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Respiratory Flashcards

1
Q 
Albuterol 
Pirbuterol 
Terbutaline 
Metaproterenol
Description
A

Short acting beta 2 agonists

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2
Q

Albuterol, Pirbuterol, Terbutaline, Metaproterenol

Mechanism

A

Increase in cAMP ->relaxation of bronchial smooth muscle and subsequent bronchodilation

Inhalation minimizes side effects (poor absorption through the lungs)

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3
Q

Albuterol, Pirbuterol, Terbutaline, Metaproterenol

Indication

A

DOC for acute relief of bronchospasm

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4
Q

Adrenergic agonist drugs

A

Albuterol, Pirbuterol, Terbutaline, Metaproterenol
Salmeterol, Formoterol
Epinhephrine
Isoproterenol

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5
Q

Adrenergic agonist adverse

A

Tremor
Tachycardia
Arrhythmia

Tolerance with excessive use

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6
Q

Salmeterol and Formoterol description

A

Long acting beta 2 agonists

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7
Q

Salmeterol and Formoterol indication

A

LABA used mainly for prophylaxis

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8
Q

Salmeterol and Formoterol mechanism

A

Increase in cAMP -> relaxation of bronchial smooth muscle and subsequent bronchodilation

Inhalation minimizes side effects (poor absorption through lungs)

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9
Q

Epinephrine mechanism

A

Increase in cAMP -> relaxation of bronchial smooth muscle and subsequent bronchodilation

Inhalation minimizes side effects (poor absorption through lungs)

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10
Q

Isoproterenol mechanism

A

Increase in cAMP -> relaxation of bronchial smooth muscle and subsequent bronchodilation

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11
Q

Epinephrine description

A

Non specific beta agonist

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12
Q

Epinephrine indication

A

Asthma with anaphylactic shock or other specifric drugs have failed

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13
Q

Isoproterenol description

A

Non specific beta agonist

Not available via inhalation

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14
Q

Isoproterenol indication

A

Bronchodiolation via beta 2

Primary use: heart block and bradycardia (beta 1)

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15
Q

Theophylline class

A

methylxanthine derivative

bronchodilator

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16
Q

Theophylline description

A

PDE inhibitor

Also blocks adenosine receptors

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17
Q

Theophylline mechanism

A

Blocks the metabolism of cAMP resulting in bronchodilation

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18
Q

Theophylline indication

A

Limited role due to small TI

Metabolized by CYP -> inducers decrease effect, inhibitors increase effect

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19
Q

Theophylline adverse

A

Seizure and arrhythmia
Tremor, insomnia and GI issues
Hypokalemia
Hyperglycemia

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20
Q

Ipratropium class

A

muscarinic antagonist

bronchodilator

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21
Q

Ipratropium description/mechanism

A

inhaled

block PS -> decrease bronchoconstriction and mucus secretion

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22
Q

Ipratropium indication

A

drug induced bronchospasm

Tx of asthma and COPD

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23
Q

Ipratropium adverse

A

Dry mouth and sedation (poor adsorption)

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24
Q

Tiotropium class

A

muscarinic antagonist

bronchodilator

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25
Tiotropium description/mechanism
long acting | Block PS -> decrease bronchoconstriction and mucus secretion
26
Anti inflammatories for respiratory (classes)
Corticosteroids Leukotriene antagonists Antibody
27
Mast cell stabilizers
Cromolyn and Nedocromil
28
Cromolyn and Nedocromil description
Mast cell stabilizers Oral, aerosol and droplets Also used for food allergies and hay fever and rhinitis
29
Cromolyn and Nedocromil mechanism
Mast cell stabilizers | Prevent release of inflammatory mediators from mast cells
30
Cromolyn and Nedocromil indication
Prophylaxis: allergen and exercise induced bronchoconstriction NOT for acute attacks
31
Cromolyn and Nedocromil adverse
Cromolyn: laryngeal edema, cough, wheezing Nedocromil: unpleasant taste
32
Beclomethasone, Flunisolide, Fluticasone, Budesonide | Description
Inhaled steroids used in the treatment of chronic asthma
33
Beclomethasone, Flunisolide, Fluticasone, Budesonide | Mechanism
Inhibit PLA2 -> decrease AA -> decreased synthesis of cytokines, prostaglandins and other inflammatory mediators Bind to glucose response elements (GRES) -> decrease inflammation
34
Beclomethasone, Flunisoloide, Fluticasone, Budesonide | Indication
Maintenance: inhalation steroids are used to suppress inflammation and reduce risk of exacerbation Acute exacerbation: systemic steroids for severe attacks (status asthmaticus) Can also treat chronic rhinitis (beclomethasone and flunisolide) -> improvement not seen for two weeks
35
Dexamethason, Prednisolone, Hydrocortisone indication
Maintenance: inhalation steroids are used to suppress inflammation and reduce risk of exacerbation Acute exacerbation: systemic steroids for severe attacks (status asthmaticus)
36
Dexamethasone, Prednisolone, Hydrocortisone Mechanism
Inhibit PLA2 -> decrease AA -> decreased synthesis of cytokines, prostaglandins and other inflammatory mediators Bind to glucose response elements (GRES) -> decrease inflammation
37
Dexamethasone, Prednisolone, Hydrocortisone description
IV steroids
38
Dexamethasone, Prednisolone, Hydrocortison Adverse
Abnormal glucose metabolism Increase appetite and weight gain HTN Adrenal suppression
39
Beclomethasone, Flunisolide, Fluticasone, Budesonide adverse
Cough Oral Thrush Dysphonia
40
Zileuton description
inhibits 5-lipoxygenase
41
Zileuton mechanism
PO administration -> block synthesis of LT's or block LT receptors -> decrease constrictionand inflammation
42
Zileuton indication
Exercise, Ag, or *aspirin induced* asthma Chronic maintenance NOT useful for acute bronchospasm
43
Zileuton adverse
overall safe But can increase LFT's
44
Zafirlukast and Montelukast description
LTD4 receptor antagonists
45
Zafirlukast and Montelukast Mechanism
PO administration -> block synthesis of LT's or block LT receptors -> decrease constriction and inflammations
46
Zafirlukast and Montelukast indication
Exercise, Ag, or *aspirin* induced asthma Chronic maintenance NOT useful for acute bronchospasm
47
Zafirlukast and Montelukast adverse
Vasculitis with EOS (rare, similar to Churg Strauss)
48
Omalizumab (antibody) description
expensive, parenteral
49
Omalizumab (antibody) mechanism
Binds IgE on sensitized mast cells preventing release of mediators
50
Omalizumab (antibody) indication
Prophylaxis when ICS are inadequate (over age 12)
51
Omalizumab adverse
anaphylaxis
52
Cough and rhinitis drug classes
Opioids Mucolytic agent H1 antagonist Alpha agonists
53
Codeine and Dextromethorphan description
Cough medications aka: Antitussives Dextromethorphan -> synthetic
54
Codeine and Dextromethorphan mechanism
Depress CNS cough center sensitivity to peripheral stimuli (low dose)
55
Codeine and Dextromethorphan indication
Severe cough that disrupts sleep
56
Codeine and Dextromethorphan adverse
Dextromethorphan has no analgesic or addictive potential, less constipating
57
N-acetylcysteine (NAC) mechanism
mucolytic agent | Breaks disulfide bonds in mucus making it easier to cough out
58
N-acetylcysteine (NAC) indication
Cystic fibrosis* | Acetaminophen overdose*
59
Diphenhydramine and Chlorpheniramine description
First generation H1 antagonist -> crosses BBB and cause drowsiness
60
Diphenhydramine and Chlorpheniramine mechanism
Block histamine release
61
Diphenhydramine and Chlorpheniramine indication
allergic rhinitis
62
Loratadine, Fexofenadine, Cetirizine description
second generation H1 antagonist -> non drowsy
63
Loratadine, Fexofenadine, Cetirizine mechanism
blocks release of histamine
64
Loratadine, Fexofenadine, Cetirizine indication
allergic rhinitis
65
Phenylephrine and Pseudoephedrine description
alpha agonists Constrict dilated arterioles in the nasal mucose Aerosol -> rapid onset and few systemic effects
66
Phenylephrine and Pseudoephedrine indication
Rhinitis
67
Phenylephrine and Pseudoephedrine adverse
Prolonged use can lead to rebound nasal congestion after discontinuation

Pharmacology (24 decks)

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