Respiratory Flashcards
what are commonly encountered respiratory diseases
asthma, chronic obstructive pulmonary disease (COPD) and allergic rhinitis
asthma is a chronic disease characterized by ______ responsive airways
hyper
what happens to Patients who have allergies and you put steroids on their eyes
IOP sky rockets bc they are a steroid responder
What does COPD include
emphysema and chronic bronchitis
this is a very common condition which is characterized by itchy, watery eyes, runny nose, and a nonproductive cough
allergic rhinitis
what is common in COPD and cystic fibrosis
accumulation of mucus.
what are the respiratory therapy drug classes
- Leukotriene inhibitors
- beta 2 agonists
- steroidal anti inflammatories
- mucolytics
what do beta 2 agonists due
It is a sympathetic agonist which is responsible for broncho dilation.
what is the suffix for luekotriene inhibitors
-kast
what is the indication for montelukast
- Asthma
- Allergic rhinitis
- bronchospasm
What is the mechanism of action of montelukast which is a leukotriene inhibitor
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).
what does cysteinyl leukotriene receptors do
constrict bronchiolar smooth muscle and increase endothelial permeability, and promote mucus secretion
What are common AE of montelukast
- headache
- flu like symptoms
- pruritus
- rash
- restlessness
what are serious AE of montelukast
- thrombocytopenia (thrombocytes are parent cells of platelets –> deficiency of platelets in the blood).
what is a hypersensitivity of montelukast
- erythema nodosom (skin inflammation in fatty layer of skin).
- angiodema
What is used for asthma therapy for long term control when its classified as moderate persistent
low to medium dose inhaled corticosteroids and a long acting beta 2 agonist.
What is a quick relief of symptoms for asthma therapy for all of the classifactions
short acting beta 2 agonist
what is a suffix for beta 2 agonists
-erol
what is the indication for albuterol
- asthma
- bronchospasm
- COPD
what is the mechanism of action of albuterol
selectively stimulates beta 2 adrenergic receptors causing relaxation in airway smooth muscle.
what are common adverse effects of albuterol
- cough
- dizziness
- headache
what are severe adverse effects of albuterol
- paradoxical bronchospasm
- hypertension
- angina
- MI
- arrhythemias
what are drug interactions of albuterol
- amphotericins, CAI’s, steroids, macrolides: cause hypokalemia
- macrolides, FQ, and azoles: QT prolongation
- Sympathomimetics: additive
what is a common steroid combo
fluticasone/salmeterol –> fluticasone is a steroidal anti inflammatory. Salmetrol is a bronchodilator.
what helps reduce the swallowing of drugs while using inhalers
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.
what is the MOA of fluticasone
acts through classic steroid pathway inhibiting arachidonic acid based eicosanoid production.
what are common adverse effects of prostaglandins
- headache
- cough
- pyrexia (fever)
- epistaxis (nose bleeds)
- nasopharyngitis
what are severe adverse effects of fluticasone
- adrenal suppression
- hypercorticism
- pediatric growth suppression
- nasal/oral candiasis, nasal ulcer or septal perforation
what are ocular adverse effects of fluticasone
- cataracts
- glaucoma
- elevated IOP
What is the mechanism of action of salmeterol
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.
what is the difference between fluticasone and salmeterol
salmeterol is a longer acting drug
what are common adverse effects of salmeterol
- headache
- nasal congestion
- rhinitis
- bronchitis
- urticaria (hives)
- tachycardia
what are severe adverse effects of salmeterol
- anaphylaxis
- angioedema
- bronchospasm
- asthma exacerbation/death
- arrhythmia
- HTN
what is the indication for advair diskus
- asthma
2. COPD maintenance
what are drug interactions of advair diskus
- beta blockers: antagonistic
- cyclosporine, azole antifungals: impair metabolism
- macrolides, amphotericins, CAI’s, and steroids: hypokalemia
- Macrolides, sympathomimetics: QT prolongation
what is a stand alone steroid therapy
mometasone (nasonex) –> corticosteroid nasal spray
what is the indication for mometasone
- allergic rhinitis
2. nasal polyp therapy
what is the mechanism of action of mometasone
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.
what are common adverse effects of mometasone
- headache
- viral infection
- epistaxis
- conjunctivitis
what are notable adverse effects of mometasone
- septal perforation
- ulcer
- candidiasis
what are ocular adverse effects of mometasone
- elevated IOP
2. glaucoma
what are contraindications of mometasone
- nasal septal ulcer
- recurrent epistaxis
- TB infection
- Ocular HSV infection
- glaucoma
- cataracts
- vision changes
What is an example of a mucolytic
acetylcysteine
what is an indication of acetylcysteine
mucolytic and for acetaminophen overdose
what is the mechanism of action of acetylcysteine
- breaks disulfide bonds
decreasing mucus viscosity - replenishes glutathione which facilitates non toxic metabolism of acetaminophen
what is glutathione
a potent antioxidant produced in our body normally
what are adverse effects of acetylcysteine
- flushing
- pruritus
- tachycardia
