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Pharm Exam 3 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

where is the site for gas exchange

A

type 1 alveolar cells

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2
Q

type of cell that produces surfactants that are secreted onto the inner surface of the alveoli

A

type II alveolar cells

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3
Q

action of surfactant

A

reduces water surface tension and supports inflation of the lungs

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4
Q

what do elastic fibers do?

A

they surround alveoli and are stretched during inflation and recoil during expiration; recoil provides a major force for expelling air from the lungs

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5
Q

PNS effect on the lungs

A

bronchoconstriction mediated by muscarinic cholinergic receptors

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6
Q

SNS effect on the lungs

A

epinephrine causes vasodilation mediated by beta-2 adrenergic receptors

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7
Q

What is the action of mast cells?

A

mast cells respond to allergens; they bind with IgE antibodies and mediate type 1 hypersensitivity responses leading to a release of histamines

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8
Q

the action of leukocytes and eosinophils in the lungs

A

respond to inflammatory challenges–> LOX is released –> activating leukotrienes that bind to leukotriene receptors (LTR) –> bronchoconstriction and edema –> congestion and coughing

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9
Q

What is COPD characterized by?

A

Chronic inflammation of the airways that eventually results in the destruction of elastic fibers that provide recoil forces needed for expiration

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10
Q

MOA of beractant

A

MOA is a surfactant preparation administered intratracheally; reduces water surface tension in alveoli and makes inflation of alveoli easier

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11
Q

Therapeutic use for beractant

A

Can be used for preterm infants and for adults experiencing respiratory distress syndrome; pulmonary infections/edema/near drowning events associated w/ dilution of surfactants along the lining of the alveoli

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12
Q

MOA of alpha-1 anti-proteinases

A

MOA is “replacement” therapy of an alpha-1 proteinase genetic deficiency disorder; this enzyme normally limits the degree of elastic fiber destruction associated with inflammatory states

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13
Q

therapeutic used for alpha-1 anti-proteinases

A

Used to treat genetically linked forms of emphysema (COPD) that is associated w/ the absence of anti-elastases in leukocytes

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14
Q

Example of an expectorant

A

guaifenesin

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15
Q

MOA of expectorants

A

MOA is mild irritants of bronchial glands, stimulates secretion of water that dilutes mucus and makes it easier to dislodge it from airways

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16
Q

Example of a mucolytic

A

acetylcysteine

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17
Q

MOA of a mucolytic

A

breaks disulfide bonds within mucoproteins that are secreted by mucus glands; reduces viscosity of mucus and makes it easier to dislodge from airways – used in Tylenol toxicity

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18
Q

Therapeutic use of mucolytics

A

Treatment of cystic fibrosis, reduces mucus accumulation

Often very bronchospastic so is typically given with albuterol to help bronchoconstriction

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19
Q

MOA of Cromolyn preparations

A

a mast cell “stabilizer”; reduces mast cell release of histamine in response to an allergen; reduces mucus secretion and congestion

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20
Q

therapeutic use of cromolyn preparations

A

Prophylactic treatment of asthma attacks and allergies

Often used for exercise induced asthma

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21
Q

Examples of antihistamines

A

diphenhydramine and loratadine

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22
Q

MOA of antihistamines

A

MOA is an H1 histamine receptor antagonist; reduces histamine induced mucus secretion and congestion

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23
Q

therapeutic use of antihistamines

A

Treatment of acute allergic reactions: rhinitis, urticaria, and conjunctivitis; motion sickness

24
Q

difference between diphenhydramine and loratadine

A

Loratadine is a 2nd generation antihistamine that does not pass BBB as readily as 1st generation… reduces CNS depression

25
Q

Example of monoclonal anti- IgE antibodies

A

omalizumab

26
Q

MOA of monoclonal anti-IgE antibodies

A

selectively binds to IgE antibodies in the blood which prevents them from attaching to mast cells, thus preventing the release of histamines

27
Q

therapeutic uses of monoclonal anti-IgE antibodies

A

Used to treat moderate to severe forms of allergic asthma; advantages include improved lung function, a reduction in asthma attacks, and reduced treatment w/ glucocorticoids

28
Q

Example of an anticholinergic

A

ipratropium

29
Q

MOA of anticholinergics (ipratropium)

A

MOA is muscarinic cholinergic receptor antagonist; Inhaler

30
Q

therapeutic uses for anticholinergics

A

Used to reduce receptor mediated bronchoconstriction associated w resp. Disorders (COPD)

31
Q

example of a leukotriene system inhibitors

A

zileuton and montelukast

32
Q

MOA of zileuton

A

Zileuton is a lipoxygenase (LOX) inhibitor which acts to block the production of leukotrienes

33
Q

MOA of montelukast

A

montelukast is a selective leukotriene receptor antagonist (leukotrienes are still produced but cannot bind)

34
Q

therapeutic use for leukotriene inhibitors

A

Used to treat leukotriene mediated bronchoconstriction and often associated w asthma and allergic responses

35
Q

examples of glucocorticoids (corticosteroids)

A

beclomethasone, prednisone (intermediate acting) and dexamethasone (long acting)

36
Q

MOA of glucocorticoids

A

MOA is cortisol receptor agonists; they stimulate the production of lipocortin which is an inhibitor of phospholipase A2, thus reducing the inflammatory cascade

37
Q

therapeutic use of glucocorticoids

A

Used to treat asthma, COPD, allergic rhinitis, derm. Allergies and RA

38
Q

Example of antitussives

A

codeine and dextromethophan

39
Q

MOA of codeine

A

opioid receptor agonist that suppresses the activation of the cough center in the brain stem

40
Q

MOA of dextromethorphan

A

MOA increases the sensory threshold for airway obstruction that activates the cough center (non-addictive, no resp. Suppression) but the precise MOA is unknown… it binds to the NMDA receptor and acts as an antagonist and a sigma-1 agonist.

41
Q

therapeutic uses of antitussives

A

cough suppressant associated with non-productive coughs

42
Q

Examples of bronchodilators

A

theophylline, albuterol, terbutaline, salmeterol and mag sulfate

43
Q

MOA of theophylline

A

a cAMP PDE inhibitor

44
Q

MOA of albuterol

A

short acting beta-2 agonist

45
Q

MOA of terbutaline

A

a short acting beta-2 agonist

46
Q

MOA of salmeterol

A

a long acting beta-2 agonist

47
Q

MOA of mag sulfate

A

MOA is not fully understood but evidence suggests that mag interferes w/ calcium channels in smooth muscle and causes muscle relaxation (bronchodilation)

48
Q

Role of cAMP in bronchodilation of the smooth muscle cell

A

CAMP promotes relaxation of the bronchial smooth muscle. Phosphodiesterase (PDE) metabolizes cAMP. We don’t want it to be metabolized! We want more cAMP to continue to broncho dilate

49
Q

therapeutic uses of bronchodilators

A

used in the treatment of asthma, etc.; theophylline can be used to treat patients who are unresponsive to albuterol and can increase rates of respiration in pre-term infants (increases sensitivity of respiratory control center to pCO2)

50
Q

Which interleukin binds to eosinophils to encourage eosinophil recruitment

A

IL-5

51
Q

Example of a cromolyn preparation

A

Intal

52
Q

Risk of Omalizumab

A

anaphylactic shock; must be given IM in a doctors office and monitored after

53
Q

Theophylline side effect

A

Activation of the SNS.. feeling very energized and hyperactive

54
Q

Children in emergency situations who are having an asthma attack and are unable to inhale albuterol should be given what?

A

terbutaline subQ

55
Q

What do eosinophils respond to, to create an inflammatory cascade?

A

Interleukin-5 (IL-5)

56
Q

MOA of reslizumab

A

IL-5 receptor antagonist; blocks the interaction between IL-5 and eosinophils

57
Q

therapeutic use for reslizumab

A

severe eosinophilic asthma

Pharm Exam 3 (5 decks)

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