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Pharmacology > Respiratroy Tract Drugs: Asthma And COPD (79) > Flashcards

Respiratroy Tract Drugs: Asthma And COPD (79) Flashcards

1
Q

Bronchial asthma

A

Recurrent and reversible shortness of breath
-lung airways narrow (bronchospasms, inflammation of bronchial mucosa)

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2
Q

Bronchospasms are a response

A

To mechanicals released form immune system and secretions

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3
Q

Airflow limitation is caused by

A

Bronchospasms and inflammation

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4
Q

Bronchial asthma

A

Alveolar ducts/alveoli remain open but airflow is obstructed
-causing difficulty breathing or wheezing

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5
Q

Status asthmaticus

A

Medical emergency
-prolonged asthma attack
-does not respond to usual medical therapy

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6
Q

COPD

A

Chronic obstructive pulmonary disease
-obstruction is constantly present, but can vary in severit y

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7
Q

Tobacco smoke and air pollution causes

A

Inflammation of the airway epithelium
-release of cytokines

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8
Q

Chronic bronchitis is

A

Continous inflammation of the bronchi and bronchioles
-result of prolonged exposure to bronchial irritants

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9
Q

Emphysema

A

Air spaces enlarge as a result of the destruction of alveolar walls
-surface area is reduced
-impaired res[iration

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10
Q

Bronchodilator’s

A

-B2 adrenergic agonists
-anticholinergics
-can think derivatives

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11
Q

B2 adrenergic agonists

A

Albutamol salbutamol

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12
Q

Anticholinergics

A

Ipratropium bromide

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13
Q

Xanthine derivatives

A

Theophylline/aminophylline

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14
Q

Anti inflammatory drugs

A

-glucocorticoids
-leukotriene modifiers

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15
Q

Issues with inhalers

A

Technique
-local effect and much quicker

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16
Q

PO drug will interact with more

A

Receptors = more AE

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17
Q

Bronchodilator’s: B agonists are

A

Sympathomimetic bronchodilators
-stimulate bronchial smooth muscle b2 andrenergic receptors

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18
Q

Two types of smooth muscle b2 adrenergic receptor s

A

-short acting B agonists (SABA)

-long acting B agonists (LABA)q

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19
Q

Selective b2 drugs

A

Activate airway smooth muscle b2 adrenergic receptors

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20
Q

Example of selective b2 drugs

A

Salbutamol (SABA)

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21
Q

Mechanisms of action of B agonists

A

Dilation of airways

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22
Q

How do B agonists dilate airways

A

Activation of smooth muscle b2 receptors

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23
Q

Activation of smoooht muscle b2 receptors

A

Relax smooth muscles of the airway resulting in bronchial dilation
-increasing airflow

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24
Q

Indications for B agonists

A

-relief of bronchospasm related to asthma, COPD, other pulmonary disease
-acute asthma attacks
-repent attacks

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25
Q

Adverse effects of B agonists

A

-cardiac stimulation

-tremors

-restlessness and insomnia

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26
Q

Why do B agonists cause cardiac stimulation

A

Tachycardia

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27
Q

Salbutamol adverse effects

A

-b2 receptor effects
-decrease receptor selectivity

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28
Q

Salbutamol adverse effects: b2 receptor effects

A

Muscle tremor, CNS, anxiety, nausea

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29
Q

Salbutamol adverse effects: decreases receptor selectivity

A

Stimulates b1 adrenergic receptors in heart

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30
Q

Stimulation of b1 adrenergic receptors in heart causes

A

Increased heart rate, palpitations, chest pains, angina

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31
Q

Why do these adverse effects happen in salbutamol

A

When inhaled form is used too frequently

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32
Q

Adverse effects are more likely with (salbutamol)

A

More likely with oral preparations

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33
Q

Good to encourage what sort of measures for clients taking bronchodilators/B agonists

A

Good state of health in order to prevent, relieve or decrease symptoms of asthma/COPD

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34
Q

Avoid exposure to conditions that

A

Precipitate bronchospsms, like smoking, allergens, stress, air pollutants

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35
Q

What else is important for bronchodilators and B agonists

A

Adequate fluid intake

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36
Q

What therapeutic effects should we be monitoring for, when on b agonists

A

Decreased: dyspnea, wheezing, restlessness and anxiety

Improved: respiratory patterns, activity tolerance

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37
Q

Mechanism of action of anticholinergics

A

Anticholinergic drug binds to cell membrane blocking ilgand from binding at binding site

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38
Q

Example of anticholinergics

A

Ipratropium

39
Q

Anticholinergics prevent… (how)

A

Bronchoconstriction on a fixed schedule use

40
Q

Anticholinergics are NOT used for

A

Acute exacerbations

41
Q

Tiotrpium, aclidinium, umeclidinium all have a

A

Longer duration of action

42
Q

Adverse effects of anticholinergics

A

-dry mouth or throat (reduces secretions)
-systemic effects (minimal)

43
Q

Two types of methylxanthines

A

Theophylline and aminophylline

44
Q

Methylxanthines are an example of

A

Bronchodilators
-smooth muscle relaxation
-greater airflow

45
Q

Theophylline is given

A

Orally

46
Q

Aminophylline is a more ____ ____ form of theophylline

A

Water-soluble

47
Q

Aminophylline is given

A

IV administration

48
Q

Mechanisms of action for methylxanthines

A
49
Q

Indications of methylxanthines

A

-mild to moderate cases of acute asthma
-adjunct agent in the management of COPD

50
Q

Theophylline is very similar in molecular structure to

A

Caffeine

51
Q

Adverse effects of methylxanthines

A

-CNS stimulation
-CV stimulation
-GI distress

52
Q

Adverse effects of methylxanthines: CNS stimulation

A

Anxiety, insomnia, seizures

53
Q

Adverse effects of methylxanthines: CV stimulation

A

-palpations (inc force of contraction and a fast HR)
-sinus tachycardia (increased HR)
-ventricular dysrhythmias
-diuresis (increased blood flow to kidneys)

54
Q

Interactions with methylxanthines: theophylline

A

Increased effects of theophylline when interacting with ciprofloxacin
-inhibits liver CYP metabolism

55
Q

Large amounts of caffeine can

A

Intensify adverse effects of methylxanthines

56
Q

Decreased effects of theophylline occur when

A

Liver enzyme inducers
-as it increases the metabolism of theophylline

57
Q

Liver enzyme inducers example

A

Phenytoin, phenobarbital
-anti seizure drugs

58
Q

Cortisol looks similar to

A

Cholesterol

59
Q

Glucocorticoids group

A

There are many drugs in this group

60
Q

Glucocorticoids have a similar action

A

To cortisol, which is an adrenal steroid hormone

61
Q

Steroid drugs structure

A

Based on cholesterol

62
Q

Glucocorticoids are….

A

Anti inflammatory

63
Q

Inhaled glucocorticoids

A

Used for chronic asthma and COPD

64
Q

Oral and IV glucocorticoids would only be used for

A

Severe and short term treatment

65
Q

Inhaled forms of glucocorticoids do what

A

Reduce systemic effects

66
Q

How long does it take for glucocorticoids to reach a therapeutic effect?

A

Several weeks

67
Q

Mechanisms of action for glucocorticoids (4)

A

-reduce inflammatory mediators

-decrease production of cytokines

-reduce infiltration and activity of inflammatory cells

-reduces edema

68
Q

Cholesterol and cortisol look very similar to

A

Budesonide

69
Q

Examples of inhaled glucocorticoids

A

Budesonide

70
Q

Combined preparation of glucocorticoids (2)

A

-glucocorticoid + Long Acting B2 Agonist (LABA)

-budesonide + formoterol

71
Q

Fluticasone

A

Inhaled glucocorticoids

72
Q

Fluticasone is used…

A

Alone or in combination with advair discus

73
Q

Fluticasone and advair diskus

A

Combo with long acting b2 agonist salmeterol

74
Q

Indications of inhaled glucocorticoids

A

Prophylaxis treatment of asthma and COPD

75
Q

COPD is prophylactically treated with

A

LABA

76
Q

Adverse effects of inhaled glucocorticoids

A

-oral fungal infections
-pharyngeal irritation
-coughing
-dry mouth
-rare systemic effects

77
Q

Care implications of inhaled glucocorticoids

A

-avoid if have candidia in sputum
-may slow growth in children (does not reduce adult height)
-possible bone loss (weight bearing exercise)

78
Q

Bronchodilators and glucocorticoids

A

Bronchodilators should be used several minutes before the glucocorticoid to provide bronchodilators before administration of the glucocorticoid

79
Q

What should you teach to clients to avoid oral fungal infections

A

Gargle and rinse the mouth with water afterward to prevent the development of oral fungal infections

80
Q

Leukotrienes cause

A

-inflammation
-bronchoconstriction
-mucus protection
-leukocyte recruitment

81
Q

Leukotrienes cause

A

Bronchoconstricion and vascular permeability

82
Q

What are leuotrienes

A

Released in immune responses in asthma
-mast cells, eosinophils

83
Q

Leukotrienes cause what symptoms

A

Coughing, wheezing, SOB

84
Q

Leukotriene modulators

A

Suppress leukotriene effects

85
Q

What do leukotriene modulators do when it comes to suppressing leukotriene effects

A

-prevent smooth muscle contraction of the bronchial airways

-decrease mucus secretion

-prevent vascular permeability

-decrease neutrophil and other leukocyte infiltration to the lungs preventing inflammation

86
Q

Leukotriene modulators cause what to be reduced

A

Inflammation in lunch is reduced
-asthma symptoms then are relieved

87
Q

Example of leukotriene receptor antagonists

A

Montelukast

88
Q

Example of leukotriene synthesis inhibitor

A

Zileuton

89
Q

Montelukast

A

Generally well tolerated

90
Q

Indications of leukotriene modulators

A

-prophylaxis and chronic treatment of asthma in adults and children

91
Q

leukotriene modulators are NOT

A

Used for acute asthmatic attacks

92
Q

Prophylactic and chronic treatment of asthma in adults and children

A

Montelukast in children ages 2 and older

93
Q

Care implications of leukotriene modulators

A

-ensure that the drug is being used for chronic management of asthma not acute

94
Q

Improvement from leukotriene modulators should be seen within

A

1 day to 1 week

Pharmacology (23 decks)

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