Week 4- Respiratory System Drugs Flashcards
What drugs are beta 2 agonists?
albuterol, levalbuterol, formoterol, salmeterol
how does albuterol work?
Bind to beta-2 receptors on smooth muscle of bronchial tissue, producing cAMP- opens up airways
is albuterol long acting or short acting?
short acting
what is albuterol used for?
BRONCHODILATOR – acute bronchospasm associated w/ asthma or COPD & exercise-induced asthma
common side effects of albuterol
hypokalemia, anginal pain, hypertension, CNS stimulant effect, headache, PVCs
DDI of albuterol
interacts w/ digoxin, MAOs, TCAs, Betablockers, coke
serious side effects of albuterol
could cause seizures
what is albuterol?
a beta 2 agonist
what class is levalbuterol?
beta 2 agonist
how does levalbuterol work?
Bind to beta-2 receptors on smooth muscle of bronchial tissue, producing cAMP- opens up airways
is levalbuterol short acting or long acting?
Short Acting- should not be monotherapy
what is levalbuterol used for?
BRONCHODILATOR- bronchospasm w/ reversible obstructive airway disease
side effects and adverse reactions to levalbuterol
Seizures, hypokalemia, anginal pain, hypertension, CNS stimulant effect, headache, PVCs
what drug class is formoterol?
beta 2 agonist
DDI of levalbuterol
Interacts w/ BB, MAOIs, tricyclics, digoxin
how does formoterol work?
Bind to beta-2 receptors on smooth muscle of bronchial tissue, producing cAMP- opens up airways
is formoterol long acting or short acting?
long acting
what is formoterol used for?
BRONCHODILATOR- long acting to prevent bronchospasm or exercise induced asthma
side effects of formoterol
Seizures, hypokalemia, anginal pain, hypertension, CNS stimulant effect, headache, PVCs
can you use formoterol or levalbuterol alone?
not monotherapy
what drug class is salmeterol?
beta 2 agonist
how does salmeterol work?
Bind to beta-2 receptors on smooth muscle of bronchial tissue, producing cAMP- opens up airways
what is the route of formoterol?
it is an inhalation powder
is salmeterol long acting or short acting?
long acting
what is salmeterol used for?
BRONCHODILATOR- long- acting bronchodilator for preventing bronchospasm
DDI of salmeterol
Interacts w/ BB, MAOIs, TCAs
side effects/adverse reactions of beta 2 agonists
Seizures, hypokalemia, anginal pain, hypertension, CNS stimulant effect, headache, PVCs
what drug class is theophylline in?
xanthine derivatives
what drug is in the xanthine class?
theophylline
how does theophylline work?
unknown mechanism, mediated by selective inhibition of specific phosphodiesterases- this produces an increase in C AMP, leads to smooth bronchial tissue
when is theophylline used?
not a first line agent… used for COPD in combination with other drugs
side effects for theophylline
irritability, restlessness, seizures, insomnia, gastro esophageal reflux
monitoring for theophylline
LEVELS NEED TO BE MONITORED 6-12 MONTHS
contraindications/precautions for theophylline
true contraindication: hypersensitivity to xanthine, peptic ulcer disease, underlying seizure disorder, risky for cardiac/chf patients
DDI of theophylline
cimetidine, disulfiram, fluvoxamine, interferon, mexiletine, rifampin, drugs used to treat seizures (such as carbamazepine, phenytoin)
which drugs are anticholinergics?
ipratropium bromide, tiotropium
what drug class is ipratropium bromide?
anticholinergic
how does ipratropium bromide work?
blocking the effects of acetylcholine, a neurotransmitter that causes muscles to contract
when is ipratropium used?
bronchodilator! used for COPD/asthma.. not first line, usually used in combo
side effects of ipratropium bromide
cough, hoarseness, GI side effects, dry mouth, headache
contraindications for ipratropium bromide
contraindicated for patients with sensitivity to atropine, bromide sensitivity
what drug class is tiotropium in?
anticholinergic
mechanism of action of tiotropium
blocking the effects of acetylcholine, a neurotransmitter that causes muscles to contracth
how is tiotropium used?
BRONCHODILATOR add on agent for asthma not well controlled (spiriva)
is tiotropium a first line agent?
Not first line! Used in combo w/ other med- dry powder
side effect of tiotropium
Dry mouth
is tiotropium for acute asthma attacks?
no
what drug class is montelukast?
leukotriene modifiers
how does montelukast work?
inhibition of airway cysteinyl leukotriene receptors
is montelukast short acting or long acting
long acting- not a rescue medication
what is montelukast used for?
treatment of persistent asthma, exercised induced bronchoconstriction, seasonal allergic rhinitis
side effects of leukotriene modifiers
headache, GI upset, myalgia
DDI of montelukast
Interacts w/ CYP450 inhibitors: rifampin, phenobarb
adverse reactions of montelukast
risk of neuropsychiatric events in kids
which drugs are corticosteriods?
beclomethasone dipropionate, budesonide, mometasone furoate, budesonide, fluticasone
how do corticosteroids work?
Inhibit IgE and mast cell mediated migration of inflammatory cells into bronchial tissue
how does beclomethasone work?
Inhibit IgE and mast cell mediated migration of inflammatory cells into bronchial tissue
what is beclomethasone’s route?
oral inhalation
what is beclomethasone used for?
long term control of asthma
side effects of beclomethasone
Xerostomia, tongue irritation, oral candidiasis (rinse mouth)
contraindications of beclomethasone
CI: acute asthma attack
Death d/t adrenal insufficiency, avoid w/ cushing’s syndrome
what class is budesonide?
corticosteroids
how does budesonide work?
Long acting- Inhibit IgE and mast cell mediated migration of inflammatory cells into bronchial tissue
route of budesonide?
oral inhalation or intranasal
what is budesonide (inhaled) used for?
long-term control of asthma
side effects of budesonide (inhaled)
Xerostomia, tongue irritation, oral candidiasis (rinse mouth)
Adverse reactions/contraindications of budesonide (inhaled)
CI: acute asthma attack
Death d/t adrenal insufficiency, avoid w/ cushing’s syndrome
use of budesonide (intranasal)
allergic rhinitis
side effects of budesonide (intranasal)
Nasal itching, irritation, sneezing, dryness
med instructions for budesonide (intranasal)
Clear nasal passages before taking medication- not immediate
what class of drug is Mometasone furoate
corticosteroid
how does Mometasone furoate work?
Inhibit IgE and mast cell mediated migration of inflammatory cells into bronchial tissue
what route is Mometasone furoate
Oral inhalation
what is Mometasone furoate used for
Long-term control of asthma
side effects of Mometasone furoate
Xerostomia, tongue irritation, oral candidiasis (rinse mouth)
contraindications and precautions of Mometasone furoate
CI: acute asthma attack
Death d/t adrenal insufficiency, avoid w/ cushing’s syndrome
what kind of drug is fluticason
corticosteroid
how does fluticasone work
Inhibit IgE and mast cell mediated migration of inflammatory cells into bronchial tissue
what routes are available for fluticasone
intranasal and oral inhalation
what is intranasal fluticasone used for
Allergic rhinitis
what is oral inhalation fluticasone used for
Long-term control of asthma
side effects of intranasal fluticasone
Nasal itching, irritation, sneezing, dryness
side effects of oral inhaled fluticasone
Xerostomia, tongue irritation, oral candidiasis (rinse mouth)
adverse reactions/ddi for fluticasone (inhaled)
Caution w/ ritonavir
CI: acute asthma attack
Death d/t adrenal insufficiency, avoid w/ cushing’s syndrome
what drugs are inhaled anti-inflammatory agents
cromolyn
what class is cromolyn nebulizer soln
Inhaled Anti-inflammatory agents
how does cromolyn nebulizer soln work?
Inhibits mast degranulation, prevents release of histamine
what is Cromolyn nebulizer soln used for
for Asthma or bronchospasm prophylaxis
what class is cromolyn intranasal
Inhaled Anti-inflammatory agents
adverse rxn/side effects to cromolyn nebulizer soln
May c/ bronchospasm—avoid beta-agonist bronchodilator, throat irritation, cough
how does cromolyn intranasal work?
Inhibits mast degranulation, prevents release of histamine
what is cromolyn intranasal used for
For Allergic Rhinitis
side effects of cromolyn intranasal
Nasal irritation and sneezing
which drugs are 1st gen antihistamines
diphenhydramine, hydroxyzine
which drugs are 2nd gen antihistamines
certirizine, fexofenadin, loratadine
what class is diphenhydramine?
antihistamine
how does diphenhydramine work?
H1 agonist- reduce histamine at H1 receptor site/
how is diphenhydramine taken/route?
1st gen- PO work peripheral H1, nonselective
what is diphenhydramine used for?
Respiratory allergies, pruritis, conjunctivities , hypersensitivity, night time sleep aid,
side effects of diphenhydramine?
Sedation, dizziness, tinnitus, dry mouth, urinary retention
adverse reactions/DDI of diphenhydramine
Potentiate CNS depressants, DDI: MAOs, SSRIs
what drug class is hydroxyzine
Antihistamines
how does hydroxyzine work?
H1 agonist- reduce histamine at H1 receptor site
how is hydroxyzine taken/route?
1st gen- PO work peripheral H1, nonselective
side effects of hydroxyzine
Sedation, dizziness, tinnitus, dry mouth, urinary retention
what is hydroxyzine used for
Allergic/vasomotor rhinitis, pruritis, nausea/vomiting
what drug class is cetirizine
antihistamine
what is another name for cetirizine
zyrtec
how does cetirizine, fexofendadine and loratadine work?
H1 agonist- reduce histamine at H1 receptor site
what is cetirizine, fexofendadin and loratadine’s route?
2nd Gen-PO
more selective, less sedating
what is cetirizine, fexofenadine and loratadine clinically used for?
Seasonal allergies, itching
side effects of 2nd generation antihistamines
Less side effects than 1st gen- some drowsiness
what drug class is fexofenadine?
antihistamine
what drug class is loratadine
antihistamine
what is another name of loratadine?
claritin
what is another name for fexofenadin?
allegra
what are some specific medications and DDI for loratidine/claritin
CYP450 Inhibitor
TAKE ON EMPTY STOMACH
which drugs are antitussives?
dextromethorphan, bezonatate, guaifenesin
what drug class is dextromethorphan
antitussive
what drug class is bezonatate?
antitussive
what drug class is guaifenesin
antitussive
how does dextromethorphan work?
Acts centrally in the cough center in the medulla to elevate threshold for coughing
what is dextromethorphan used for?
Nonproductive cough (no asthma)
side effects of dextromethorphan
Drowsiness, dizziness, nausea, GI upset, heaache
DDI and adverse reactions with dextromethorphan
Caution w/ hepatic impairment DDI: CNS depressants, no MAOIs
how does benzonatate work?
anesthetize the stretch receptors in the respiratory passages, thereby decreasing their activity and calming the cough peripherally at its source
what is benzonatate used for
Nonproductive, dry cough
(no asthma)
side effects of benzonatate
Drowsiness, dizziness, nausea, GI upset, heaache
DDI/adverse reactions to benzonatate
Caution w/ hepatic impairment DDI: CNS depressants, no MAOIs
how does Guaifenesin work
Increase output of resp tract, decrease adhesiveness and surface tension
what is Guaifenesin used for
Cough (not persistant cough)
what are the side effects of Guaifenesin
GI upset, nausea, vomiting, drowsiness
