Side Effects

Question 1

Epoprostenol (Flolan) IV Continuous Infusion

Answer 1

dosing: ng/kg/min

CI: HFrEF (left)
Warning: vasodilation reactions (hypotension, flushing), reboound PH, bleeding risk, bloodstreatm infection risk with longer infusion

SE: hypotension, flushing, jaw pain, myalgias, thrombocytopenia, edema

**POTENT vasodilators, avoid interruptions are large dose reductions

Question 2

Treprostinil

Answer 2

CI: severe hepatic impairment
Warning: vasodilation reactions, rebound PH

SE: Hypotension, flushing, jaw pain, myaligias, thrombocytopenia, edema

**POTENT vasodilators, avoid interruptions are large dose reductions

Question 3

Bosentan

Answer 3

BW: teratogenic!!!!! = REMS
Hepatotoxicity!!!!!!

CI: pregnancy, use with cyclosporine or glyburide
Warning: hepatoxicity, fluid retention

SE: headache, URTI

***approved for children 3 years or older

Question 4

Sildenafil (Revatio)

Answer 4

CI: nitrates = HYPOTENSION!!!!!!!!

Warning: hearling loss and vision loss, hypotension, priapism

SE: headaches

Question 5

Tadalafil (Adcirca)

Answer 5

CI: nitrates = HYPOTENSION!!!!!!!!

Warning: hearling loss and vision loss, hypotension, priapism

SE: headaches

Question 6

Albuterol (ProAir, Proventil, Ventolin)

Answer 6

Warning: CVD, gluacoma, hyperthyroidism, seizures, diabetes
SE: nervousness, tremor, tachycardia, palpitations, cough, hyperglycemia, hypokalemia

90 mcg/ inh 1-2 inhalations q4-6h

Question 7

Salmeterol (Serevent)

Answer 7

BW: increase of asthma-related deaths and hospitalizations in pediatric patients

SE: nervousness, tremor, tachycardia, palpitations, cough, hyperglycemia, hypokalemia

Question 8

Pulmicort

Answer 8

Budesonide
CI: acute episodes of asthma
Warning: HIGH dose for prolonged periods can cause adrenal suppression, decreased bone mineral density (fractures), growth retardation, and immunosuppression

SE: dysphone (speech trouble), oral candidiasis, cough, hyperglycemia

Question 9

Singulair

Answer 9

Montelukast
BW: neuropsych events
SE: HA, dizziness, URTI

Question 10

Theophylline

Answer 10

Warning: exacerbate arrthythmia, PUD, and seiures
SE: N/V, tachycardia, tremor, insomnia (converted to caffeine)

Toxicity: persistent vomiting, arrhythmias, seizures

Question 11

Omalizumab (Xolair)

Answer 11

Indicated for allergic asthma

BW: anaphylaxis
Warning: serious CV and cerebrovacular events
SE: injection rxns, HA, arthralgias

*** initiate under healthcare supervision for at least 3 doses
SC every 2 - 4 weeks

Question 12

Abuterol

Answer 12

Short acting beta 2 agonist
leads to BRONCHOdilation because of bronchial smooth muscle relaxation

Question 13

Formoterol MOA

Answer 13

Long acting beta 2 agonist
Leads to BRONCHOdilation because of bronchial smooth muscle relaxation

*** can be used for rescue or maintenance ONLY in combination with an ICS

Question 14

Spiriva

Answer 14

Warning: caution with narrow angle gluacoma, myasthenia gravis, urinary retention, BPH, hyperplasia, and bladder neck obstruction.

SE: dry mouth, URTI, cough

Question 15

Atrovent HFA

Answer 15

Warning: caution with narrow angle gluacoma, myasthenia gravis, urinary retention, BPH, hyperplasia, and bladder neck obstruction.

SE: dry mouth, URTI, cough

Question 16

Roflumilast

Answer 16

CI: moderate to severe liver impairment
Warning: psych events
SE: diarrhea, weight loss

Question 17

Aclidinium

Answer 17

Warning: caution with narrow angle gluacoma, myasthenia gravis, urinary retention, BPH, hyperplasia, and bladder neck obstruction.

SE: dry mouth, URTI, cough