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pharm exam quiz 3 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What is Roflumilast?

A

A PDE 4 inhibitor used primarily for severe COPD, particularly for those with chronic bronchitis.

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2
Q

What is the MOA of Roflumilast?

A

Reduces inflammation by increasing levels of cyclic AMP within the lung cells, leading to decreased inflammatory activity which helps decrease severity of exacerbations in COPD.

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3
Q

What are side effects of Roflumilast?

A

GI symptoms and weight loss

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4
Q

What are the muscarinic antagonists?

A

Ipratropium: (short acting muscarinic antagonist) commonly used for quick symptom relief in COPD

Tiotropium: (long-acting muscarinic antagonist), used in COPD for long term management

Umeclidinium: (long-acting muscarinic antagonist)

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5
Q

What is the MOA of muscarinic antagonists?

A

also known as anticholinergics, they block the action of acetylcholine on muscarinic receptors in the airways. this blockage prevents acetylcholine from causing bronchoconstriction and mucus secretion, leading to bronchodilation and reduction in mucus production.

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6
Q

What are side effects of muscarinic antagonists?

A

dry mouth, but because they act locally in the lungs when inhaled, systemic side effects are minimal

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7
Q

What is Theophylline?

A

A bronchodilator that works by relaxing smooth muscle in the airways, helping to relieve airflow obstruction.

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8
Q

What are side effects of Theophylline?

A

Narrow therapeutic range so even slight increases in blood levels can lead to toxicity.
Theophylline toxicity can cause seizures and cardiac arrhythmias

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9
Q

How is Theophylline metabolized?

A

In the liver by the CYP450 family. This means that drugs that inhibit CYP450 can increase theophylline levels while drugs that induce CYP450 can decrease theophylline levels.

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10
Q

What are the medications under the beta agonist drug class?

A

Short acting: albuterol (used as a rescue inhaler for asthma symptoms)

Long acting: Salmeterol, Formoterol (used for asthma and COPD management, typically combined with an ICS.) Indacaterol (used once daily for COPD)

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11
Q

What illnesses do beta agonists help treat?

A

Beta agonists are used in treatment of asthma and COPD

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12
Q

What is the MOA of beta agonists?

A

stimulates beta 2 receptors in the smooth muscles of the airways leading to bronchodilation which helps improve airflow and reduce symptoms like SOB and wheezing.

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13
Q

What are common side effects of beta agonists?

A

Tachycardia
Hyperglycemia
Hypokalemia

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14
Q

what are notable drug interactions with beta agonists to be aware of?

A

beta blockers can counteract the bronchodilation effect. diuretics can exacerbate hypokalemia.

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15
Q

What are the drugs under leukotriene modifiers?

A

Montelukast: A leukotriene receptor antagonist

Zileuton: Leukotriene inhibitor that works differently by blocking the enzyme 5-lipoxygenase.

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16
Q

What is the MOA for montelukast and zileuton?

A

Montelukast: Inhibits leukotriene binding which reduces airway inflammation, mucus production, and bronchoconstriction helping to alleviate asthma symptoms.

Zileuton: Inhibits enzyme 5- lipoxygenase which is the enzyme responsible for making leukotriene, so this action reduces the overall production of leukotrienes.

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17
Q

What are side effects of leukotriene inhibitors?

A

Elevated LFTs
Churg Strauss Syndrome (blood vessel inflammation).

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18
Q

What is the MOA of acetylcysteine?

A

Breaks the disulfide bonds in the mucus, which decreases the thickness of the mucus. This helps to loosen and thin mucus and makes it easier to cough up and clear the airways.

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19
Q

What is the unique use of acetylcysteine?

A

Antidote for acetaminophen overdose. it replenishes glutathione, a substance that detoxifies the liver from harmful metabolites of acetaminophen.

20
Q

What are side effects of acetylcysteine?

A

N/V, rhinorrhea, unpleasant odor and taste (due to its sulfur content, this drug has a strong smell often described as rotten eggs), and bronchospasm (monitor for patients with asthma)

21
Q

What is the indication of use for Guaifenesin?

A

primary expectorant used to manage conditions with thick mucus.

22
Q

What is the MOA of guanifenesin?

A

increases the volume and reduces the thickness of respiratory secretions. this action helps to thin and loosen mucus in the airways making it easier to cough up and clear mucus from the lungs. Promotes a more productive cough.

23
Q

What are the essential inhaled corticosteroid drugs to be aware of?

A

Fluticasone, Budesonide, Beclomethasone

24
Q

What is the MOA of inhaled corticosteroids and oral glucocorticoids?

A

They reduce inflammation by inhibiting the release of inflammatory mediators. They do this by blocking phospholipase A2 and reducing activity of inflammatory cells.

25
Q

What are side effects of inhaled glucocorticoids?

A

Oral candidiasis
Cough/hoarseness/throat irritation
Because they are inhaled, systemic side effects are rare.

26
Q

What are the drugs under the oral glucocorticoids class?

A

Prednisone and methylprednisolone (only for short term use)

27
Q

What are side effects of oral glucocorticoids?

A

Weight gain
Mood changes
Hyperglycemia
Adrenal Suppression
Osteoporosis

28
Q

What are the medications under the decongestant drug class?

A

Sudafed (oral decongestant)
Sudafed PE (oral and nasal forms)
Afrin (nasal decongestant)

29
Q

What is the MOA of decongestants?

A

Stimulate alpha receptors in the nasal mucosa leading to vasoconstriction of the nasal passages, which causes decreased swelling and congestion.

30
Q

What are side effects of decongestants?

A

Rebound congestion: If used for more than 3-4 days, can lead to worsening congestion after the medication wears off.

Tachycardia/HTN, restlessness/nervousness with oral decongestants

31
Q

What is the mast cell stabilizer?

A

Cromolyn

32
Q

What is the MOA of Cromolyn?

A

Stabilizes mast cells, preventing them from releasing histamine and other inflammatory mediators that trigger allergy symptoms.

It is a preventative medication, so it must be taken consistently long term to be effective, as it doesn’t provide immediate relief of symptoms.

33
Q

What are side effects of Cromolyn?

A

Cromolyn is poorly absorbed systemically, so it has generally minimal systemic side effects and is well tolerated.

34
Q

What are the medications under the antitussives drug class?

A

Codeine: narcotic antitussive
Dextromethorphan: non-narcotic antitussive
Benzonatate: peripherally acting antitussive

35
Q

What is the MOA of codeine?

A

opioid antitussive that works by acting on the cough center in the CNS to suppress the cough reflex. It also reduces mucus secretions, providing more relief from cough.

36
Q

What is the MOA of Dextromethorphan?

A

Non-narcotic that acts on the CNS cough center to reduce the urge to cough but without the analgesic effects of opioids.

37
Q

What is the MOA of Benzonatate?

A

Peripherally acting antitussive that works by numbing the stretch receptors in the respiratory trat and lungs. This action reduces the cough reflex by decreasing the sensation that triggers coughing.

38
Q

What is a serious side effect of Benzonatate?

A

ingesting or chewing the capsules can lead to severe numbness and choking risk due to local anesthetic effect

39
Q

What is a serious side effect of Dextromethorphan?

A

High doses can cause euphoria, hallucinations, or dissociation making it a potential for drug abuse.

40
Q

What patients are contraindicated for taking Codeine?

A

Patients with respiratory depression, asthma or COPD.

41
Q

What patients are contraindicated from taking Dextromethorphan?

A

Patients taking MAOIs as this combination can lead to serotonin syndrome, a serious condition involving confusion, high BP, and muscle rigidity.

42
Q

What are the first generation antihistamine drugs?

A

Benadryl
Chlor-Trimeton
Hydroxyzine
Promethazine

43
Q

What are the second generation antihistamine drugs?

A

Zyrtec, Claritin, Allegra, Patanase, Astelin

44
Q

What is the MOA of antihistamines?

A

They block H1 receptors which prevent histamine from binding to these receptors. Histamine plays a key role in allergic reactions causing symptoms like itching, sneezing, runny nose, and inflammation.

First generation antihistamines cross the blood brain barrier, blocking H1 receptors in the CNS and peripheral tissues, leading to sedative effects.
Second generation antihistamines are more selective to peripheral H1 receptors, resulting in fewer CNS effects.

45
Q

What are the main side effects of antihistamines?

A

Sedation, Drowsiness
Anticholinergic effects (Dry mouth, Blurred Vision, Urinary retention, constipation.

Second generation has less of these side effects than the first generation

46
Q

Which patients are contraindicated from taking antihistamines?

A

Elderly patients due to CNS effects
Glaucoma patients (can worsen intraocular pressure)
BPH patients (can worsen urinary retention)

pharm exam quiz 3 (13 decks)

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