Test 3: Details of Drugs Flashcards
non-steroidal anti-asthma medications are used for:
to prevent and control asthma symptoms… they reduce daytime symptoms and night time awakenings and decrease the need for beta agonist
indications for non-steroidal anti-asthma medications:
- prophylactic management of asthma
- alternative to inhaled steroids
- combination with inhaled steroids to reduce steroid dose
- controller rather than reliever
what are leukotrienes?
potent bronchoconstrictors that are activated by the IgE allergic reaction and responsible for CysLTs, that occur when mast cells degranulate
____ and ____ are known for their role allergy and inflammation in asthma
eosinophils, basophils
mode of action for zafirlukast (accolate) and montelukast (singulair)
blocks the leukotrienes (cystLTs) from attaching to CysLT1 leukotriene receptor therefore preventing bronchospasm, secretion of mucus, and vascular permeability allowing airway inflammation
mode of action for zileuton (zyflo)
inhibits 5-LO enzyme that causes formation of leukotrienes from arachidonic acid. prevents bronchospasm and inflammation
how are leukotriene modifier / antileukotrienes taken?
taken orally (enteral = by mouth)
mode of action for omalizumab (Xolair)
man-made DNA-dervived humanized antibody that binds to IgE; inhibits attachment of IgE to mast cells and basophils, reducing release of chemical mediators of allergic response
mode of action for benralizumab (faserna) mepolizumab (nucala) relizumab (cinqiar)
blocks IL-5, which is pro-inflammatory cytokine responsible for producing, activating, and migration of eosinophils; therefore reducing eosinophils
how are monoclonal antibody taken?
taken parenterally = IV or subcutaneous injection
mode of action for cromolyn sodium (Intal)
inhibits release of histamine and leukotrienes from mast cells, (aka mast cell stabilizer
mode of action for nedocromil (Tilade)
mast cell stabilizer
adverse effects for zileuton (zyflo)
- headache
- liver enzyme elevation
- unspecific pain
- dyspepsia
adverse effects of zafirlukast (accolate)
- headache
- infection
- nausea
- possible liver enzyme changes
adverse effects for montelukast (singulair)
- headache
- influenza
- abdominal pain
adverse effects for monoclonal antibody
- injection site reaction
- viral infection
- respiratory tract infection
- headache
- sinusitis
- pharyngitis
adverse effects for mast cell stabilizer
- cough/dry mouth
- sore throat
- bad taste in mouth
- headache
- nausea
systemic route (oral or IV) of transmission is preferred for what class of drugs?
aerosolized anti-infective agents
What is pentamidine isethionate (NebuPent) used for?
has been used in past for treatment of opportunistic pneumonia caused by pneumocystis jiroveci, which is causative agent of pneumocystis pneumonia (PCP)
mode of action for pentamidine isethionate (NebuPent)
- antiprotozoal agent
- exact mode of action is unknown
- studies suggest that pentamidine interferes with metabolism by block RNA and DNA synthesis
side/adverse effects of aerosolized pentamidine isethionate (NebuPent)
- cough - bad or metallic taste
- bronchial irritation - pharyngitis
- bronchospasm - conjunctivitis
- wheezing - rash
- SOB - chest pain
- fatigue
systemic side effects of inhaled pentamidine
- decreased appetite/nausea - pancreatitis
- dizziness - hypoglycemia
- night sweats/chills
- spontaneous pneumothorax
- neutropenia
to ensure the protection of healthcare clinicians when giving these drugs, they must use
nebulizer using a negative pressure room or booth and ensure personnel barrier protection
Respiragard II nebulizer is what kind of nebulizer system
a nebulizer system with a one way valve and expiratory filters to reduce environmental contaminiation
Indications of ribavirin (virazole)
- patients hospitalized with RSV (Respiratory syncytial virus)
- lower respiratory tract infection
- complicated congenital heart disease
- bronchopulmonary dysplasia, CF, other chronic lung condition
- premature infants
- immunodeficiency/ recent transplant or chemotherapy
mode of action for ribavirin (virazole)
- not completely understood
- used to stop viral RNA synthesis and viral mRNA capping
- prevents construction and shedding of viable viral particles
dosage and administration of ribavirin (virazole)
dosage: 20mg/mL of 2% solution
administration: SPAG (tent, hood, mechanical ventilator)
side effects of ribavirin (virazole)
- deterioration of pulmonary function
- skin irritation/ rash
- eyelid erythema/conjunctivitis with aerosol administration
- equipment malfunctions from drug precipitate
environmental contamination with aerosolized ribavirin (virazole)
- potential for mutagenic and carcinogenic effects
- teratogenic and embrocidal (pregnant patients and practitioners should not be exposed)
- exposure to ribavirin in health care workers
indication for inhaled tobramycin (TOBI)
intended to manage chronic infection with P. aeruginsoa in patients with CF
side effects of inhaled tobramycin (TOBI)
voice alteration and tinnitus
- side effects increase if patient is on other antibiotics taken via IV
mode of action for tobramycin (TOBI)
- bactericidal against gram NEGATIVE organisms
- blocks protein synthesis in the bacteria and causes cellular death
administration of inhaled TOBI
- SMV
- cannot be mixed with other solutions
- should be inhaled after other treatment
- healthcare worker exposure should be minimized
- pretreat with bronchodilator
- drug incompatibility
what drug do you need to refrigerate
tobramycin
side effects of systemic TOBI
- ototoxicity - hypomagnesemia
- loss of hearing - allergic reactions
- vertigo - fetal harm
- nausea - deafness
- nephrotoxicity
- neruomuscular blockade
- worsening of neuromuscular disorder
mode of action for inhaled aztreonam (cayston)
synthetic bactercidal antibiotic
what does inhaled aztreonam treat
treats pulmonary symptoms in patients with CF dealing with P.aeruginosa infections
what type of system is used for inhaled aztreonam
aerosolized using the alteration nebulizer system
adverse effects for inhaled aztreonam (cayston)
- bronchospasm
- decreased FEVI
indications for inhaled zanamivir (relenza) (DPI)
treatment of uncomplicated influenza illness in adults, during the early onset of infection
mode of action for zanamivir (relenza)
- neuraminidase inhibitor
- binds with and blocks the enzymes action
- inhibits virus particle seperation
- prevents virus release from infected cells
adverse effects of zanamivir (relenza)
- bronchospasm
- deterioration of lung function
- under treament of bacterial infection
- not effective against bacterial infection that may exhibit flu-like symptoms
- look for reactions such as diarrhea, nausea, vomiting, cough, dizziness, and headaches
indications for inhaled pulmonary vasodilators
- pulmonary hypertension caused by: COPD, and corpulmonale, acute hypoxemia seen in ARDS or shock, premature babies
Nitric Oxide indications
- treatment of neonates with persistent pulmonary hypertension (PPH)
- relaxes vascular smooth muscle in pulmonary vasculature
- when inhaled, produces pulmonary vasodilation, reducing pulmonary artery pressure and improving V/Q mismatching
adverse/ side effects of nitric oxide
- hypotension is most common side effect
- rebound pulmonary hypertension and hypoxemia
- toxic NO2; nitrous and nitric acid; you can prevent this by decrease contact time and concentration of gas
- methemoglobinemia
dosage for nitric oxide
to increase PaO2 = 1-2 ppm
to decrease pulmonary artery pressures = 10-40 ppm
indications for iloprost (ventavis)
used in treatment of pulmonary hypertension
how is Iloprost administered
with I-neb nebulizer
mode of action for iloprost (ventavis)
acts by dilating pulmonary vasculature and affect platelet aggregation
Side effects of iloprost (ventavis)
- headaches
- increased cough
other side effects secondary to the vasodilatory properties of iloprost - syncope
- pulmonary edema
mode of action for treprostinil (tyvaso)
prostacyclin analogue that causes vasodilation of pulmonary and systemic arterial vascular beds and inhibits platelet aggregation
indications for treprostinil (tyvaso)
indicated for treatment of pulmonary arterial hypertension to increase walking distance in patients with New York heart association calls III symptoms
administration of Treprostinil (tyvaso)
Tyvaso inhalation system
what is neublized flonlan used for
- used in the treatment of pulmonary hypertension to provide selective pulmonary vasodilation and improve arterial oxygenation
- temporary management of adult patients with ARDS or mild to moderate pulmonary hypertension that is unresponsive to conventional therapy
contradictions of flolan (epoprostenol)
do not use flown with patients who have congestive heart failure (CHF) with severe left ventricular failure
Application of Flolan
- via mechanical ventilator
- infusion pump
- mini heart low flow nebulizer
- IV extension set
Which drug should not be discontinued abruptly to avoid potential increase in PAP and/or worsening of oxygenation
Flolan (epoprostenol)
