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Pharmacology 2 > Respiratory: Asthma/COPD > Flashcards

Respiratory: Asthma/COPD Flashcards

1
Q

Bronchial Asthma

A

bronchospasms: narrowing

Inflammation of bronchial mucosa

Status asthmaticus: medical emergency. prolonged asthma attack that does not respond to therapy

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2
Q

COPD

A

Chronic bronchitis and emphysema

Inflammation of airway epithelium. Infiltration of Inflammatory cells and release of cytokines.

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3
Q

Chronic Bronchitis

A

Chronic inflammation of bronchioles or bronchi

Due to prolonged exposure to irritants

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4
Q

Emphysema

A

Alveoli enlarge due to destruction of alveolar walls

Surface area of gas exchange reduced

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5
Q

Bronchodilator Drugs

A

B2-Adrenergic Agonists
•Salbutamol

Anticholinergics
Ipratropium bromide (atrovent)

Xanthine Derivatives
Theophylline/Aminophylline

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6
Q

Anti-Inflammatory Respiratory Drugs

A

Glucocorticoids
•Budesonide

Leukotriene Modifiers
•Montelukast

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7
Q

Bronchodilators: B agonists

A

Sympathomimetic bronchodilators

Stimulate bronchial smooth muscle B2 adrenergic receptors
•Short Acting B Agonists
•Long Acting B Agonists

Selective B2 drugs activate smooth muscle B2 adrenergic receptors.
•Salbutamol

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8
Q

B agonist indications

A

Relief of bronchospasm related to Asthma , COPD, etc.

Treatment of:
Acute attacks
Prevent attacks: Chronic management, exercise-induced

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9
Q

B Agonist (Salbutamol) Adverse effects

A

Tachycardia (B1)
Tremors (B2)
Restlessness (B1, B2)
Insomnia (B1, B2)

Stimulates B1 receptors as well; increased HR, palpitations, chest pain

B1: heart
B2: Lungs/muscles

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10
Q

B Agonist Care Considerations

A

Increase fluid intake

Avoid exposure to irritants: smoking

Monitor for therapeutic effects:
•Decreased dyspnea
•Decreased wheezing
•Improved resp patterns
•Improved activity tolerance

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11
Q

Anticholinergics

A

Bronchodilator
Prevents bronchoconstriction (fixed schedule use)
•COPD
•NOT used alone for acute exacerbations

Drug: Ipratropium bromide

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12
Q

Anticholinergic main adverse effect

A

Dry mouth

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13
Q

Methylxanthines (Xanthine derivatives)

A

Bronchodilator

Quick relief of bronchospasm. greater airflow into and out of lungs.

Theophylline
•Oral med

Aminophylline
•More water-soluble form of theophylline
•IV administration

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14
Q

Methylxanthines (Xanthine derivatives) Adverse Effects

A

CNS stimulation
•Anxiety, insomnia, seizures

Cardiovascular Stimulation
•Palpitations
•Tachycardia
•Ventricular dysrhythmias

GI distress
•Nausea, vomiting

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15
Q

Methylxanthines (Xanthine derivatives) Drug Interactions

A

Ciprofloxacin increases effects of theophylline by inhibiting CYP metabolism

Large amounts of caffeine can intensify adverse effects

Liver enzyme inducers such as antiseizure drugs increase metabolism of theophylline, thus decreasing effects of theophylline

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16
Q

Anti-Inflammatory Respiratory Drugs

A

Glucocorticoids
•Budesonide - Inhaled
•Fluticasone - Inhaled

Leukotriene Modulators
•Montelukast

17
Q

Glucocorticoids

A

Anti-Inflammatory

Steroid drugs: structure based on cholesterol

Inhaled: Used for chronic asthma and COPD
Oral/IV for severe/short-term Tx

Not for symptomatic relief of asthma attacks.

Inhaled forms reduce systemic effects

May take several weeks for full effect

DRUGS:
Budesonide
Fluticasone

18
Q

Glucocorticoids Mechanism Of Action

A

Many mechanisms
•Reduce inflammatory mediators
•Decrease cytokine production
•Reduce edema

19
Q

Inhaled Glucocorticoids Combination Preparation

A

Glucocorticoid + long-acting b2-agonist (LABA)

•Budesonide + formoterol = symbicort

•Fluticasone + Salmeterol = Advair Diskus

20
Q

Inhaled Glucocorticoid Indications

A

Prophylaxis for asthma and COPD (with LABA)

21
Q

Inhaled Glucocorticoid Adverse Effects

A

Oral fungal infections
Coughing
Dry mouth

22
Q

Inhaled Glucocorticoid Care Considerations

A

Avoid if candida in sputum
May slow growth in children
Possible bone loss

If also using b2 agonist bronchodilator: use bronchodilator FIRST

Teach patients to gargle and rinse mouth after use to prevent against fungal infection

23
Q

Leukotriene Modulators

A

Anti-Inflammatory

Leukotrines are released in immune response in asthma. Causes inflammation, bronchoconstriction, mucus, wheezing, cough, SOB.

Leukotriene modulators reduce inflammation in lung

DRUG:
Montelukast

24
Q

Leukotriene Indications

A

Prophylaxis and chronic treatment of asthma in adults and children.

Montelukast in children ages 2+

NOT for acute asthma attacks

25
Q

Leukotriene Care Considerations

A

Ensure it’s being used for chronic management of asthma, NOT acute.

On a continuous schedule

Improvement should be seen in 1 day - 1 week

26
Q

Chromolyn

A

Mast Cell Stabilizer

Prevents release of substances that cause bronchospasm

Prophylactic - NOT for acute asthma

Pharmacology 2 (11 decks)

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