Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm Exam 3 > Smoking, Asthma, COPD > Flashcards

Smoking, Asthma, COPD Flashcards

1
Q

True/False: Smoking is bad for you.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name 3 First line options for smoking cessation.

A
  1. Nicotine gum
  2. Nicotine Lozenge
  3. Transdermal Nicotine Patch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pregnancy Category of Nicotine Gum?

A

Category D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ADRs of Nicotine Gum? (Nicorette)

A

Mouth soreness
hiccups
dyspepsia
aching jaw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What route of absorption does Nicotine Gum use? (Nicorette)

A

Buccal Absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MOA of Nicorette?

A

Resin complex: nicotine, polacrilin
Sugar free chewing gum base
Contains buffering agents to enhance buccal absorption of nicotine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MOA of Nicotine Lozenge?

A

Nicotine polacrilex formulation: delivers 25% more than gum
Sugar free
Contains buffering agents to enhance buccal absorption of nicotine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MOA of Nicotein Transdermal Patch? (Nicoderm CQ)

A

Nicotine = well absorbed across skin
Delivery to systemic circulation avoids hepatic first-pass metabolism
Plasma nicotine levels are lower and fluctuate less than

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Can you Swim or Cut Nicotine patch?

A

Yes Swim

NO Cut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ADR of Nicotine Lozenge?

A

Nausea, hiccups, cough, heartburn, headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ADR of Nicotine Patch?

A

1st hour: Mild itching, burning, tingling

Others: vivid dreams/sleep disturbances, HA, local skin rxns. (rotate patch site, use steroid cream.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MOA of Nicotine Inhaler?

A

Delivers 4 mg nicotine vapor over 80 puffs, absorbed across buccal mucosa

(Try not to inhale)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How long must you wait to eat or drink after Nicotine Inhaler (Pfizer)

A

15 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ADR of Nicotine Inhaler?

A 
Mild irritation of the mouth or throat (40%)
Cough (32%)
Headache
Rhinitis (23%)
Dyspepsia (indigestion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MOA of Varenicline (Chantix)

A

Non-nicotine cessation aid, partial nicotinic receptor agonist.

Binds with high affinity and selectivity at a4b2 neuronal nicotinic acetylcholine receptors: stimulates low-level agonist activity, competitively inhibits binding of nicotine

Clinical effects: Symptoms of nicotine withdrawal, blocks dopaminergic stimulation responsible for reinforcement & reward associated with smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When should pt begin Varenicline (Chantix)

A

Patients should begin therapy 1 week PRIOR to their quit date. The dose is gradually increased to minimize treatment-related nausea and insomnia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Major Warnings with Varenicline (Chantix)

A

Neuropsych symptoms/Suicidality

Cardiovascular events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Other ADRs with Varenicline (Chantix)

A

Common: N/V, sleep disturbances [insomnia, abnormal dreams], constipation, FARTS!

Uncommon: hypersensitivity, serious skin rxn, accidental injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What must patient do with every dose of Varenicline (Chantix)

A

Drink a full Glass of Water!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

MOA of Bupropion [Wellbutrin, Zyban]?

A

Unclear
Blocks DA and NE reuptake

(Use with other Nicotine Replacement Therapies)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CI with Bupropion (Wellbutrin)

A

SEIZURES, h/o eating disorders, use of MAO-I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ADRs of Bupropion (Wellbutrin, Zyban)?

A

Dry mouth, insomnia, weight loss or may delay weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pregnancy Category of Clonidine?

A

Category C… for Clonidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What special consideration do you have to consider when taking a patient off Clonidine?

A

Must taper dosing due to rebound hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ADRs of Clonidine?

A

Dry mouth (40%)
Drowsiness (33%)
Dizziness (16%)
Sedation, constipation (10%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Pregnancy category of Nortriptyline?

A

Category D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

3 Warnings when with Nortriptyline?

A

Counsel pts not to drive
Risk of arrhythmias and impaired contractility
Avoid with MAOI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

ADRs of Nortriptyline?

A 
Sedation, dry mouth (64 – 78%)
Blurred vision (16%)
Urinary retention
Lightheadedness (49%)
Tremor (23%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When should you start a patient on Nortriptyline for smoking cessation?

A

Start 10 – 28 days prior to quit date to reach steady state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What Class of drugs do Albuterol, Levoalbuterol, Pirbuterol belong?

A

Short Acting Beta Agonists (SABA)

31
Q

MOA of Short Acting Beta Agonists?

Albuterol, Levoalbuterol, Pirbuterol

A

Bind B2 adrenergic receptors, relax bronchial smooth muscle

32
Q

What is the 1st line for acute asthma symptom relief and prevention of exercise-induced bronchoconstriction

A

Short Acting Beta Agonists (SABAs)

Albuterol, Levoalbuterol, Pirbuterol

33
Q

What is the MOST effective medication class for relieving acute bronchospasm [“rescue inhaler”]

A

Short Acting Beta Agonists (SABAs)

Albuterol

34
Q

What is the MAJOR contraindication for SABAs?

A

Betablockers

35
Q

ADRs of Short Acting Beta Agonists?

Albuterol, Pirbuterol, Levoalbuterol

A

Tachycardia
tremor
HA
hypokalemia

36
Q

Onset of Action for SABA?

A

3-5 Minutes

37
Q

When should you reassess pt’s who are only taking SABA?

A

Increasing use indicates inadequate control: using > 2x/week = reassess tx!

38
Q

To what class do Ipratropium (Atrovent) and Ipratropium & albuterol (Combivent, Duoneb) belong?

A

Inhaled Anticholinergics

39
Q

MOA of Inhaled Anticholinergics?

Ipratropium

A

Indicated for relief of bronchospasm→ Only relieves cholinergic mediated bronchospasm

Does not modify antigen reaction
Ineffective in EIB
Less cardiac stimulation than SABAS

40
Q

Indication for use of Inhaled Anticholinergics?

Ipratropium

A

1st line for bronchospasm with beta blockers

Used off label for asthma→ not proven effective

41
Q

ADRs of Inhaled Anticholinergics?

A

dry mouth

increased wheezing?

42
Q

What class do the following drugs belong?

Prednisone
Methylprednisolone
Prednisolone

A

Systemic Corticosteroids

43
Q

MOA of Systemic Corticosteroids?

Prednisone, Methylprenisolone, Prednisolone

A

Inhibit cytokine production, adhesion, protein activation, inflammatory cell migration and activation - immunosuppressant

44
Q

Indications for use of Systemic Corticosteroids?

A

Short term burst [3-10 days] to gain control of inadequately controlled asthma

Long term symptom prevention in severe persistent asthma

45
Q

Contraindications for Systemic Corticosteroids?

A

Betablockers

46
Q

ADRs of systemic corticosteroids?

A

Short term: hyperglycemia, inc appetite, fluid retention, weight GAIN, mood alteration, HTN, peptic ulcer

Long term: adrenal axis suppression, growth suppression, thinning of skin, osteoporosis, HTN, DM, Cushing’s, impaired immune fxn

(Don’t use Systemic Corticosteroids for longer than you have to)

47
Q

To what class do the following drugs belong?

Beclomethasone HFA (QVAR)
Budesonide (Pulmicort)
Flunisolide (Aerobid, Aerospan)
Fluticasone (Flovent)
Mometasone (Asmanex)
A

Inhaled Corticosteroids (Glucocorticoids)

48
Q

What am I drinking?

A

Pabst Blue Ribbon

49
Q

MOA of Inhaled Corticosteroids?

Beclomethasone
Budesonide
Flunisolide
Fluticasone
Mometasone
A

Potent anti-inflammatory agents

Increase blood neutrophil counts

Reduce: inflammatory mediators [prostaglandins and leukotrienes], other WBCs and lymphocyte and macrophage fxn

Anti-inflammatory:

  • Block late phase reaction to allergen
  • Reduce airway hyper-responsiveness
  • Inhibit cytokine production, adhesion, protein activation & inflammatory cell migration/activation
  • Reverse beta receptor down regulation
  • Inhibit microvascular leakage
50
Q

Are Inhaled Corticosteroids 1st line in adults with Persistent Asthma?

Beclomethasone
Fluticasone
Flunisolide

A

YES

1st line in adults w/ persistent asthma

  • Prevent sx
  • Suppress, reverse, & control inflammation [↓ exacerbation FREQUENCY]
  • Most potent & consistently effective long term control rx for asthma
  • decrease need for oral corticosteroid
  • Reduce symptom severity
  • Improve asthma control and QOL
  • Improve PEF and spirometry
  • Decrease airway hyper-responsiveness
  • Prevent exacerbations
  • Reduce systemic corticosteroids, ED care, hospitalization and mortality
  • May help with loss of lung function in adults
51
Q

ADRs of Inhaled Corticosteroids?

Budesonide, Fluticasone, Beclomethasone

A 
Oral candidiasis
dysphonia
cough
reflex cough
bronchospasm
52
Q

The following Drugs belong to which Class?

Salmeterol [Serevent, Advair]
Fluticasone/vilanterol [Breo Ellipta]
Formoterol [Symbicort, Dulera]
Indacaterol [Arcapta]

A

Long Acting Beta Agonists (LABAs)

53
Q

MOA of Long Acting Beta Agonists?

Salmeterol, Vilanterol, Formoterol, Indacaterol

A

Relaxes bronchial smooth muscles - bronchodilation

54
Q

Indications for use of Long Acting Beta Agonistis?

Salmeterol, Formoterol

A

Longer duration of action than SABAs [12 hrs]

USE WITH STEROID - do NOT use as monotherapy or for acute sx

55
Q

Warnings for LABA?

A

Black box for asthma pts ???

56
Q

ADRs of LABA?

Salmeterol, Vilanterol, Formoterol, Indacaterol

A

Tachycardia
tremor
hypokalemia
prolonged QT [usually OD]

57
Q

What Class do the following drugs belong?

Montelukast [singulair]
Zafirlukast [Accolate]

A

Leukotriene receptor antagonists [LTRAs]

58
Q

What Class does the following drug belong?

Zileuton [Zyflo]

A

5-lipoxygenase inhibitor

59
Q

MOA of Leukotriene Receptor Antagonists?

Montelukast, Zafirlukast

A
  • alternative tx for mild persistent asthma
  • adjunct tx with ICS for moderate asthma [proven reduction in systemic steroid use, no change in need for rescue inhalers]
  • modest improvement in lung function as monotherapy
60
Q

MOA of Zileuton?

5-Lipoxygenase inhibitor

A

Inhibits leukotriene production

61
Q

At what age can the following drugs be used?

Montelukast
Zafirlukast
Leukotriene Receptor Antagonists

A

Montelukast = 1 y/o

Zafirlukast = 7 y/o

62
Q

Zifirlukast (Leukotriene Receptor Antagonist) and Zileuton (5-lipoxygenase inhibitors) are Both P450 Inhibitors!

A

The two Zs of Leukotrienes are p450 inhibitors

63
Q

What class does the following drug belong?

Theophylline [Theo-24, Theolair, Quibron-T]

A

Methylxanthines

64
Q

MOA of Methylxanthines? (Theophylline)

A

Nonselective phosphodiesterase inhibitor

relaxes bronchial smooth muscle

↑ diaphragm contractility/mucociliary clearance

65
Q

MOA of Omalizumab [Xolair]?

Injection

A

Anti-IGE

Inhibits binding of IgE to IgE receptors on mast cells and basophils

66
Q

MOA of Mepolizumab?

A

IL-5 antagonist
IL-5: major role in growth and activation of eosinophils, blocking IL-5 prevents binding to eosinophils - ↓inflamm response

67
Q

MOA of Reslizumab?

A

IL-5 antagonist

68
Q 
The following drugs are used for what Dz?
Tiotroprium [Spiriva]
Glycopyrrolate [Seebri]
Aclidinium [Tudorza]
Roflumilast [Daliresp]
A

COPD

69
Q

MOA of Tiotroprium (Spiriva)

A

Long acting anticholinergic
Blocks M3 receptors that lead to bronchial smooth muscle constriction
Allows for bronchodilation, slower than alpha agonist

70
Q

MOA of Glycopyrrolate and Aclidinium?

newer inhalers

A

Anticholinergics

71
Q

Why are Anticholinergics used in pt’s which airway problems?

A

Release of acetylcholine from parasympathetic nerves activates postjunctional muscarinic receptors present on airway smooth muscle, submucosal glands, and blood vessels to cause bronchoconstriction, mucus secretion, and vasodilatation, respectively. … These changes are due to increased parasympathetic nerve activity.

72
Q

MOA of Romflumilast?

A

PDE4 inhibitor
PDE4 metabolizes cAMP
Increases intracellular cAMP in lung cells
No direct bronchodilator activity
Reduces moderate to severe exacerbations in pts with chronic bronchitis and COPD

73
Q

Romflumilast ADRs?

A

N/D/Ab pain, decreased appetite, HA, sleep disturbances, weight LOSS

Psych: suicidality, insomnia, anxiety, depression, suicidal thoughts, mood changes

P450 substrate!

Pharm Exam 3 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions