Respiratory Flashcards
Resilzumab
IL-5 receptor antagonist has been approved for severe eosinophillic asthma
Severe asthma where patient eosinophil levels are elevated despite compliance and glutocorichoids
Eosinophillic asthma
What are drug treatment strategies for patients who have stable copd and have fev1 value that is less then 70% of healthy individuals
Bronchodilators and anticholinergics
Codeine MOA
Opioids agonist that suppresses cough center in brain stem
Bronchodilators- theophylline
Camp pde inhibitors.
Can use if unresponsive to albuterol
Albuterol and terbulatine
Short acting beta 2 adrenergic agonist
Salmeterol
Long acting beta 2 adrenergic agonist
Mag sulfate
Bronchodilators- MOA not fully known but interfere with calcium channels and causes smooth muscle relaxation
Is theophylline a good choice for people who experience seizures or insomnia
No it activates the sns because it’s non selective bronchodilator. Also interacts with seizure meds
What are the types of asthma
Intermittent or persistent.
Persistent is mild/moderate/severe
Goals of treatment for asthma
Minimize side effects, prevents progressive loss of pulmonary function and LDAS, ***3 more
Intermittent treatment of asthma
Prn bronchodilators/rescue inhalers, short acting beta agonist (albuterol and terbutaline)
Persistent (mild/mod/severe) asthma treatment
And severe
Daily inhalation of glucocorticoids first line and prn rescue inhaler
Severe- long acting beta2 agonist
Acute severe asthma treatment
Oxygen, systemic dose glucocorticoid, nebulized form of short acting beta 2 agonist combined with ipathdium
Alveolar type 2 cells
Produce surfactant.
What happens when elastic fibers break down around alveoli
Copd
Bronchial glands release water to ?
Keep airways moist
Pns activated by
Bronchoconstriction by muscarinic cholinergic receptors
Sns and epi cause
Bronchodilation mediated by beta 2 adrenergic receptors
Elastic fibers surround alveoli are stretched during what part of breathing?
Inspiration
Beractant moa/therapeutic use
Surfactant preparation administrated intratrachaelly. Reduces water surface tension in alveoli and makes inflation of alveoli easier
Used in preterm infants and events where dilution of surfactant like drowning/ards/pulmonary
Alpha1 antityrpsin (type of antielastase ) deficiency moa/therapeutic use
Treat genetically linked form of emphysema (copd) that is associated with the absence of antilastases in leukocytes/without antielastase there is a breakdown of elastic around alveoli leading to copd. MOA replacement therapy of an alpha1 prolastin (alpha1 antityrpsin) iv infusion
Expectorant/guaifenesin MOA / therapeutic use
Menthol containing. MOA mild irritant of bronchial glands. Stimulates secretion of water that dilutes mucous and makes it easier to dislodge
Mucolytics MOA/therapeutic use
Acetylcysteine (mucomyst) MOA- breaks disulfide bonds with mucoproteins that are secreted by mucus glands. Reduces viscosity of mucus and makes it easier to dislodge from airways. Antidote to Tylenol overdose. Helps replace glutathione
Med is bronchospastic needs albuterol and beta 2 agonist before hand
Cromolyn preparations (intal)
MOA- mast cell stabilizer. Reduces mast cell release of histamine in response to an allergen/ reduces mucus secretion and congestion. Uses prophylactic treatment of asthma attach, must be used before and not for an acute attack. Usually used before exercise induced asthma
Omalizumab
Monoclonal anti igE antibody. 2 week injection. Increased risk of anaphylactic reaction must be done in dr office. MOA- selectively binds to Ige antibodies in blood which prevents them from attaching to mast cells and prevents release of histamine following antigen exposure
Treat moderate/severe forms of allergic asthma and reduces treatment with glucocorticoids
Anticholinergics - ipatropium
MOA- Muscarinic cholinergic receptor antagonist
Therapeutic use- reduce cholinergic receptor mediated bronchoconstriction associated with respiratory disorders/ copd
Leukotiene system inhibitors
zilueton/montelukast
Inflammatory challenge chart
Zilueton/ montelukast
MOA/ zileuton is lipooxygenase inhibitor which acts to block production of leukotines
Montelukast is a selective leukotrienes receptor antagonist
Glucocorticoids - steroid anti inflammatory
Prednisone- Intermed
Dexamethasone - long acting
MOA- steroid anti inflammatory drugs are cortisol receptor agonist. Stimulate production of lipocortin which is an inhibitor of phospholipase a2 and this reduces production of arachiodomic acid, prostaglandin and Leuko which results in reduced inflammation. Used for asthma, copd, allergies and immunosuppressant
Dextromethorphan
Cough supressant. Increases the sensory threshold for airway obstruction that activates the cough center. Precise MOA unknown shown to be NMDA antagonist and signal receipt agonist
