Respiratory Drugs Flashcards
What is COPD most commonly d/t?
Cigarette smoke
What are two different types of COPD?
Bronchitis
Emphysema
How is chronic bronchitis caused?
Mucociliary escalator system becomes paralyzed
How is emphysema caused? D/t what?
Alveoli become hyper-inflated
D/t macrophage releasing protease that destroys elastin
What are three things that cause SOB in asthma?
Bronchoconstriction
Edema
Mucus production
What are environmental factor that cause asthma?
Exercise
Cold air
Allergens
What inflammatory chemicals cause asthma?
Histamine
Prostaglandins
Leukotrienes
ECF-A
What does ICS inhibit?
PLA2
What does LTRA stand for?
Luekotriene receptor antagonist
What are the 3 classes of bronchodilators?
Beta-2 agonist
Anticholinergics
Methylxanthines
What are two types of beta-2 agonist?
LABA
SABA
What is the MOA of beta agonists?
Activate adenylate cyclase to increase cAMP which causes SM dilation
What does phosphodiesterase (PDE) do to cAMP?
Breaks down cAMP
What is the MOA of methylxanthines?
Inhibits PDE and adenosine
What does adenosine do?
Increases release of histamine which increases bronchoconstriction
What is the MOA of muscarinic antagonists?
Decrease the release ACh which causes bronchoconstriction
What does adenylate cyclase do to lungs?
AC increases the production of cAMP which causes SM dilation
What are the 3 Long Acting Beta Agonist?
Arformoterol(Brovana)
Formoterol(Foradil,Perforomist)
Salmeterol(Serevent)
Why does DPI stand for?
Dry powder inhaler
What is the name of the 2 drugs that are methylxanthines?
Theophylline(Theo-Dur)
Aminophylline
What is the Theophylline therapeutic range?
10-20mcg/mL
What are the 3 anticholinergic drugs?
ipratropium(Atrovent)
tiotropium(Spiriva)
aclidinium(Tudorza)
What condition are anticholinergics useful for? Why?
COPD
Because it reduces secretions in bronchioles
What prevents anticholinergic bronchodilators from going systemic?
They are quaternary compounds that prevent it from crossing the membrane
What are 2 vital signs that bronchodilators can greatly effect?
Increase HR and BP
What helps loosen secretions when taking a bronchodilator?
Hydration
Why can having anxiety with asthma be dangerous?
Can increase the risk for an asthmatic attack
What is the goal w/ lungs when taking a bronchodilator?
Pt free of wheezing and clear lungs in 2-5 days
When does toxicity for theophylline levels start?
> 20mcg/mL
What must be done to prevent thrush development when taking a ICS?
Rinse out mouth after using ICS
What two types of drugs are leukotriene inhibitors?
LTRA
lipoxygenase inhibitor
What levels must be monitored when taking a leuoktriene inhibitor?
AST and ALT levels
What is PDE4 inhibitors indicated for?
COPD
What is the MOA of omalizumab(Xolair) and mepolizumab(Nucala)?
Targets IgE and binds to it to prevent IgE from attaching to mast cells to release histamine
What is considered mild/intermittent asthma? What is the drugs to be used for this?
<2 episodes/wk
SABA PRN
What is considered mild/persistent asthma? What is the drugs to be used for this?
> 2 episodes/wk but <1/day
ICS
SABA PRN
What is considered moderate/persistent asthma? What is the drugs to be used for this?
Daily episodes
ICS
LABA
What is fluticisone w/ salmeterol called?
Advair
What is budesonide w/ formoterol called?
Symbicort
What is fluticasone w/ vilanterol?
Breo Ellipta
What is considered severe/persistent asthma? What is the drugs to be used for this? What medication should be considered if a pt has allergies?
Multiple daily episodes
High dose corticosteroid
LABA
Consider omalizumab(Xolair)
