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Pharmacology > Respiratory > Flashcards

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
Q

Tiotropium description/mechanism

A

long acting

Block PS -> decrease bronchoconstriction and mucus secretion

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26
Q

Anti inflammatories for respiratory (classes)

A

Corticosteroids
Leukotriene antagonists
Antibody

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27
Q

Mast cell stabilizers

A

Cromolyn and Nedocromil

28
Q

Cromolyn and Nedocromil description

A

Mast cell stabilizers
Oral, aerosol and droplets
Also used for food allergies and hay fever and rhinitis

29
Q

Cromolyn and Nedocromil mechanism

A

Mast cell stabilizers

Prevent release of inflammatory mediators from mast cells

30
Q

Cromolyn and Nedocromil indication

A

Prophylaxis: allergen and exercise induced bronchoconstriction
NOT for acute attacks

31
Q

Cromolyn and Nedocromil adverse

A

Cromolyn: laryngeal edema, cough, wheezing
Nedocromil: unpleasant taste

32
Q

Beclomethasone, Flunisolide, Fluticasone, Budesonide

Description

A

Inhaled steroids used in the treatment of chronic asthma

33
Q

Beclomethasone, Flunisolide, Fluticasone, Budesonide

Mechanism

A

Inhibit PLA2 -> decrease AA -> decreased synthesis of cytokines, prostaglandins and other inflammatory mediators

Bind to glucose response elements (GRES) -> decrease inflammation

34
Q

Beclomethasone, Flunisoloide, Fluticasone, Budesonide

Indication

A

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
Q

Dexamethason, Prednisolone, Hydrocortisone indication

A

Maintenance: inhalation steroids are used to suppress inflammation and reduce risk of exacerbation

Acute exacerbation: systemic steroids for severe attacks (status asthmaticus)

36
Q

Dexamethasone, Prednisolone, Hydrocortisone Mechanism

A

Inhibit PLA2 -> decrease AA -> decreased synthesis of cytokines, prostaglandins and other inflammatory mediators

Bind to glucose response elements (GRES) -> decrease inflammation

37
Q

Dexamethasone, Prednisolone, Hydrocortisone description

A

IV steroids

38
Q

Dexamethasone, Prednisolone, Hydrocortison Adverse

A

Abnormal glucose metabolism
Increase appetite and weight gain
HTN
Adrenal suppression

39
Q

Beclomethasone, Flunisolide, Fluticasone, Budesonide adverse

A

Cough
Oral Thrush
Dysphonia

40
Q

Zileuton description

A

inhibits 5-lipoxygenase

41
Q

Zileuton mechanism

A

PO administration -> block synthesis of LT’s or block LT receptors -> decrease constrictionand inflammation

42
Q

Zileuton indication

A

Exercise, Ag, or aspirin induced asthma
Chronic maintenance
NOT useful for acute bronchospasm

43
Q

Zileuton adverse

A

overall safe
But
can increase LFT’s

44
Q

Zafirlukast and Montelukast description

A

LTD4 receptor antagonists

45
Q

Zafirlukast and Montelukast Mechanism

A

PO administration -> block synthesis of LT’s or block LT receptors -> decrease constriction and inflammations

46
Q

Zafirlukast and Montelukast indication

A

Exercise, Ag, or aspirin induced asthma
Chronic maintenance
NOT useful for acute bronchospasm

47
Q

Zafirlukast and Montelukast adverse

A

Vasculitis with EOS (rare, similar to Churg Strauss)

48
Q

Omalizumab (antibody) description

A

expensive, parenteral

49
Q

Omalizumab (antibody) mechanism

A

Binds IgE on sensitized mast cells preventing release of mediators

50
Q

Omalizumab (antibody) indication

A

Prophylaxis when ICS are inadequate (over age 12)

51
Q

Omalizumab adverse

A

anaphylaxis

52
Q

Cough and rhinitis drug classes

A

Opioids
Mucolytic agent
H1 antagonist
Alpha agonists

53
Q

Codeine and Dextromethorphan description

A

Cough medications aka:
Antitussives
Dextromethorphan -> synthetic

54
Q

Codeine and Dextromethorphan mechanism

A

Depress CNS cough center sensitivity to peripheral stimuli (low dose)

55
Q

Codeine and Dextromethorphan indication

A

Severe cough that disrupts sleep

56
Q

Codeine and Dextromethorphan adverse

A

Dextromethorphan has no analgesic or addictive potential, less constipating

57
Q

N-acetylcysteine (NAC) mechanism

A

mucolytic agent

Breaks disulfide bonds in mucus making it easier to cough out

58
Q

N-acetylcysteine (NAC) indication

A

Cystic fibrosis*

Acetaminophen overdose*

59
Q

Diphenhydramine and Chlorpheniramine description

A

First generation H1 antagonist -> crosses BBB and cause drowsiness

60
Q

Diphenhydramine and Chlorpheniramine mechanism

A

Block histamine release

61
Q

Diphenhydramine and Chlorpheniramine indication

A

allergic rhinitis

62
Q

Loratadine, Fexofenadine, Cetirizine description

A

second generation H1 antagonist -> non drowsy

63
Q

Loratadine, Fexofenadine, Cetirizine mechanism

A

blocks release of histamine

64
Q

Loratadine, Fexofenadine, Cetirizine indication

A

allergic rhinitis

65
Q

Phenylephrine and Pseudoephedrine description

A

alpha agonists
Constrict dilated arterioles in the nasal mucose
Aerosol -> rapid onset and few systemic effects

66
Q

Phenylephrine and Pseudoephedrine indication

A

Rhinitis

67
Q

Phenylephrine and Pseudoephedrine adverse

A

Prolonged use can lead to rebound nasal congestion after discontinuation

Pharmacology (24 decks)

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