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Pharmacology 3 > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

1
Q

What are the 2 types of cough?

A

Productive/ Useful

Non-productive / Useless

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2
Q

Which cough do you suppress?

A

Useless

ONLY suppress useful when its exhausting tho the patient

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3
Q

What are the two types of cough medicine?

A

Expectorants

Suppressants

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4
Q

How do cough expectorants work?

A

Mucolytic– reduce viscosity of the mucus secreations

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5
Q

What are the 2 types of mucolytics?

A

Guaifenesin

NAC (Mucomyst)

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6
Q

Who uses NAC?

A

Cystic Fibrosis

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7
Q

What is as effective as guifenesin?

A

WATER

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8
Q

What are the 3 types of cough suppressants?

A
  • Codeine (narcotic)
  • Dextromethorphan (OTC centrally acting)
  • Benzonatate (local numbing agent)
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9
Q

What do you call DM abusers?

A

Syrup heads

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10
Q

How do you treat ACE-I cough?

A

NOTHING, switch to ARM

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11
Q

What is another name for cough suppressant?

A

anti-tussive

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12
Q

What is asthma?

A

chronic inflammatory process of hyperactive bronchi

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13
Q

What type of disorder is asthma?

A

Polygenic disorder- histamine, leukotrienes, prostaglandins

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14
Q

Basic approach to asthma treatment?

A
  • Prevent allergen exposure
  • Reduce inflammation & hyperactivity
  • Dilate the narrowed bronchi
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15
Q

How do glucocorticoids treat asthma?

A

reduce bronchial hyperactivity and inflammation

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16
Q

How are glucocorticoids administered?

A

PO, IV, Inhalation

Use inhalation first (no systemic toxicity)

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17
Q

are glucocorticoids lipophilic or hydrophilic?

A

Hydrophilic (so they stay in lungs)

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18
Q

what is a/e of steroids?

A

thrush (inhalation)

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19
Q

What are the 6 risks of steroids?

A
  • Sodium retention
  • Hyperglycemia
  • Osteopenia
  • PUD
  • Hypokalemia
  • Immune suppression
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20
Q

Which steroids produce HPA suppression?

A

PO and IV (not inhaled)

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21
Q

How do you manage PO/IV steroids?

A

TAPER doses, always administer in the morning (steroids are activating)

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22
Q

What is a stress dose?

A

burst of steroids (50-100mg) to deal with stress since the body produces steroids to stress

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23
Q

Who should get stress dose?

A

Addisons disease

24
Q

What is risk of steroids?

A

growth stunting

25
Q

What is Cromolyn?

A

Powder inhaler

Mast cell stabilizer, so reduces histamine release on exposure to allergens

26
Q

When should you use Cromolyn?

A

Preventative therapy, does NOT terminate acute attacks.

Role in exercise-induced asthma

27
Q

B2 agonists do what?

A

Bronchodilators (stimulate B2 receptors on lungs and vasculature)

Sympathomimetics

28
Q

What is Primatene Mist?

A

OTC Epi, no longer available

29
Q

Name the main short acting B2 agonist

A

Albuterol, rescue agent

30
Q

How does albuterol come?

A

PO (syrup, tabelets) but they lose B2 selectivity so patient may complain of tachycardia

31
Q

What are the long acting B2 agonists?

A

Salmeterol
Formoterol

SLOW ON SLOW OFF so not for acute attacks

32
Q

What should you avoid in asthmatics?

A

Non-selective B blockers

33
Q

What is Terbutaline?

A

B2 agonist with potent effects on smooth muscle, tocolytic

34
Q

What is tocolytic?

A

Delays / reverses labor, opposite of misoprostol

35
Q

What does ACh do to the lungs?

A

Opposite of epi/Ne, bronchoconstricts

36
Q

What does anti-cholinergic do?

A

Bronchodilate, parasympatholytic agents

37
Q

What is anti-cholinergic inhalers used for?

A

COPD, sometimes adjunct in asthma

38
Q

What do anticholinergics end it?

A

“-tropium”

39
Q

Leukotriene receptor antagonists are used for what?

A

second line agents for asthma but not many head-to-head comparisons with other forms.

40
Q

What does PDE-4 do?

A

Phosphodiesterase Inhibitors 4- class of pacman like enzymes that chew up cAMP

41
Q

What does cAMP do?

A

Bronchodilation

42
Q

How does PDE-4 inhibitor work?

A

increases levels of cAMP = bronchodilation

43
Q

Who should use PDE-4 inhibitors?

A

COPD assocated with chronic bronchitis, NOT emphysema

44
Q

What else do PDE-4 inhibitors have?

A

anti-inflammatory properties

45
Q

What does PDE-5 do?

A

causes erections

46
Q

What is the association with the main PDE-4 inhibitor? name it and dosage

A

Roflumilast, 500mcg PO Qd, associated with suicidal ideations

47
Q

What is status asthmaticus? What would you see? How do you treat?

A

life threatening emergency.

See: mucus plugs, refractoriness to B2 agonists, respiratory acidosis.

Treat with IV steroid therapy, may require intubation

48
Q

Why does status asthmaticus occur?

A

not breathing = anaerobic metabolism takes over = lactic acid build up and CO2 build up

49
Q

What does MDI stand for? What is in them?

A

Meter Dose Inhaler = active ingredient + propellant

50
Q

What propellant is used?

A

HFAs have replaced CFCs (global warming risk)

51
Q

How do you take a MDI?

A

shake, exhale, slowly inhale while you actuate MDI

52
Q

MDI for elderly and children have what?

A

spacer

53
Q

What is risk with MDI?

A

localized thrush– treat with gargling warm water following administration

54
Q

how do you know how much is in your MDI?

A

drop in water, if it floats its empty, sinks its completely full

55
Q

What is a nebulizer?

A

converted solutions or suspensions of drugs into aerosols, usually driven by a gas or ionization process

56
Q

What is the combination steroid inhaler?

A

Advair Diskus- steroid + long acting B2 agonist

57
Q

Can drugs be absorbed through the lungs?

A

YES, put down ET tube, double the dose

Pharmacology 3 (10 decks)

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