Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm Spring 2014 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Asthma meds are aimed at

A

flattening the response to inflammatory mediators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why is it that steroids that work in asthma have minimal response in COPD?

A

Because the inflammation in COPD is of a different pathway than that of asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Inhaled _________ can help reduce the frequency of COPD exacerbations

A

corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

This type of medication has only a modest ole in increasing air outflow in a patient with COPD with chronic breathlessness that is worsened by exercise

A

Bronchodilators

So basically in COPD, bronchodilators don’t really help and the steroids used in asthma don’t really work either. People with COPD are placed on corticosteroids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

R sided heart failure with COPD

A

Those with CB experience R HF and cor pulmonale as part of the disease process

Those with emphysema experience R heart problems during acute infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pink puffers refer to __1___

Blu bloaters refer to __2__

A 
1= emphysema
2= CB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PaCO2 in COPD

A

High in CB

Normal in emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Types of bronchodilators used

A

Beta agonists
Anti-cholinergics
Methyxanthines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Problem with using epi for treatment of bronchoconstriction

A

It has B1 and alpha effects as well, which can cause tachycardia, palpitations, and vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Selective B2 agonists

(Short and long acting)

A 
Short acting:
- Terbutaline
- Albuterol
- Levalbuterol (the most B2 selective!)
- Salbumatol
^^ We go for the first three of these because we can repeat the dose multiple times

Long-acting

  • Salmeterol (pts on this at home and use albuterol for acute attacks)
  • Formoterol

All of these B2 selective agents have an affinity for B2 200-400 times stronger than that for B1.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What happens at high doses of B2 selective agents?

A

They become less selective and start affecting other receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Effect of B2 agonists on electrolytes

A

Hypokalemia**- increased uptake by skeletal muscle. Also there is release of glucose, causing an insulin spike, driving K+ into cells. Also, B2 stimulates the Na/K pump, further driving K+ into cells.

Hypomagnesemia

Hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

3 beneficial effects of B2 on the bronchi

A

Smooth muscle relaxation / bronchodilation
Decreased release of histamine from mast cells
Increased ciliary clearance of mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Onset of action of B2 agonists

A

15-30 minutes

Levalbuterol may act as soon as 5 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are B2 agonists given?

A

Inhaled, nebulized, aerosolized, powder, orally, SQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Only B2 agonist that can be given SQ

A

Terbutaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Side effects of B2 agonists

A 
Muscle tremor (B2)
Increased HR (B1)
Vasodilation (B2)
Metabolic changes (B2)- hypokalemia, hyperglycemia, and mypomagnesemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can B2 side effects be minimalized?

A

Inhalation delivery (decreases systemic effects by keeping it in the lungs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Albuterol dosing

A

100cmg/puff
2 puffs Q4-6 hours
Nebulizer dose: 2.5-5 mg in 5mL of saline

20
Q

Albuterol DOA

A

4-8 hours

21
Q

Albuterol has an additive effect with _______ on bronchomotor tone

A

Anesthetics

22
Q

2 Isomers of albuterol

A

R- This is Levalbuterol and is more B2 selective

S- This type of albuterol has more affinity for B1

23
Q

How to blunt airway hyperresponsiveness prior to anesthesia

A

4 puffs of albuterol

or

2 puff albuterol + 1mg/kg of lidocaine IV

24
Q

Bitolterol

A

B2 selective agent that resembles albuterol but is longer lasting.
CV side effects are rare
Dose is 270mcg/puff
Max of 16-20 puffs/day

25
Q

SQ use of terbutaline

A

SQ use resembles the effects of epinephrine.
Used for status asthmaticus or pre-term labor
Dose for adults in .25mg SQ Q 15 min
Dose for peds is .01mg/kg SQ

26
Q

Terbutaline inhaler dose

A

200mcg/puff

Max of 16-20 puffs/day

27
Q

How can terbutaline be administered?

A

Inhalation
SQ
Oral

28
Q

How do long-acting B2 agonists work?

A

They have a lipophilic side chain that resists degradation. Results in a DOA of 12-24 hours. These are not used for acute attacks.

29
Q

How can the amount of time between asthma flare-ups be avoided?

A

Combined therapy of a long-acting B2 agonist and a steroid

30
Q

Methylxanthines are also called ______

A

Phosphodiesterase inhibitors

31
Q

What is the MAJOR PREVENTATIVE treatment for patients with asthma?

A

Inhaled corticosteroids

32
Q

This is the most important type of drug in the management of asthma

A

Inhaled corticosteroids

33
Q

Do corticosteroids cure asthma?

A

No. They are used as a supportive therapy, not a cure.

34
Q

The degree of bronchoconstriction and hyperresponsiveness in asthma paralleles _____

A

the degree of inflammation

35
Q

Asthma is characterized by these two features

A

Inflammation and hyperresponsiveness

36
Q

Effect of using corticosteroids with a B2 blocker

A

It increases the DOA of the B2 blocker

37
Q

Effect of eosinophil degranulation

A

Interferes with the activity of M2 receptor, causing bronchoconstriction

38
Q

Salmeterol is given as a combination of

A

Salmeterol and fluticasone

39
Q

These are the most important drugs in asthma management

A

Corticosteroids

40
Q

These are the most important drugs in COPD management

A

anticholinergics (tiotropium is best –> only FDA approved anticholinergic for COPD).

Tiotropium has minimal SE because it doesn’t cross the respiratory epithelium

41
Q

Methylxanthines (phosphodiesterase inhibitors) interact with this anesthetic

A

Halothane

42
Q

How long does it take for cromolyn to take effect? How does cromolyn work? What are the SEs?

A

It is a mast cell stabilizer (inhibits antigen-induced histamine release). It is for preventative therapy only!!! Takes 7 days for effect to kick in.

43
Q

Montelukast (Singulair) can interact with ____ and cause ______

A

Warfarin

Prolonged PT

44
Q

The Anti-IgE antibody we know if called

A

Omalizumab

45
Q

Nerves that aren’t part of the ANS can release these substances to induce bronchiole dilation

A

NO and VIP

Pharm Spring 2014 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions