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Pharmacotherapeutics > Respiratory, Gastrointestinal, Endocrine & Bone Mineral Density > Flashcards

Respiratory, Gastrointestinal, Endocrine & Bone Mineral Density Flashcards

1
Q

Drugs that DECREASE VISCOSITY of secretions and help prevent thick mucus from blocking respiratory pathways. Commonly used to treat COPD & pneumonia

A

Mucolytics

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2
Q

Facilitate PRODUCTION & EJECTION of mucus and helps prevent thick mucus from blocking respiratory pathways. Commonly used to treat COPD and pneumonia.

A

Expectorants (Guaifensesin)

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3
Q

Two classifications of medications used to treat obstructive pulmonary disease

A

Bronchodilators & Anti-inflammatory agents

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4
Q

Types of Bronchodilators

A

Beta-adrenergic agonists, Xanthine derivatives, & anticholinergics

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5
Q

Anti-inflammatory agent used for obstructive pulmonary diseases

A

Glucocorticoids

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6
Q

Beta-Adrenergic Agents

A

Stimulation of beta-2 receptors on respiratory smooth muscle cells to cause RELAXATION via bronchodilation. Can be selective or nonselective
Ex: Albuterol, Levalbuterol, Salmeterol

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7
Q

Route of administration for Beta-adrenergic agents

A

Inhalation (preferred - inhalers or nebulizers), orally, and subcutaneously

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8
Q

Adverse effects of beta-adrenergic agents

A

Tolerance, cardiac irregularities (nonselective), stimulation of CNS receptors causing nervousness, restlessness, and tremor

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9
Q

Xanthine Derivatives

A

Treat airway obstruction by producing bronchodilation - Mechanism is debated upon.
Ex: Theophylline, caffeine, aminophylline

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10
Q

Adverse effects of xanthine derivatives

A

Toxicity (overlap of therapeutic & toxic ranges) - Nausea, confusion, irritability, and restlessness. Cardiac arrhythmias, fatal seizures

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11
Q

Anticholinergic Drugs

A

Block the acetylcholine receptors on respiratory smooth muscle cells to prevent vasoconstriction caused by increased vagal tone and acetylcholine release – Result in bronchodilation
Choice drug in COPD treatment

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12
Q

Choice drug in COPD treatment

A

Anticholinergic Drugs

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13
Q

Glucocorticoids

A

Control inflammation induced bronchospasms by causing powerful anti-inflammatory effects

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14
Q

Most effective drug at controlling asthma

A

Glucocorticoids

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15
Q

What should be done after taking glucocorticoid medications by mouth?

A

Rinse mouth out after to reduce risk of oral irritation

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16
Q

Adverse effects of glucocorticoids

A

Osteoporosis, skin breakdown, muscle wasting, retardation of growth, cataracts, glaucoma, hyperglycemia, & aggravation of DM/HTN

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17
Q

Leukotriene Inhibitors

A

Inflammatory compounds used to control airway inflammation - Combined with glucocorticoids and beta agonists for better management of COPD & asthma

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18
Q

First line of defense for LONG TERM asthma management - Main treatment for asthma

A

Glucocorticoids - Combined with beta-2 agonists for optimal results

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19
Q

Why are glucocorticoids preferred for asthma over bronchodilators?

A

They reduce the inflammation that underlies asthma, not just treat the secondary manifestations

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20
Q

Best choice for asthma attacks

A

Short acting beta-2 agonist. Leukotriene inhibitors can also be used to control inflammation

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21
Q

First choice drug for treating COPD by maintaining airway patency and prevent airflow restriction

A

Anticholinergics
Long-acting beta-2 agonists are also used to promote bronchodilation

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22
Q

Pharmacological management for maintaining airway patency in Cystic Fibrosis

A

Bronchodilators and mucolytics or expectorants limit formation of mucus plugs.
Systemic glucocorticoids are useful in limiting airway inflammation and improving pulmonary function (prednisone)

23
Q

When should PT be scheduled after administration of medication?

A

30-60 minutes after mucolytic and expectorants are given via nebulizer

24
Q

Bronchodilator Toxicity

A

Cardiac arrhythmias, nervousness, confusion, tremors (systemic effects)

25
Q

Rehab considerations for Glucocorticoid treatment

A

Skin breakdown
Prevent overstressing of bones/musculotendinous structures

26
Q

Drugs that control & limit gastric acid

A

Antacids, H2 receptor blockers, & proton pump inhibitors

27
Q

Antacids

A

Neutralize stomach acids
Types include aluminum, magnesium, sodium bicarbonate or combinations

28
Q

Adverse effects of antacids

A

Electrolyte imbalances, changes in other drug pharmacokinetics that rely on stomach acidity (should NOT be taken within 2 hours of other orally administered drugs)

29
Q

H2 Receptor Blockers

A

Prevent stimulation of gastric acid secretions by blocking histamine receptors
Treat acute and long-term management of peptic ulcer & GERD

30
Q

Side Effects of H2 receptor blockers

A

Headache, dizziness, mild GI problems, arthralgia, myalgias, tolerance

31
Q

Proton Pump Inhibitors

A

Inhibit the enzyme responsible for secreting acid from gastric parietal cells by 80-95%

32
Q

Drug of choice for long-term management of gastric/duodenal ulcers & GERD

A

Proton Pump Inhibitors

33
Q

Adverse effects of PPI

A

Gastric acid rebound, gastric polyps, GI tumors, decreased bone mineralization and risk of fx

34
Q

Clinical Use of Endocrine Drugs

A
  1. Replacement Therapy
  2. Diagnosis of Endocrine Disorders
  3. Exploitation of beneficial effects
  4. Alter normal endocrine function
35
Q

Adrenocorticosteroids (2)

A

Glucocorticoids & Mineralcorticoids

36
Q

Primarily involved in control of glucose metabolism and body’s ability to deal with stress - Decreases inflammation and suppresses immune system

A

Glucocortocoids

37
Q

Maintains fluid and electrolyte balances in the body

A

Mineralcorticoids - Ex: Aldosterone

38
Q

Glucocorticoids - Endocrine Indications

A
  • Restore normal function after adrenal cortical hypofunction (Addison’s)
  • After removal of adrenal glands or pituitary gland
  • Rheumatoid arthritis
  • Manage systemic inflammation
  • Treat severe acute inflammation (no more than 4)
  • Control inflammation or suppress immune system for short-periods of time
39
Q

Adverse effects of endocrine glucocorticoids

A

Adrenocortical suppression, drug induced Cushing’s Syndrome (hypersecretion), breakdown of tissues (catabolic effect), loss of bone strength (osteoclast), peptic ulcers, slow growth, etc.

40
Q

Aldosterone (Mineralcorticoids)

A

Maintains fluid & electrolye balance within the body - Works on kidneys to increase sodium & water reabsorption and excretion of potassium

Commonly used as replacement therapy - Addison’s disease

41
Q

Negative Physiological Effect of Aldosterone

A

Increased production promotes renal sodium and water retention – Leads to HTN and heart failure

Can also cause inflammation, hypertrophy, and fibrosis of cardiac/vascular tissues

42
Q

Adverse effects of mineralcorticoids

A

HTN, edema, weight gain, hypokalemia

43
Q

Mineralcorticoid Antagonists

A

Potassium sparing diuretics used to treat HTN and heart failure

44
Q

Conditions treated with Glucocorticoids

A

Obstructive pulmonary disease (asthma, cystic fibrosis), endocrine issues
More specific: RA, ankylosing spondylitis, lupus erythematosus, acute bursitis

45
Q

What kind of supplements are taken to prevent bone loss in OP, Rickets, Osteomalacia, & Hypoparathyroidism?

A

Calcium Supplements

46
Q

Maximum tolerated dose of Ca per day?

A

2,500 mg/day

Any dose above 1,000mg/day increases risk of arterial calcification and cardiovascular disease

47
Q

Adverse Effects of Calcium Supplements

A

Hypercalcemia (constipation, drowsiness, fatigue, headache), confusion, irritability, cardiac arrhythmias, HTN, N/V

48
Q

Vitamin D

A

Increase intestinal absorption of calcium and phosphate

Too much can cause vitamin D toxicity

49
Q

Bisphosphonates

A

Inhibit osteoclast activity, promote bone mineralization, inhibit abnormal bone formation, prevent bone pain/fractures, and prevent bone loss

50
Q

Primary treatment for Osteoporosis?

A

Bisphosphonates

51
Q

Adverse Effects of Bisphosphonates

A

Death of bone tissue in jaw (osteonecrosis), atypical subtrochanteric hip fx, GI disturbances

52
Q

Calcitonin

A

Mimics endogenous calcitonin
Prevents bone loss in OA, postmenopausal OP, and glucocorticoid induced OP

53
Q

Rehab implications for Estrogen Therapy

A

Enhance bone mineralization by incorporating weight bearing & resistance exercises

Pharmacotherapeutics (13 decks)

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