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pharmacology exam 1 > respiratory medications > Flashcards

respiratory medications Flashcards

1
Q

where are histamines stored?

A

mast cells

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2
Q

what are the s/sx of H1 receptor stimulation?

A

vasodilation
increased capillary permeability
bronchoconstriction
pain/itching
mucus production

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3
Q

where are antihistamine found in the body?

A

bone marrow, GI tract, and skin

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4
Q

what is the distribution of histamine?

A

found in practically all tissues in the body, but highly concentrated in GI tract, skin, and lungs

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5
Q

where are mast cells stored?

A

skin and soft tissues

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6
Q

how or why are mast cells released

A

allergic reaction: mediated by IgE
non allergic reaction: drugs or cell injury

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7
Q

what are the 4 histamine receptors?

A

H1
H2
H3
H4

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8
Q

what happens if H2 is stimulated?

A

stomach acid secretion

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9
Q

what are classic antihistamines for the H1 blockers (antagonists)?

A

highly sedating (1ST GEN)
- diphenhydramine
- chloropheniramine
- hydroxyzine
- meclizine
- promethazine

less sedating (2ND GEN)
- certerizine
- loratadine
- fexofenadine

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10
Q

what is meclizine used for?

A

vertigo

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11
Q

what are the side effects of diphenhydramine?

A

extreme sedation (it is used in most sleeping aids)

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12
Q

do antihistamines alter the length of the common cold?

A

NO

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13
Q

what does H1 blocking work well for?

A

local swelling (bee sting)
acute rash
hay fever

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14
Q

how do anticholinergics alter nasal secretions and sx of allergic rhinitis?

A
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15
Q

what are adverse effects of H1 blockers?

A

sedation
constipation
urinary retention
dry mucus membranes

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16
Q

what are seasonal allergies

A

they are inhaled (such as pollen)

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17
Q

what are perennial allergies?

A

inhaled ones would be: dust mites, dander, dust

ingested ones would be: wheat, eggs, milk, and nuts

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18
Q

if someone is allergic to sage brush and they move to another area with “no allergens”, how come this might no be effective?

A

often times allergic people are allergic to more than one type of pollen.

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19
Q

are antihistamines good for unclogging a stuffy nose?

A

no, they are only effective at controlling sneezing, itching, and rhinorrhea.

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20
Q

what is the most common nasal antihistamine?

A

Azelatine

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21
Q

what is one example of a glucocorticoid?

A

fluticasone

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22
Q

what is the response rate to glucocorticoids?

A

90%

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23
Q

what is so important about cromolyn?

A

serious side effects are rare
long acting
not used in emergencies

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24
Q

what is an example of a leukotriene modifier?

A

motelukast:
safe and helps with congestion

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25
Q

what will help someone ween themselves off a nasal decongestant like oxymetazoline?

A

if they start one course of intranasal glucocorticoids 1 week prior to discontinuing oxymetazoline.

also discontinuing one nostril at a time.

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26
Q

what should a provider use caution with when prescribing an oral decongestant?

A

should be given WITH EXTREME CAUTION to someone with cardiac disease

27
Q

why do we have to keep pseudoephedrine behind the counter

A

because people make meth with it.

28
Q

what routes can a decongestant be given?

A

oral tablets or liquid

29
Q

what CNS change does decongestants cause?

A

CNS stimulation

30
Q

what do opioid antitussives do?

A

increase the cough threshold

31
Q

why is a cough good at times

A

cough can help expel pathogens and mucus/sputum

32
Q

what is the number one antitussive?

A

codeine

33
Q

what does DM stand for in Robitussin DM?

A

dextromethorphan

34
Q

what does dextromethorphan do?

A

can diminish pain BUT can also cause hallucinations in large doses

35
Q

what action do beta 2 agonist have on the lungs?

A

they stimulate bronchoconstriction

36
Q

what is a SABA?

A

albuterol

37
Q

what are 2 LABAs?

A

salmeterol
formoterol

38
Q

what are rescue inhalers?

A

SABA: albuterol

39
Q

which treatments are used on a fixed schedule (daily)?

A

salmeterol
formoterol

40
Q

who should use DPIs?

A

people with COPD tend to like this more because they dont have to hold their breath

stroke patients find this easier to use.

41
Q

should everyone use a spacer with an MDI?

A

YES

42
Q

what are 2 inhaled glucocorticoids?

A

fluticasone
prednisone

43
Q

why are glucocorticoids beneficial?

A

quickly decrease inflammation in the lungs and decrease mucus production

44
Q

are glucocorticoids fixed dose or PRN?

A

either

45
Q

how do glucocorticoids effect growth in children?

A

slows their growth

46
Q

in what order would you give an albuterol MDI and a betamethasone MDI? why?

A

you would give albuterol first because it would open up the airway, so the steroid could get into the lungs better

47
Q

how can you prevent oral thrush in a pt taking an inhaled glucocorticoid?

A

have them rinse out their mouth with water after taking the medication

48
Q

what is the MOA of anticholinergics?

A

they work on muscanaric receptors in the lungs

49
Q

what is one major anticholinergic

A

ipratropium

50
Q

are anticholinergics used for asthma?

A

they are used in asthma in children

and if your adult patient with asthma it can be used as a last resort to tweak any receptor that might open up their airway

51
Q

what are leukotriene modifiers?

A

fairly new drug class used to treat asthma

52
Q

what is the most common leukotriene modifier used?

A

motelukast

53
Q

how long does it take for montelukast to reach maximum effectiveness?

A

24 hours

54
Q

discuss montelukast use in the control of exercise induced asthma

A

needs to be taken 2 hours before anticipated activity

but its rarely used for this purpose .

55
Q

what is the safest of all asthma drugs?

A

cromolyn

56
Q

how does cromolyn work?

A

suppressed inflammation by stabilizing cytoplasmic membrane of mast cells, preventing the release of histamine.

57
Q

in what cases might theophylline still be used?

A

in old cases of asthma and COPD

58
Q

what do you need to monitor when a pt is on theophylline?

A

plasma levels

59
Q

are there any drugs that shorten the length of the common cold?

A

no there are only drugs to treat the symptoms

60
Q

what is the best method to treating the symptoms of a common cold?

A

use separate drugs to treat the symptoms you already have rather than take a combo drug that has effects you dont need

61
Q

what kind of drug is guaifenesin?

A

expectorant

62
Q

what does guaifenesin do?

A

thins mucus and makes it easier to cough up

63
Q
A

pharmacology exam 1 (4 decks)

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