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Pharm 225A > Respiratory meds > Flashcards

Respiratory meds Flashcards

1
Q

Two main classes of drugs for asthma

A
  • Bronchodilators
  • anti inflammatory agents
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2
Q

Types of bronchodilators

A
  • B2 adrenergic agonist
  • Methylxanthines
  • anticholinergics
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3
Q

MoA B2 Adrenergic agonists

A
  • relaxes smooth muscle –> bronchodilation
  • increase ciliary motility –> mucus clearance
  • suppress histamine release
  • increase myocardial conductivity
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4
Q

Albuterol

A
  • short acting beta2 agonist ; inhaled
  • quick relief of acute bronchospasm; prevention of exercise induced bronchospasm
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5
Q

levalbuterol

A
  • short acting beta2 agonist; inhaled
  • quick relief of acute bronchospasm; prevention of exercise induced bronchospasm
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6
Q

Terbutaline

A
  • short acting beta2 agonist; inhaled
  • SQ/IV for fetal distress, suppress pre-term labor
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7
Q

Salmeterol

A
  • long acting beta2 agonist; inhaled
  • commonly used with fluticasone (ICS)
  • decreases s/s and risk of exacerbations, improves lung fxn
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8
Q

Formoterol

A
  • long acting beta2 agonist; inhaled
  • commonly used with budesonide (ICS)
  • decreases s/s and risk of exacerbations, improves lung fxn
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9
Q

AEs of B2 agonist (short acting)

A
  • well-tolerated
  • tachy, angina, tremors
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10
Q

AEs of B2 agonist (long acting)

A
  • must be combined with ICS in persistent asthma
  • discontinue LABA is possible once asthma control achieved
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11
Q

MoA of Methylxanthines

A
  • release of Epi in adrenal medulla –> smooth muscle relaxation of bronchi
  • improved resp muscle
  • increases cardiac output and mucus clearance
  • decreased airway inflammation
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12
Q

Theophylline

A
  • methylxanthine; inhaled
  • narrow therapeutic index
  • SE’s: insomnia, N/V, Toxicity = tachycardia and convulsions
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13
Q

Theophylline toxicity risk

A
  • increase risk of toxicity with CYP1A2 and 3A4 inhibitors
  • ex. propranolol, ciprofloxacin, LT modifiers, caffeine
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14
Q

MoA of anticholinergics

A
  • block muscarinic receptors –> bronchodilation
  • block bronchoconstriction
  • off label asthma, mostly for COPD
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15
Q

Ipratroprium bromide

A
  • short acting inhaled anti-cholinergic agent
  • used in combo with SABA albuterol
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16
Q

Tiotropium Bromide

A
  • long acting inhaled anti-cholinergic agent
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17
Q

AEs of anticholinergic agents

A
  • dry mouth
  • constipation
  • urinary retention
  • blurred vision
  • tachy
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18
Q

Types of anti-inflammatory drugs

A
  • steroidal/non-steroidal
  • leukotriene modifiers
  • biologics
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19
Q

MoA of Corticosteroid

A
  • decreased levels of inflammatory mediators
  • decreased airway edema, mucus production/hypersecretion
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20
Q

Fluticasone

A
  • inhaled corticosteroid/glucocorticoid
  • paired with LABA salmeterol
  • most effective anti-asthma
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21
Q

Budesonide

A
  • inhaled corticosteroid/glucocorticoid
  • paired with LABA formoterol
  • most effective anti-asthma
22
Q

methylprednisolone

A
  • oral glucocorticoid
  • also injectable
23
Q

prednisone

A
  • oral glucocorticoid
24
Q

AEs of glucocorticoid

A
  • oropharyngeal candidiasis if inhaled improperly
  • dysphonia
  • growth suppression in children

to minimize = spacer, rinse mouth after admin, antifungal use

25
Long term SEs of systemic steroids
- cushings syndrome - adrenal insufficiency - CNS effects (nervousness/depression) - immunosuppression - osteoporosis - peptic ulcers - growth retardation in children - catracts/glaucoma
26
MoA of leukotriene D4 receptor antagonist
- blocks D4 receptors - bronchodilates, decreases mucus, exercise induced asthma prevention
27
MoA of 5-Lipooxygenase Inhibitors
- prevent formation of leukotrienes - leads to anti-inflammation/bronchodilation
28
Zafirlukast
- PO - leukotriene D4 receptor blocker
29
Montelukast
- PO - leukotriene D4 receptor blocker - also for exercise induced asthma
30
Zileuton
- PO - 5-lipo-oxygenase inhibitor - need to monitor LFTs
31
Leukotriene Modifiers AEs
- headache - Nausea/diarrhea - BBW - neuropsychiatric events - upper RTI
32
Cromolyn (MoA, Use, Route, AEs)
- MoA: prevents release of inflamm. mediators (not bronchodilator) - Uses: prophylaxis of exercise induced bronchospasm - route: inhaled, nebulizer - AEs: occasional cough/bronchospasm
33
Anti-IgE Antibody MoA
- Prevents release of mediators of allergic response that cause bronchospasm
34
AEs of Anti-IgE antibody
- BBW: anaphylaxis after 1st dose/delayed onset (>1 year)
35
Omalizumab
- recombinant monoclonal antibody - route: SubQ every 2-4 wks for 3 doses - 2nd choice for allergy related asthma if all others fail
36
Drugs used in the tx of COPD
- short acting/long acting bronchodilators - Glucocorticosteroids
37
Roflumilast (class/route/MoA/AE)
- Phosphodiesterase 4 inhibitor - PO - MoA: smooth muscle relaxation --> bronchodilation and decreased inflammation for severe COPD - AE: weight loss, N/V, suicidal thoughts
38
MoA of anithistamines
- inhibit histamine release - histamine receptor antagonist
39
Diphenhydramine (class/route/AEs)
- aka benadryl, 1st gen antihistamine - oral, intranasal - AEs: sedation, stimulant effect in some patients - 2nd & 3rd gen have less SEs
40
Mometasone
- intranasal corticosteroid in treatment in allergic rhinitis
41
MoA of decongestants
- alpha 1 adrenergic agonist - vasoconstriction --> less mucosal edema and exudation - immediate effects
42
Phenylephrine
- PO or nasal decongestant - extensive 1st pass metabolism when PO
43
Psuedoephedrine
- PO decongestant - can be manipulated into methamphetamine
44
Oxymetalozine
- intranasal decongestant
45
AEs of decongestants
- rebound when used > 3-5 days - irritability, anxiety, insomnia - increased BP (caution for HTN/CAD patients)
46
MoA of antitussives
- Central: suppress cough center in medulla - peripheral: lessen irritation of respiratory tract - not recommended for children under 6 (seizures)
47
Dextromethorphan (DM)
- non-opioid antitussives, PO - blocks the cough reflex center in the CNS - abused if used in large quantities
48
Diphenhydramine
- non-opioid antitussive, PO - MoA: sedative/anticholinergic props, cough suppression - AEs: sedation, dizziness, dry mouth
49
Benzonatate
- non-opioid antitussive, PO - decreases sensitivity of respiratory tract receptors
50
Opioid antitussives (MOA)
- MoA: suppresses CNS cough center & inhibits sensory nerves in bronchi - contain codeine
51
Guaifenesin
- PO - Expectorant - decrease cough frequency, decrease phlegm thickness, removal of secretions
52
Acetylcystine
- PO - mucolytic - breaks up respiratory mucoprotein into smaller strands; mucus more watery - also for cystic fibrosis and overdose of acetaminophen

Pharm 225A (7 decks)

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