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Pharmacology - Test #4 > Respiratory Pharm I > Flashcards

Respiratory Pharm I Flashcards

1
Q

Three components influencing bronchoconstriction

A

Activation of Mast Cells
Local Inflammation
Vagal Stimulation

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2
Q

Agents tat reduce bronchoconstriction and increase relaxation all increase levels of intracellular _____

A

cAMP

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3
Q

How do sympathomimetics act to treat asthma

A

Increase cAMP via Gs receptor subunit

Relaxes smooth muscle/Decreases Mast cell release

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4
Q

Examples of selective short acting beta adrenergic agents

A

Albuterol, terbutaline

metaproterenol, pirbuterol

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5
Q

Which beta adrenergic agent is a Pure R mixture

A

Levabuterol

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6
Q

Two main examples of long acting beta-agonists

A

Salmeterol and Formoterol

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7
Q

When to use a long acting beta agonist

A

Used w/ inhaled steroids for mainenence therapy

NOT for acute exacerbations

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8
Q

Antimuscarinic agonists are especially helpful in what conditions

A

Non-allergic (COPD)

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9
Q

Antimuscarinic agents used to help out COPD paients

A

Ipatropium

Tiotropium

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10
Q

How do methylxanthines work?

A

They block phosphodiesterase activity, preventing breakdown of cAMP. This causes bronchodilation and inhibition of inflammatory cells. This leads to a non-specific, inexpensive treatment.

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11
Q

Examples of methylxanthines that can be used to treat asthma?

A

Theophylline, Caffeine, Theobromine

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12
Q

Aside from asthma/COPD treatment, methylxanthines may also cause…

A

Increased Alertness, Nervousness, Tremor
Tachycardia, Rare arrythmias
Increased gastric acid, digestive enzyme secretion
Increased diaphragmatic fxn

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13
Q

Main issues with using the methylxanthine THEOPHYLLINE

A

Wide variation in blood levels

Narrow window to therapeutic range

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14
Q

Example of an Anti-IgE antibody

A

Omalizumab

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15
Q

How do anti-IgE antibodies work

A

They target the Fc portion of IgE, preventing its attachment to mast cells and basophils. This reduces the frequency/severity of exacerbations for llergen induced.

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16
Q

Downside of treating with omalizumab

A

Given parenterally

VERY expensive

17
Q

How does Cromolyn work?

A

Inhaled powder that inhibits mast cell degranulation by a poorly understood mechanism (membrane stabolization)

18
Q

When to use Cromolyn

A

Prophylactically, NOT during attack

19
Q

Two approaches of leukotriene modifiers

A

Inhibition of 5-lipoxygenase (zileuton)

LTD4 receptor antagonist (montelukast)

20
Q

Aerosol steroid treatments to know…

A

Beclomethasone, Fluticasone

21
Q

Oral/parenteral steroids used in emergencies

A

Prednisone, Dexamethasone

22
Q

Talk through the stepwise increase in asthma treatment

A 
SABA PRN
Add in Low Dose ICS
Plus LABA
Increase Steroid Dose
If really bad, add omalizumab
23
Q

Why do nebulizers work better than inhalers

A

Continuous use over minutes
Larger particles generated, so higher doses given
Problem – Bacterial contamination

24
Q

How do spacers help improve inhaler activity?

A

Aids in aerosolization

More makes it to lungs

25
Q

Typical approach to therapy with COPD

A

Long acting beta agonists and anticholinergic agents
Can add theophylline – but dangerous side effects
Inhaled steroids can be added in

26
Q

Drugs that are not helpful for COPD exacerbations

A

NSAIDs

anti-leukotrienes

27
Q

What to keep in mind when treating a COPD exacerbation

A

Keep patient out of hospital – infection
Steroids may help, but less than asthma
Antibiotics for infections – Doxy
Avoid O2, Dehydration

28
Q

General strategies for treatment of nasal allergies

A 
Avoidance of Triggers
Antihistamines
Nasal Steroids
Saline
Possibly antileukotrienes to decrease secretions
29
Q

Commonly used antihistamines

A

Diphenhydramine, Chlorpheniamine, hydroxyzine

Fexofenadine, Loratadine, Certirizine

30
Q

Name nasal steroids

A

Mometasone

Fluticasone

31
Q

Commonly used decongestants

A

Pseudophedrine or phenylephrine

Pharmacology - Test #4 (9 decks)

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