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Pharmacology (Dale Turley) > Respiratory Pt. 2 - Exam 4 > Flashcards

Respiratory Pt. 2 - Exam 4 Flashcards

1
Q

Pseudoephedrine (Sudafed) MOA?

A

stimulates smooth muscle alpha adrenergic receptors, producing vasoconstriction and reducing nasal congestion (sympathomimetic) - mimics the sympathetic nervous system

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2
Q

Pseudoephedrine is the sympathomimetic drug of the ______________ & ___________ chemical classes

A

phenethylamine

amphetamine

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3
Q

Indications to used Pseudoephedrine ?

A

nasal congestion

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4
Q

avoid using Pseudoephedrine during the ___ trimester

A

1st

caution advised in the 2nd and 3rd trimesters due to possible risk of teratogenicity

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5
Q

Serious reactions with Pseudoephedrine ?

A

Arrhythmias

HTN

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6
Q

Common reactions with Pseudoephedrine ?

A

Insomnia
Urinary Retention
Tachycardia
Tremor

Others: HA, CNS stimulation, Palpitations, Increased BP, Anxiety, Dizziness, Nausea

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7
Q

Peds dosing of Pseudoephedrine is based on?

A

age

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8
Q

Never give a child under __ years old any kind of cough or cold product containing decongestants or AH, w/o seeking advice of a HCP - it is bad for the kidneys

A

2

use nasal saline, honey in water

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9
Q

Antihistamines MOA?

A

decrease histamine-mediated contraction of smooth muscle of the bronchi, intestine, and uterus

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10
Q

Antihistamines clinical use?

A

prevent allergic responses mediated by histamine, such as rhinitis and urticaria

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11
Q

First Generation Antihistamines H-1 examples?

A

Diphenhydramine ( Benadryl)

Chlorpheniramine

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12
Q

Second Generation Antihistamines H-2 examples?

A

Certirizine (Zyrtec)

Desloratadine ( Clarinex)

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13
Q

Antihistamines with _______ & _________ see decrease in absorption.

A

calcium and magnesium

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14
Q

Antihistamines pharmacokinetics ?

A

rapidly absorbed in 15-30 min, 60-70% protein bound, metabolism is minimal, excretion in feces and urine; HF: wide range

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15
Q

Antitussives (codiene, dextromethorphan) act on the cough center in the _______ by elevating its threshold for the cough reflex

A

medulla

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16
Q

Clinical uses of Antitussives ?

A

cough suppression, throat irritation

often combined with benzocaine in thrust lozenges to block the pain from throat irritation when coughing

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17
Q

Examples of Antitussives ?

A

Dextromethorphan (Delays)

Guaifenesin/hydrocodone (Hycotuss, and antitussive/expectorant)

Diphenhydramine/dextromethorphan (Duratuss DM, an antihistamine/antitussive)

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18
Q

Antitussives potentiate _____ , as psych medication for bipolar or depression - mood stabilizer) by increasing the risk of toxicity; do not use concurrently

A

MAOI’s - monoamine oxidase inhibitors

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19
Q

_______ & Antitussives potentiate each other; possibility of respiratory distress

A

alcohol

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20
Q

Codeine _________ - pill and liquid form

A

phosphate

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21
Q

Benzonatate - ________ ______ - great for cough and not a narcotic

A

Tessalon Perles

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22
Q

Codeine Phosphate MOA?

A

binds to various opioid receptors, producing analgesia, sedation and antitussive effects )opioid agonist)

Schedule Drug controlled

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23
Q

Codeine Phosphate Black Box warning

A

death related to ultra-rapid metabolism of codeine to morphine - respiratory depression and death have occurred in children who receive codeine post-tonsillectomy and/or adenoidectomy

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24
Q

Antitussives have risks from concomitant use with _______________, ___ ___________

A

Benzodiazepines, CNS Depressants

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25
Q

When codeine is ingested , it is converted to ________ in the liver by CYP2D6

A

morphine

Some people have DNA variations that make this enzyme more active, causing codeine to be converted to morphine faster and more completely than in other people.

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26
Q

_____-_____ ____________ are more likely to have higher than normal amounts of morphine in their blood after taking codeine

A

ultra-rapid metabolizers

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27
Q

indications for antitussives ?

A

cough

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28
Q

Codeine/Guaifenesin liquid is a cough suppressant and ___________ combination

A

expectorant - which work by loosening mucus

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29
Q

_____ using antitussives in pregnant and lactation.

A

avoid

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30
Q

Serious reactions when using antitussives ?

A

respiratory depression
CNS depression

Others:
Hypotension, orthostatic, Bradycardia, Syncope, seizures, bowel obstruction

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31
Q

Hydrocodone/ Homatropine trade name is ?

A

Hycodan

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32
Q

Hydrocodone is a ________ cough medicine

A

narcotic

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33
Q

____________ is a drug that works against the narcotic to prevent an overdose of this medication

A

Homatropine

34
Q

Hycodan (hydrocodone/homatropine) is a ______________ & ________ cough suppressant combination

A

anticholinergic and narcotic

35
Q

The anticholinergic properties of Hycodan ( hydrocodone/homatropine) work by ?

A

drying up secretions

Homatropine is the anticholinergic

36
Q

The narcotic properties of Hycodan ( hydrocodone/homatropine) work by ?

A

depressing the cough reflex in the brain

37
Q

Homatropine is an _____________

A

anticholinergic

38
Q

Homatropine is an anticholinergic medication that is an antagonist at __________ _____________ receptors and thus the PNS.

A

muscarinic acetylcholine

39
Q

Homatropine is also used in the eyes as a ___________ and as a _________.

A

cycloplegia and mydriatic

40
Q

Benzonatate (Tessalon Perles) MOA?

A

anesthetizes respiratory passage, lung, and pleural stretch receptors, reducing cough reflex (ester local anesthetic)

41
Q

A __________, chemically related to other ester local anesthetics such as procaine and tetracaine used in the eye

A

butyl amine

Benzonatate safe because it acts more locally

42
Q

Indications for Benzonatate?

A

cough

43
Q

Xanthine Derivatives stimulate the ___________ center?

A

respiratory

44
Q

Xanthine Derivatives such as aminophylline and theophylline interact with ________, ____________, _______ by increasing levels

A

caffeine, St. Johns wort, ephedra

45
Q

Anticholinergics inhibit muscarinic cholinergic receptors , like ________ or ________ which acts longer and my have ________ effects with other anticholinergics

A

Tiotropium (Spiriva)

46
Q

Examples of inhaled anti-inflammatory agents?

A

Leukotriene receptor agonists (LTA)
Oxygenase inhibitors
Monoclonal ABS
Mast Cell Stabilizers (sodium chromoglycates , Leukotriene modifiers)

47
Q

Leukotriene receptor agonists inhibit enzyme responsible for producing inflammatory response to leukotrienes by ________ the leukotriene’s receptor that makes __________________ possible

A

blocking,bronchoconstriction

48
Q

Used in long-term control and prevention of symptoms in mild persistent asthma

A

Leukotriene receptor agonists

49
Q

____________ are used as a combination therapy with inhaled corticosteroids for moderate persistent asthma

A

Leukotriene receptor agonists

NOT FOR COPD

50
Q

Examples of Leukotriene receptor agonists?

A

Zafirlukast (Accolate)

Montelukast (Singulair)

51
Q

what must be taken regularly, even during symptom-free periods

A

Leukotriene receptor agonists

must take it every day whether they have active dyspnea or not

52
Q

Zafirlukast (Accolate) and Montelukast (Singulair) need to be taken every single day to build up levels in the body to get ___________ effect

A

therapeutic

53
Q

Persistent asthma or asthma caused by allergies, cats, grass, pollen and environment type things take singular if __ months or older and ________ if __ years or older

A

singular if 12 months age and older and

Accolate if 5 years or older

54
Q

Class of Oxygenase inhibitors

A

mast cell stabilizers

55
Q

Example of oxygenate inhibitors?

A

Zileturon (Xyflo) 600 mg PO BID

56
Q

MOA of Zileturon (Xyflo)?

A

inhibits 5-lipoxygenase, interfering w/ leukotriene formation (leukotriene inhibitor)

57
Q

Clinical uses of Zileturon (Xyflo)?

A

long term control of mild persistent asthma in those older than 12 y.o.

58
Q

Zileturon (Xyflo) is used with ___ in moderate persistent asthma as combination therapy

A

ICS

59
Q

What do you want to monitor when taking long term oxygenate inhibitors ?

A

LFT periodically during the first year cause these medications make LFT increase

60
Q

The idea of a “_____ ______” was first proposed by ____ _______ in the 20th century

A

magic bullet

paul ehrlich

61
Q

“a compound could be made that selectively targeted a disease-causing organism, then a toxin for that organism could be delivered along with the agent of selectivity”

who said this?

A

paul Ehrlich 20th century

62
Q

Monoclonal antibodies bind to ___ receptors on mast cell and eosinophils preventing release of mediators to the allergic response

A

IgE

63
Q

Clinical uses for Monoclonal antibodies ?

A

Moderate to persistent asthma

especially in those patients reactive to perennial allergens and in whom asthma symptoms are not controlled by ICS

64
Q

Example of Monoclonal antibodies ?

A

Omalizumab (Xolair) modulator

65
Q

BBW of Monoclonal antibodies ?

A

Anaphylaxis - 6% risk of reaction when infused with the medicine

can occur right away or after many dosages

66
Q

Combination products use ___

A

ICS

67
Q

Examples of Combination products?

A

Advair - salmeterol/fluticasone

Combivent - Albuterol/ipratropium

68
Q

There are differences in _______ when using combination products

A

potency

69
Q

________ is a highly reactive nonmetal and oxidizing agent that readily forms oxides with most elements as well as other compounds

A

oxygen

70
Q

Oxygen is used to treat emphysema , PNA, CHF and some disorders that cause increased pulmonary artery pressure and any disease that _______ the bodies ability to take up and use _______ oxygen

A

impairs

gaseous

71
Q

Medical devices for delivery of oxygen:

A 
tanks
regulators
PPD
ventilators
tents
masks
nasal canulas
oxygen generators (90-95%)
72
Q

02 delivery percentages ________ from nasal cannula to nonrebreathers

A

increases

nasal cannula, simple mask, venturi’s mask, partial rebreather, nonrebreather

28% ro 60-90%

73
Q

On the venturi mask you can adjust the _______ ______ and you can change the oxygen delivery amount

A

venturi barrel

venturi is a way to start to lean people off oxygen therapy

blue 24%
white 28%
orange 31%
yellow 35%
red 40&
green 60%
74
Q

Nebulizer machines are for delivery of ________

they are not delivery machines they are just compressors

A

aerosols

75
Q

Examples of Durble medical good (DMG)?

A

nebulizers
canes
hospital bed

76
Q

CPAP - continuous positive airway pressure is a therapy common treatment for obstructive _____ _____

A

sleep apnea

make sure you used distilled clean water for humidification

77
Q

Helix is what combo?

A

oxygen and helium

78
Q

what is the benefit of using helix?

A

this mixture of helium and oxygen generates less resistance than atmospheric air when passing through the airways of the lungs, and thus requires less effort by a patient to breathe in and out of the lungs

79
Q

what is the mixture amount of helix?

A

O2 - 21%

Helium - 79%

80
Q

what type of oxygenation administration rose is used in critical care and ICU units and used in ARDS?

A

HeliO2 blender

Pharmacology (Dale Turley) (31 decks)

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