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Systemic Pharm > Respiratory > Flashcards

Respiratory Flashcards

1
Q

what are commonly encountered respiratory diseases

A

asthma, chronic obstructive pulmonary disease (COPD) and allergic rhinitis

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2
Q

asthma is a chronic disease characterized by ______ responsive airways

A

hyper

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3
Q

what happens to Patients who have allergies and you put steroids on their eyes

A

IOP sky rockets bc they are a steroid responder

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4
Q

What does COPD include

A

emphysema and chronic bronchitis

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5
Q

this is a very common condition which is characterized by itchy, watery eyes, runny nose, and a nonproductive cough

A

allergic rhinitis

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6
Q

what is common in COPD and cystic fibrosis

A

accumulation of mucus.

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7
Q

what are the respiratory therapy drug classes

A
  1. Leukotriene inhibitors
  2. beta 2 agonists
  3. steroidal anti inflammatories
  4. mucolytics
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8
Q

what do beta 2 agonists due

A

It is a sympathetic agonist which is responsible for broncho dilation.

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9
Q

what is the suffix for luekotriene inhibitors

A

-kast

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10
Q

what is the indication for montelukast

A
  1. Asthma
  2. Allergic rhinitis
  3. bronchospasm
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11
Q

What is the mechanism of action of montelukast which is a leukotriene inhibitor

A

Selectively binds to airway cysteinyl leukotriene receptors blocking their stimulation by their endogenous ligands (LTC4, LTD4, and LTE4) which are released by mast cells and eosinophils).

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12
Q

what does cysteinyl leukotriene receptors do

A

constrict bronchiolar smooth muscle and increase endothelial permeability, and promote mucus secretion

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13
Q

What are common AE of montelukast

A
  1. headache
  2. flu like symptoms
  3. pruritus
  4. rash
  5. restlessness
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14
Q

what are serious AE of montelukast

A
  1. thrombocytopenia (thrombocytes are parent cells of platelets –> deficiency of platelets in the blood).
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15
Q

what is a hypersensitivity of montelukast

A
  1. erythema nodosom (skin inflammation in fatty layer of skin).
  2. angiodema
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16
Q

What is used for asthma therapy for long term control when its classified as moderate persistent

A

low to medium dose inhaled corticosteroids and a long acting beta 2 agonist.

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17
Q

What is a quick relief of symptoms for asthma therapy for all of the classifactions

A

short acting beta 2 agonist

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18
Q

what is a suffix for beta 2 agonists

A

-erol

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19
Q

what is the indication for albuterol

A
  1. asthma
  2. bronchospasm
  3. COPD
20
Q

what is the mechanism of action of albuterol

A

selectively stimulates beta 2 adrenergic receptors causing relaxation in airway smooth muscle.

21
Q

what are common adverse effects of albuterol

A
  1. cough
  2. dizziness
  3. headache
22
Q

what are severe adverse effects of albuterol

A
  1. paradoxical bronchospasm
  2. hypertension
  3. angina
  4. MI
  5. arrhythemias
23
Q

what are drug interactions of albuterol

A
  1. amphotericins, CAI’s, steroids, macrolides: cause hypokalemia
  2. macrolides, FQ, and azoles: QT prolongation
  3. Sympathomimetics: additive
24
Q

what is a common steroid combo

A

fluticasone/salmeterol –> fluticasone is a steroidal anti inflammatory. Salmetrol is a bronchodilator.

25
Q

what helps reduce the swallowing of drugs while using inhalers

A

spacers; allow aerosol to remain in device after its injected from cylinder until you can inhale it and allows it to enter at a rate which is consistent with your inhalation. Spacer allows it to remain in chamber until you inhale it which facilitates better passage in airways.

26
Q

what is the MOA of fluticasone

A

acts through classic steroid pathway inhibiting arachidonic acid based eicosanoid production.

27
Q

what are common adverse effects of prostaglandins

A
  1. headache
  2. cough
  3. pyrexia (fever)
  4. epistaxis (nose bleeds)
  5. nasopharyngitis
28
Q

what are severe adverse effects of fluticasone

A
  1. adrenal suppression
  2. hypercorticism
  3. pediatric growth suppression
  4. nasal/oral candiasis, nasal ulcer or septal perforation
29
Q

what are ocular adverse effects of fluticasone

A
  1. cataracts
  2. glaucoma
  3. elevated IOP
30
Q

What is the mechanism of action of salmeterol

A

it is a chemical analog of albuterol which has a lipophilic side chain that enhances duration of action; like albuterol this beta 2 agonist produces relaxation of airway smooth muscle.

31
Q

what is the difference between fluticasone and salmeterol

A

salmeterol is a longer acting drug

32
Q

what are common adverse effects of salmeterol

A
  1. headache
  2. nasal congestion
  3. rhinitis
  4. bronchitis
  5. urticaria (hives)
  6. tachycardia
33
Q

what are severe adverse effects of salmeterol

A
  1. anaphylaxis
  2. angioedema
  3. bronchospasm
  4. asthma exacerbation/death
  5. arrhythmia
  6. HTN
34
Q

what is the indication for advair diskus

A
  1. asthma

2. COPD maintenance

35
Q

what are drug interactions of advair diskus

A
  1. beta blockers: antagonistic
  2. cyclosporine, azole antifungals: impair metabolism
  3. macrolides, amphotericins, CAI’s, and steroids: hypokalemia
  4. Macrolides, sympathomimetics: QT prolongation
36
Q

what is a stand alone steroid therapy

A

mometasone (nasonex) –> corticosteroid nasal spray

37
Q

what is the indication for mometasone

A
  1. allergic rhinitis

2. nasal polyp therapy

38
Q

what is the mechanism of action of mometasone

A

inhibits multiple inflammatory cytokines and produces multiple glucocorticoid and mineralocorticoid effects, which means its similar to aldosterone which is responsible for fluid retention and elevation of bp.

39
Q

what are common adverse effects of mometasone

A
  1. headache
  2. viral infection
  3. epistaxis
  4. conjunctivitis
40
Q

what are notable adverse effects of mometasone

A
  1. septal perforation
  2. ulcer
  3. candidiasis
41
Q

what are ocular adverse effects of mometasone

A
  1. elevated IOP

2. glaucoma

42
Q

what are contraindications of mometasone

A
  1. nasal septal ulcer
  2. recurrent epistaxis
  3. TB infection
  4. Ocular HSV infection
  5. glaucoma
  6. cataracts
  7. vision changes
43
Q

What is an example of a mucolytic

A

acetylcysteine

44
Q

what is an indication of acetylcysteine

A

mucolytic and for acetaminophen overdose

45
Q

what is the mechanism of action of acetylcysteine

A
  1. breaks disulfide bonds
    decreasing mucus viscosity
  2. replenishes glutathione which facilitates non toxic metabolism of acetaminophen
46
Q

what is glutathione

A

a potent antioxidant produced in our body normally

47
Q

what are adverse effects of acetylcysteine

A
  1. flushing
  2. pruritus
  3. tachycardia

Systemic Pharm (9 decks)

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