Respiratory Drugs Flashcards
Salmeterol, Formoterol, Indacaterol
Long acting B2 agonists that have an extended lipophilic side chain causing them to remain in tissue for an extended period of time; should only be used for prophylactic therapy and not acute attacks
Indacaterol ➡️ indicated for COPD
***Must prescribe anti-inflammatories to go with this drug
ADRs: Similar to short acting; corticosteroids will help prevent tolerance
Ipratropium, Tiotropium
Muscarinic antagonists that prevent the Ach stimulated increase in cGMP respiratory smooth muscle cells
Commonly used in combo w/ b2 agonists as they have mixed results alone; Ipratropium can be used for rhinitis
ADRs: Bitter taste, xerostomia, glaucoma if sprayed in eye
Theophylline
PDE inhibitor, adenosine-receptor antagonist, anti-inflammatory, and promotes contraction of diaphragm
-Commonly used on pts. whose asthma is not controlled by SABA/corticosteroid therapy; caffeine (another methylxanthine) can be given to preterm infants
CYP metabolized
ADRs: Low levels- N/V High levels- Seizure, arrhythmia
***LOW TI
Beclomethasone, Budesonide, Triamcinolone Acetate
MOA in respiratory disease: Anti-inflammatory by inhibiting production of prostaglandins and leukotrienes
*****UPREGULATE B2 RECEPTOR EXPRESSION
Commonly given as a combo inhaler w/ LABAs
-Indicated for acute exacerbations of asthma and severe COPD
ADRs: Dysphonia, oral/pharyngeal candidiasis
Albuterol, Terbutaline
Short acting B2 agonists; used to reverse asthmatic attacks
-Should only be used rarely (acutely), if it is used frequently, it indicates a need for anti-inflammatory therapy (glucocorticoids)
ADRs: Tremors, anxiety, tachycardia, tolerance (downregulation of B2 receptors)
Zafirlukast, Montelukast
MOA: Leukotriene receptor antagonists that inhibit bronchoconstriction and smooth muscle contraction
-Alternative to corticosteroids if they are not tolerated
ADRs: Hepatoxicity; Zafirlukast=CYP inhibitor; Montelukast=mildest
Zileuton
MOA: Inhibits lipooxygenase
Same uses as Zafirlukast and Montelukast
ADRs: SEVERE hepatotoxicity; fever, chills; CYP inhibition
Omalizumab
MOA: IgE antibody tht inhibits its binding to mast cells
-Effective therapy reserved for severe COPD not responding to other therapy
ADRs: Anaphylaxis
Drugs used for cough
Opiods (hydrocodone, codeine) that directly inhibit the cough center in the medulla and dextromorphan (inhibits NMDA receptors)
ADRs: Respiratory depression (bad for asthma), dysphoria, fatigue, addiction
Guaifenesin
Mucolytic drug that is used as an expectorant (Mucinex)
N-acetylcysteine
Mucolytic drug that cleaves disulfide bonds; indicated for acetaminophen OD, chronic bronchitis, and sometimes CF
Dornase alpha
DNAse that thins mucous and is the DOC for CF pts.
Oxymetazoline, pseudoephrine
Symptomatic adrenergic a-agonist that constrict swollen nasal mucosa
ADRs: Rebound nasal congestion, HTN, tachycardia, nausea
Benzonatate
Cough suppressant that works thru stimulation of peripheral vagal fibers
ADRs: Dizziness
Pneumoniae assoc. With effusions
Staph and strep
SIRS Tx
Antibiotics and FLUIDS
Anaerobic suspicion
Poor dentition
Vomiting
Alcohol
Aspiration
Hospital assoc. Pneumonia
GNR OR STAPH
Legionella also possible, would see Hyponatremia
