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A1 > Respiratory Pharmacology > Flashcards

Respiratory Pharmacology Flashcards

1
Q

Dose delivered by neb required __x higher dose to produce bronchodilation

A

6-10x

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2
Q

Classes of respiratory medications

A

Bronchodilators- B2 agonists, Anticholinergics
Anti-inflammatories- Mast cell stabilizers, Leuktreine antagonists, Corticosteroids
Methylxanthines-Theophylline

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3
Q

Muscarinic receptors

A

1- Arousal
2- cardiac inhibition
3- bronchoconstriction
4- CNS K/Ca channels
5- CNS dopamine release

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4
Q

Atropine dose

A

1-2mg

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5
Q

Ipratropium class and receptor

A

SAMA
M3 blocker

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6
Q

What drug is best to treat bronchospasm d/t beta blocker?

A

Ipratropium

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7
Q

SAMA vs LAMA

A

Atropine, ipratropium
Glyccopyrolate, tiotropium, umeclidinium, aclidinium

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8
Q

S/E anticolinergics

A

Narrow angle glaucoma (they increase pressure)
Blurry vision
Urinary retention
Paradoxical bronchospasm d/t m2 blockade

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9
Q

Tocolytics

A

Beta agonists
Terbutaline

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10
Q

Terbutaline BB warning:

A

Tachycardia, hyerglycemia, hypokalemia, pulmonary edema, MI, death
Increased fetal HR, neonatal hypoglycemia

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11
Q

What is terbutaline?

A

Bronchodilator and tocolytic- has fallen out of practice
Still can be used for catecholamine extravasation

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12
Q

SABA vs LABA

A

Albuterol, levalbuterol (R enantiomer)
Salmeterol, vilanterol, formoterol, aformoterol, olodaterol

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13
Q

LABA BB warning:

A

Asthmas related death, should not be used alone!

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14
Q

B2 agonists side effects

A

Tremor, hyperglycemia, tachycardia, HTN, hypokalemia, hypomagnesemia

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15
Q

Membrane stabilizers, what does it do to make breathing easier

A

Cromolyn- surpresses secretions ONLY, used for prophylactic treatment of asthma

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16
Q

Methylxanthines, MOA,

A

Caffeine, theophylline, theobromine (chocolate)
Stimulates CNS, increases BP, increases inotropy, relaxes smooth muscle
PDE blocker
Adenosine blocker

17
Q

Theophylline side effects

A

Theo=god= meet god
Vtac/ seizures
15-25- gi upset, nv, tremor
25-35- tachycardia, PVC
>35- Vtac seizures

18
Q

H1 vs H2

A

1- smooth muscle contraction, antidromic, coronary vasoconstriction
2- Increase inotropy, hr, coronary vasodilation, bronchodilation
Both cause cap permeability

19
Q

Histamine triple response

A

Edema
Pruritis
Flare (dilated arteries)

20
Q

1st vs 2nd H blockers examples

A

1- benadryl, dimenhydrinate, hyrdoxyzine,
2- loratadine, cetirizine, fexofenadine, levocetirizine

21
Q

H1 anatagonist side effects

A

CNS- sedation
Anticholinergics- dry mouth, blurred vision
Cardiac- QT prolongation, HB

22
Q

Glucocorticoid vs mineralcorticosteriods (effect on the body)

A

G- anti inflammatory
M- Reabsorption of NA and excrete K

23
Q

The only FDA approved use for steroids?

A

Replacement therapy for deficiency states
However; also used off-label for anti emetics, laryngeal edema, septic shock, asthma, more

24
Q

Can steroids cross placenta?

A

Yes!

25
Q

Cushing vs addisons

A

Cushings- too much cortisol (from exogenous)
Addisons- not enough cortisol

26
Q

Surgeons concerns about corticosteroids

A

Masking infection
Altering glucose control in diabetics
Aseptic necrosis femoral head
Failure of bone fusion

27
Q

Steroids in anesthesia

A

They may suppress HPA axis, blunting effect of cortisol release, leading to hypotensive shock
Prednisone/ decadron at nighttime is more likely to suppress

28
Q

Steroid therapy unlikely to suppress HPA axis

A

Prednisone 5mg/day or less
Every other day dosing
<3 weeks of therapy

29
Q

After cessation of steroids, how long for the recovery of HPA axis

A

12 months or longer

30
Q

Who should get steroid supplementation?

A
  1. Diagnosed adrenal insufficiency via ACTH test
  2. High risk HPA suppression- 20mg/day >3 weeks, S&S of cushings
  3. Burns of sepsis
31
Q

Signs and symptoms of acute adrenal crisis

A

Too little cortisol (addisons)
Hypotensive refractory to pressors
Hypoglycemia
Hypovolemia
Met acidosis
Decreased LOC
Hyperkalemia

32
Q

Triple action therapy

A

Breztri (formoterol, budesonide, glycopyrolate)
Trelegy (Vilanterol, fluticasone, umeclidinium)

32
Q

DuoNeb

A

Albuterol, ipratropium

33
Q

Catecholamines that can be used for bronchodilation

A

Epi
Isoproterinol
Ephederine

A1 (124 decks)

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