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Parker: Pulmonary pharmacology > Restrictive lung dz and PH > Flashcards

Restrictive lung dz and PH Flashcards

1
Q

This drug is a surfactant purified from bovine creatures

A

Beractant

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2
Q

What does Beractant treat?

A

NRDS

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3
Q

This is Dr. Sweatman’s favorite drug

A

Methotrexate

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4
Q

Along with being an anticancer agent, what else can methotrexate treat?

A

Inflammatory disease that can effect the lung such as RA and sarcoidosis

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5
Q

What is methotrexate’s MOA for treating cancer?

A

It inhibits the dihydrofolatereductase enzyme thus decreasing tetrahydrofolate synthesis –> inhibits formation of thymadine –> inhibits DNA synthesis

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6
Q

What is methotrexate’s MOA for treating inflammatory diseases like RA and sarcoidosis?

A

Inhibits enzymes involved in purine metabolism –> increased levels of adenosine –> decreased inflammation

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7
Q

This drug is the DOC for treating Wegener’s granulomatosis

A

Rituximab

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8
Q

What is Rituximab’s MOA?

A

It is a B cell (CD20) antibody

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9
Q

What is another treatment for Wegener’s

A

Cyclophosphamide

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10
Q

What is cyclophosphamide’s MOA?

A

It is an alkylating agent that suppresses B cell activity

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11
Q

What is yet another treatment of Wegener’s?

A

Azathioprine

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12
Q

Acronym for Wegener’s drugs?

A

CAR: cyclophosphamide, azathioprine, rituximab

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13
Q

What is the MOA for Azathioprine?

A

It is a purine analogue that inhibits purine synthesis.. It depresses the immune system

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14
Q

What are the 4 classes of drugs that treat PH?

A

Prostanoids, Endothelin-1 receptor antagonists, Phosphodiesterase type 5 inhibitors, and Calcium channel blockers

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15
Q

What are the 3 prostanoids?

A

EIT: Epoprosterenol, Iloprost, Treprostinil (all have “prost” in the name)

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16
Q

What is the general side affect that you must watch for in all the prostenoids?

A

Bleeding (be careful giving these drugs in combination with antithrombic drugs like warfarin, aspirin)

17
Q

Which prostanoid is especially known for hemoptysis?

A

Iloprost

18
Q

Which prostanoid is a pain in the ass cuz you have to take 6-9 inhaled doses/day?

A

Iloprost

19
Q

Which prostanoid has the longest half life (4hr) and can be given SC or IV?

A

Treprostinil

20
Q

Which prostanoid has a weird side effect of jaw pain?

A

Treprostinil

21
Q

Which prostanoid is metabolized by CYP2C8 and thus has decreased clearance with gemfibrozil and increased clearance with rifampin?

A

Treprostinil

22
Q

What is the MOA of the prostanoids? 3 things

A
  1. Induce vasodilation
  2. Retard smooth muscle growth
  3. Disrupt platelet aggregation
23
Q

What are the 2 endothelia-1 receptor antagonists?

A

BA: Bosentan, Ambrisentan (“sentan”)

24
Q

What is the MOA of the endothelia-1 antagonsits?

A

Endothelin-1 is a potent vasoconstrictor so these drugs antagonize the vasoconstriction –> vasodilation

25
Q

How are these drugs different/better than prostacyclins?

A

They are orally active

26
Q

What is a contraindication in both the endothelia-1 antagonists?

A

Pregnancy

27
Q

Which endothelia-1 receptor antagonist has ADE’s including blood and liver toxicities and you need to check LFT’s?

A

Bosentan

28
Q

Both the endothelia-1 antagonists are metabolized by what enzymes in the liver?

A

CYP3A4 and CYP2C9 (the most common ones)

29
Q

What is the only drug on the condensed drug list that is a Phosphodiesterase type 5 inhibitor?

A

Tadalafil

30
Q

What is Tadalafil’s MOA?

A

Prepetuate endogenous cGMP –> vasodilation and decreased cell proliferation

31
Q

What is the weird and highly Sweatmany ADE of Tadalafil?

A

Change in color vision

32
Q

What are the 3 calcium channel blockers that treat PH?

A

DAV: Deltiazem, Amlodipine, Verapamil

33
Q

What is the MOA of the calcium channel blockers?

A

Block Calcium channels.. calcium is the key mediator of smooth muscle contraction

34
Q

What is the test you must do before giving someone a calcium channel blocker for PH?

A

Vasodilator challenge!!!

35
Q

Describe the vasodilator challenge

A

Give the patient IV epoprosterenol, IV adenosine, and inhaled NO. Monitor their PAP and CO. “Passing” the test means that they had a decrease in PAP and no change in CO

36
Q

What are some “in general” ADE’s of calcium channel blockers?

A

Hypotension, bradycardia, flushing, edema

37
Q

Which calcium channel blocker is very favorable because of its long half life and thus easier dosing schedule?

A

Amlodipine (half life: 35-50 hr)

38
Q

This calcium channel blocker is contraindicated in PH

A

Verapamil

Parker: Pulmonary pharmacology (7 decks)

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