Respiratory Pahrmacology Flashcards
Albuterol (proventil)
Short acting beta 2 agonist that works by relaxing bronchial smooth muscle production broncodilation
Indication for albuterol (proventil)
Asthma attacks and bronchospasm
Does albuterol effect b2 of heart
Not if dose is smal
MOA albuterol (proventil)
Activates b2 receptor in lungs causing relaxation fo bronchial smooth muscle and subsequent bronchodilator
How administer albuterol
Inhaled or nebulizer
Side effects albuterol
Angina, tachycardia, tremor
Angina and albuterol
Inadequate oxygen to the heart
Tachycardia albuterol
Can activate b1
Tremor albuterol
Yup
Terbutaline (breathine)
B2 agonist administered for short term control of asthma and tocolytic to suppress preterm labor
Side effects terbutaline (breathing)
Tremors, tachycardia, hypotension, pulmonary edema, hyperglycemia
MOA terbutaline
B2 agonist
Increase bronchodilation and reduce resistance of the airway in asthmatics
Also relax SM of uterus and delaying onset of labor
Indications terbutaline
Asthma
Tocolytic -delays preterm labor by relaxing AM of uterus and stopping contraction
Tachycardia and terbutaline
Can stimulate b1 at high doses -increase heart rate, angina, palpitations, cardiac ischemia
Chest pain, nervousness, somnolence, flushing
Tremor terbutaline
Overstimulation b2 b1 at high dose
Hypotension terbutaline
High dose b1 hr increase causing decrease in bp and fluid volumes shift compartments, changes in electrolytes can occur resulting in hypothalamic
Pulmonary edema terbutaline
Stimulate b1 could possibly increase the leaking of fluid from capillaries thus promoting the development of pulmonary edema
Hyperglycemia terbutaline
Overactivation of b2
Careful in diabetics
Theophylline
Methylxanthine medication used to treat asthma (and sometimes COPD). Metabolized by p450 and works by inhibiting phosphodiesterase, leading to increased cAMP, which causes bronchodilation.
MOA theophylline
Inhibits phosphodiesterase (which breaks down cAMP to AMP) increased cAMP lead to bronchodilation
Also inhibits TNFa , leukotrienes, and inhalation
Increases cAMP
Indications for theophylline
Asthma also COPD and infant apnea
Side effects theophylline
Cardiotoxicity, neurotoxicity, blocks adenosine action (blocks A1, 2, 3 adenosine receptors in the heart. May cause arrhythmias to occur in patients who were taking adenosine previously)
Chromodynamics (mast cell stabilizers)
Chromodynamics sodium (intel) or cromoglicic acid is a medication prevents the release of inflammatory agents like histamine from entering the tissue.
MOA cromolyn
Stabilizes mast cels, which break down as part of inflammatory reaction to release histamine (vasodilator) prevent mast cells from breaking down and releasing contents
Indication cromolyn
Asthma prophylaxis
Bronchial inflammation
Allergic rhinitis
Side effects cromolyn
Cough (increases the viscosity of mucus secretions), bronchospasm
How is cromolyn given
Fixed schedule
Montelukast (singular)
Leukotrienes modifier that works by blocking the action of leukotrienes receptors int he lungs and bronchial tubes, reducing inflammation and bronchoconstriction in patients with asthma
Indication for montelukast
Allergic rhinitis, exercise induced bronchospasm prention or maintence therapy of asthma
Why shouldn’t montelukast be used to treat asthma attacks
Not fast acting
Side effects of montelukast
Fatigue, headache, suicidal thoughts, changes in mood, increased risk of developing churg-Strauss syndrome (eosinophilia granulomatosis with polyangitis)
MOA montelukast
Leukotrienes are inflammatory mediators, responsible for producing bronchoconstriction, inflammation, and airway edema in patients with asthma.
Montelukast blocks the action of leukotriene receptors in the lungs and bronchial tubes, thereby reducing inflammation and bronchoconstriction
Indications for montelukast
Allergic rhinitis, asthma prophylaxis, exercise induced bronchospasm
Allergic rhinitis and singular
For patients who do not respond to intranasal glucocorticoid or antihistamine therapy, due to rare but serious side effects that can occur
Side effects montelukast (Singulair)
Fatigue, headache, mood changes, suicidal thoughts
Montelukast (singulair) and churg-Strauss
- an eosinophilia granulomatosis with polyangitis
- life threatening autoimmune disorder that causes inflammation of the blood vessels. Can lead to tissue death and destruction of the lungs
What is a common sign of churg Strauss
Asthma