesonide (Symbicort)
formoterol/mometasone (Dulera)
samlmeterol/fluticasone (Advair HFA/Advair diskus)
vilanterol/fluticasone (Breo Ellipta)

24
Q

Leukotriene-modifying drugs

A

montelukast (Singular)
zafirlukast (Accolate)
zileuton (Zyflo)

25
Q

LABA drugs

A

Salmeterol (Serevent diskus)

formoterol (Perforomist or Foradil)

26
Q

contraindications to SABA/LABA drugs

A

use with caution with known cardio disease, DM, glaucoma, hyperthyroidism, and seizure disorders

27
Q

when would you use leukotriene modifier drugs

A

alternate medications for long term control of mild persistent asthma or with an ICS for long term control of moderate persistent asthma

28
Q

mast cell stabilizer drugs

A

cromolyn (neb)

29
Q

methylxanthine drugs

A

theophylline

aminophylline

30
Q

omalizumab high risk for anaphylaxis

A

Observe for 2 hours after 1st 3 doses and 30min after each dose thereafter

31
Q

How long does it take to achieve max benefit with most asthma control medications

A

3-4 months

32
Q

exercise induced bronchospasm

A

SABA 15 minutes prior to exercise if anticipated, otherwise they can try warming up, breathing through a mask

33
Q

SAMA (short-acting anticholinergics) drugs

A

Ipratropium bromide (Atrovent)

34
Q

LAMA (long term anticholinergic) drugs

A 
tiotropium bromide (Spiriva)
aclidinium bromide (Tudorza)
umeclidinium bromide (Incruse ellipta)
35
Q

combo SABA/SAMA drugs

A

ipratropium bromide/albuterol (DuoNeb) - nebulizer

ipratropium bromide/albuterol (Combivent Respimat) - inhaler

36
Q

combo LAMA/LABA drugs

A

tiotropium/olodaterol (Stiolto Respimat)

37
Q

Tx for Group A COPD

A

prn: SABA or SAMA (SABA if on LAMA)
maint: LAMA or LABA or SABA/SAMA

38
Q

Tx for group B COPD

A

prn: SABA or SAMA or SABA/SAMA (SABA if on LAMA)
1st choice maint: LAMA or LABA
2nd choice maint: LAMA/LABA

39
Q

Tx group C COPD

A

prn: SABA or SAMA or SABA/SAMA (SABA if on LAMA)
1st choice maint: LAMA/ICS or LABA/ICS
2nd choice maint: LABA/LAMA or LAMA/PDE4I or LABA/PDE4I

40
Q

PDE4I drugs for COPD

A

roflumilast (Daliresp)

41
Q

Tx for group D COPD

A

prn: SAMA or SABA or SAMA/SABA (SABA if on LAMA)
1st choice maint: ICS/LAMA or ICS/LABA
2nd choice maint: ICS/LAMA/LABA or ICS/LABA/PDE4I or LABA/LAMA or LAMA/PDE4I

42
Q

ultra long-acting beta-adrenergic agonists (ULABAs)

A

Vilanterol
indacaterol (Arcapta)
olodaterol (Striverdi)
aformoterol (Brovana)

43
Q

SAMA and LAMA contraindications

A

use with caution in narrow-angle glaucoma, myasthenia gravis, prostatic hyperplasia, and bladder neck obstruction

44
Q

methylxanthines (theophylline) and smoking

A

smoking induces theophylline metabolism lowering drug concentration

45
Q

PDE4I adverse events

A

increases suicide risk

weight loss

46
Q

when are abts indicated in acute bronchitis

A

concomitant COPD
high fevers
purulent sputum
respiratory symptoms >4-6 days

47
Q

why are those with chronic bronchitis predisposed to respiratory infections

A

overproduction and hypersecretion of mucus from goblet cells

impaired mucociliary clearance due to chronic inhalation of irritating substances

48
Q

tx of simple chronic bronchitis

A

amoxicillin or doxycycline

49
Q

tx for complicated chronic bronchitis

A

augmentin
2nd or 3rd generation cephalosporin
macrolide
fluoroquinolone

50
Q

when should fluoroquinolones be used for bronchitis

A

when patients fail alternative abt treatment, those with allergies to alternative abts, those with resistant pathogens

51
Q

preferred tx for pna in previously healthy adults with no recent abt usage and no risk factors for DRSP

A

macrolide (azithromycin or clarithromycin) OR doxycycline

52
Q

preferred tx for pna in those with comorbidities, abt usage in past 3 months, or risk factors for DRSP

A

B lactam (high dose amoxicillin) or Augmentin

Pharmacology (11 decks)

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