Respiratory Meds

Question 1

Describe the effects of methylxanthines in the body and state the therapeutic window of methylxanthines

Answer 1

Causes bronchodialation

therapeutic wondow: 5-15 mcg/mL

Question 2

List 2 toxic effects of methylxanthines, including the dose resulting in toxicity

Answer 2

30+ mcg/mL
2 toxic effects: cardiac dysrhythmias, convulsion

Note: methylxanthines can also cause adverse effects such as CNS excitation, diuresis, and vasodialation

Question 3

2 examples of methylxanthines

Answer 3

Theophylline

Aminophylline

Question 4

Name 2 examples of anticholinergics used for bronchoconstriction

Answer 4

Ipratropium, titotropium

Question 5

Identify 2 adverse effects of anticholinergics

Answer 5

dry mouth, irritation of pharynx

Question 6

List 2 indications for anticholinergics

Answer 6

COPD (it is main!) and asthma

Indication = in medicine, a sign, symptom, or medical condition that leads to the recommendation of a treatment, test, or procedure.

Question 7

List 4 examples of corticosteroids and long-acting beta-agonist (LABAs) combination inhalers

Answer 7

Budesonide/formoterol

Fluticasone/salmeterol

Fluticasone/vilanterol

Mometasone/formoterol

Question 8

Identify 8 adverse effects of glucocorticoids that mimic the symptoms of Cushing’s syndrome

Answer 8

Remember with the gesture!!!

1. Moon face
2. Facial hair
3. mood swings
4. buffalo hump
5. potential for increased fluids
   (corticosteroid hormones include aldosterone, which retains sodium in kidney)
6. changing fat distribution
7. difficult on bones and skin
8. suppresses growth in children

Question 9

Specify 2 factors that result in more significant systemic side effects of glucocorticoids

Answer 9

greater dosage and longer time of use

result in more systemic side effects and increased risk of adrenal gland suppression

Question 10

Describe the mechanism of action of leukotriene modifiers

Answer 10

LMs (anti-leukotriene) suppress the smooth muscle constriction and inflammatory response

Added when glucocorticoids aren’t enough

Question 11

List 3 examples of leukotriene modifiers

Answer 11

Montelukast, zafirlukast, and zileuton

Question 12

Specify 2 adverse effects of leukotriene modifiers

Answer 12

1. neuropsychiatric effects (irritability, bad dreams, insomnia, depression, etc.)
2. Zileuton may impact LIVER –> monitor ALT levels

Question 13

Describe an example of an IgE antagonist, including its route of administration, indication, cost, and adverse effects

Answer 13

Omalizumab

SubQ

high cost

2 adverse effects: anaphylaxis, risk of cancer