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pharmacology > respiratory medications > Flashcards

respiratory medications Flashcards

1
Q

albuterol (Proventil)
C:
MOA:
I: SABA vs LABA
CI: SABA vs LABA

A

C: bronchodilator; beta 2 receptor agonist
MOA: stim B2 receptors in lungs –> relax SM in bronchioles = dilation, dec resist, inc cAMP
I:
- SABA: PRN, intermittent, emergency, acute
- LABA: daily use, maintenance
CI:
- SABA: nonemergency
- LABA: emergency/severe situations

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2
Q

albuterol (Proventil)
K:
- SABA O, P, D
- LABA O, P, D

A

K:
- SABA: O = 5min (strong), P = fast, D = 4-8hrs
- LABA: O = 5min (weak), P = slow, D = 12hrs

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3
Q

SE of albuterol (Proventil)

A

SNS stimulation
- rebound b.spasms
- throat irritation
- tremor/nervous/arrythmias (adult)
- tachy, palpitations

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4
Q

what route of B2 agonists lead to less side effects

A

inhaled

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5
Q

name short acting beta agonists (SABAs)
-“LAMP”

A

levalbuterol, albuterol, metoproterenol, pirbuterol

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6
Q

name long acting beta agonists (LABAs)

A

formoterol, salmeterol

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7
Q

pt education with albuterol (Proventil)

A

limit caffeine, SABA vs LABA

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8
Q

what should the nurse monitor when giving albuterol (Proventil)

A

monitor O2 sats, VS, lung sounds

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9
Q

theophylline
C:
MOA:
I:
CI:

A

C: bronchodilator; xanthine derivative
MOA: direct effect –> SM in lungs –> inhib phosphodiesterase = inc cAMP = b.dilation
I: chronic asthma (prevent/maintenance), modest bronchodilator
CI: acute attack, cardiac arryth, heart/seizure/PUD/liver pts, no babies or elders

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10
Q

theophylline
K: TR?
INT:

A

K: TR = 5-20 mcg/mL
INT: everything, check compatibility w other meds

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11
Q

SE of theophylline

A

hyperglycemia, HA, seizures, insomnia, inc HR, inc RR, dec BP, theophylline toxicity

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12
Q

SE of theophylline toxicity
- measurements for mild and severe theophylline toxicity
- tx?

A

irritable, arrythmias
- mild: 20-25 mcg/mL
- severe: >30 mcg/mL

tx: charcoal and wait

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13
Q

what is another xanthine derivative

A

aminophylline

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14
Q

pt education with theophylline

A

take without food
limit caffeine
low carb, high protein help with elimination
don’t smoke

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15
Q

ipratropium (Atrovent)
C:
MOA:
I:
CI:

A

C: bronchodilator; anticholinergic
MOA: inhib muscarinic receptors, dec cGMP, dec SM contract = b.dilation
I: maintenance
CI: bladder obs (prostate hyper.), glaucoma, peanut/soybean allergy

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16
Q

ipratropium (Atrovent)
K: longer D than _____
SE:

A

K: longer duration than B2 agonists
SE: can’t see, can’t spit, can’t pee, can’t shit
HA, dizzy, anxiety

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17
Q

what are other anticholinergic bronchodilators

A

tiotropium (long acting)
aclidinium (for COPD)

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18
Q

name the bronchodilator respiratory medications

A

albuterol (Proventil)
theophylline
ipratropium (Atrovent)

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19
Q

cromolyn sodium (Intal)
C:
MOA:
I:
CI:

A

C: anti-inflammatory; mast cell stabilizer
MOA: inhib mast cell rupture = inhib release of histamine/leukotrienes
I: prophylaxis to b.spasms/asthma
CI: acute attacks, cardiac pts (arryth), lactose intolerance

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20
Q

cromolyn sodium (Intal)
K: O, TR in___, exc thru___?

A

O = 15min
TR = 2-4wks
exc thru poop

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21
Q

SE of cromolyn sodium (Intal)

A

abrupt cessation = rebound b.spasms
HA, throat irritation, bad taste, nausea

22
Q

pt education with cromolyn sodium (Intal)

A

drink water b4/after to sooth throat
take 15-20min before strenuous activity

23
Q

what are other mast cell stabilizer anti-inflammatory medications

A

nedocromil, omalizumab

24
Q

omalizumab (Zolair)
C:
MOA:
I:
CI:

A

C: anti-inflammtory; mast cell stabilizer
MOA: inhib IgE receptors = no IgE bind = no allergic response
I: pts >12yrs, mod-severe asthma
CI: acute attacks, cardiac, lactose intolerance

25
Q

omalizumab (Zolair)
K: route and TR in___
SE:

A

K: SUBQ, TR in 2-4 weeks
SE: inj site rxn, life threatening anaphylaxis, viral infections

26
Q

pt education with omalizumab (Zolair)

A

stay in Dr’s office for a few min to monitor for allergic rxn

27
Q

what respiratory medication to take if inhaled corticosteroids don’t help

A

omalizumab (Zolair): anti-inflammatory mast cell stabilizer

28
Q

zafirlukast (Accolate)
C:
MOA:
CI:

A

C: anti-inflammatory; leukotriene receptor antagonist [2nd LINE AGENTS]
MOA: inhib receptor for leukotrienes = no cysteine = no b.constriction
CI: neuropsychiatric events, liver disease

29
Q

zafirlukast (Accolate)
K: route, take without ____
INT:

A

K: PO, take without food
INT: warfarin, theophylline, erythromycin

30
Q

SE of zafirlukast (Accolate)

A

HA #1, dizzy, fever, rash, anaphylaxis, inc LFT

31
Q

pt education with zafirlukast (Accolate)

A

take without food

32
Q

name other leukotriene receptor antagonist anti-inflammatory medications

A

montelukast, zileuton

33
Q

SE of zafirlukast (Accolate)

A

HA #1, dizzy, fever, rash, anaphylaxis, inc LFT

34
Q

montelukast (Singulair)
C:
MOA:
I:
CI:

A

C: anti-inflammatory; leukotriene receptor antagonist [2ND LINE AGENTS]
MOA: inhib receptor for leukotrienes = no cysteine, no b.constriction
I: better option for liver disease
CI: neuropsychiatric events

35
Q

montelukast (Singulair)
K: best abs at ____, how many times daily
INT:

A

K: best abs at night, once daily
INTR: phenobarbital, rifampin

36
Q

SE of montelukast (Singulair)

A

HA, dizzy, fever, rash, inc LFT

37
Q

pt education with montelukast (Singulair)

A

take at night

38
Q

zileuton (Zyflo)
C:
MOA:
I:
CI:

A

C: anti-inflammatory leukotriene receptor antagonist [2ND LINE AGENTS]
MOA: inhib enzyme in lipoxygenase pathway = dec prod of leukotrienes
I: pts >12yrs
CI: neuropsychiatric events

39
Q

zileuton (Zyflo)
K: 1/2 life
INT:

A

K: short 1/2 life
INT: warfarin, theophylline, propanolol

40
Q

SE of zileuton

A

HA, fever, rash, anaphylaxis, inc LFTs

41
Q

name the second line agent anti-inflammatory medications

A

zafirlukast, montelukast, zileuton
leukotriene receptor antagonists

42
Q

flunisolide (Aerobid)
C:
MOA:
I:

A

C: anti-inflammatory; corticosteroids
MOA: inhib cytokine, leukotriene, prostaglandin prod = no release of inflammatory mediators
inc # of B2 receptors = promote b.dilation
airway eosinophil recruitment = immunosuppressive
I: best anti-inflammatory effect (high effective, high potent)

43
Q

CI of flunisolide (Aerobid)

A

acute attacks
systemic fungal infections
live virus vax
HTN, CHF, PUD, diabetes, resp infections

44
Q

INT with flunisolide (Aerobid)

A

azole antifungals, ASA
BC, barbs, diuretics, theophylline
warfarin

45
Q

SE of inhaled flunisolide (Aerobid)
- what are inhaled corticosteroids for

A

oral fungal infections
PNA
delayed child growth
- inhaled corticosteroids are 1st line asthma tx

46
Q

SE of PO/IV flunisolide (Aerobid)
- what are PO/IV corticosteroids for

A

anxiety, seizures, insomnia
hirsutism, obesity, buffalo hump
electrolyte imb (hyperkalemia)
striae, osteoporosis
- PO/IV corticosteroids are for short term tx

47
Q

pt education with flunisolide (Aerobid)
- how many days to taper off?
- why do we need to taper off?

A
  • don’t abruptly stop, taper off over 7 days
  • taper off due to adrenal suppression
48
Q

why can corticosteroids cause hirsutism

A

structurally similar to sex steroids

49
Q

which corticosteroids are MDI

A

flunisolide (Aerobid), fluticasone (Advair), beclomethasone

50
Q

which corticosteroids are PO

A

prednisone, methylprednisone

51
Q

which corticosteroid is available IV

A

methylprednisone

pharmacology (15 decks)

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