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APRN A. Pharm- Test 1 > Week 4- Respiratory System Drugs > Flashcards

Week 4- Respiratory System Drugs Flashcards

1
Q

What drugs are beta 2 agonists?

A

albuterol, levalbuterol, formoterol, salmeterol

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2
Q

how does albuterol work?

A

Bind to beta-2 receptors on smooth muscle of bronchial tissue, producing cAMP- opens up airways

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3
Q

is albuterol long acting or short acting?

A

short acting

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4
Q

what is albuterol used for?

A

BRONCHODILATOR – acute bronchospasm associated w/ asthma or COPD & exercise-induced asthma

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5
Q

common side effects of albuterol

A

hypokalemia, anginal pain, hypertension, CNS stimulant effect, headache, PVCs

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6
Q

DDI of albuterol

A

interacts w/ digoxin, MAOs, TCAs, Betablockers, coke

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7
Q

serious side effects of albuterol

A

could cause seizures

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8
Q

what is albuterol?

A

a beta 2 agonist

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9
Q

what class is levalbuterol?

A

beta 2 agonist

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10
Q

how does levalbuterol work?

A

Bind to beta-2 receptors on smooth muscle of bronchial tissue, producing cAMP- opens up airways

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11
Q

is levalbuterol short acting or long acting?

A

Short Acting- should not be monotherapy

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12
Q

what is levalbuterol used for?

A

BRONCHODILATOR- bronchospasm w/ reversible obstructive airway disease

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13
Q

side effects and adverse reactions to levalbuterol

A

Seizures, hypokalemia, anginal pain, hypertension, CNS stimulant effect, headache, PVCs

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13
Q

what drug class is formoterol?

A

beta 2 agonist

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13
Q

DDI of levalbuterol

A

Interacts w/ BB, MAOIs, tricyclics, digoxin

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14
Q

how does formoterol work?

A

Bind to beta-2 receptors on smooth muscle of bronchial tissue, producing cAMP- opens up airways

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15
Q

is formoterol long acting or short acting?

A

long acting

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16
Q

what is formoterol used for?

A

BRONCHODILATOR- long acting to prevent bronchospasm or exercise induced asthma

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17
Q

side effects of formoterol

A

Seizures, hypokalemia, anginal pain, hypertension, CNS stimulant effect, headache, PVCs

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18
Q

can you use formoterol or levalbuterol alone?

A

not monotherapy

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19
Q

what drug class is salmeterol?

A

beta 2 agonist

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20
Q

how does salmeterol work?

A

Bind to beta-2 receptors on smooth muscle of bronchial tissue, producing cAMP- opens up airways

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21
Q

what is the route of formoterol?

A

it is an inhalation powder

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22
Q

is salmeterol long acting or short acting?

A

long acting

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23
Q

what is salmeterol used for?

A

BRONCHODILATOR- long- acting bronchodilator for preventing bronchospasm

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24
Q

DDI of salmeterol

A

Interacts w/ BB, MAOIs, TCAs

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25
Q

side effects/adverse reactions of beta 2 agonists

A

Seizures, hypokalemia, anginal pain, hypertension, CNS stimulant effect, headache, PVCs

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26
Q

what drug class is theophylline in?

A

xanthine derivatives

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27
Q

what drug is in the xanthine class?

A

theophylline

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28
Q

how does theophylline work?

A

unknown mechanism, mediated by selective inhibition of specific phosphodiesterases- this produces an increase in C AMP, leads to smooth bronchial tissue

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29
Q

when is theophylline used?

A

not a first line agent… used for COPD in combination with other drugs

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30
Q

side effects for theophylline

A

irritability, restlessness, seizures, insomnia, gastro esophageal reflux

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31
Q

monitoring for theophylline

A

LEVELS NEED TO BE MONITORED 6-12 MONTHS

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32
Q

contraindications/precautions for theophylline

A

true contraindication: hypersensitivity to xanthine, peptic ulcer disease, underlying seizure disorder, risky for cardiac/chf patients

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33
Q

DDI of theophylline

A

cimetidine, disulfiram, fluvoxamine, interferon, mexiletine, rifampin, drugs used to treat seizures (such as carbamazepine, phenytoin)

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34
Q

which drugs are anticholinergics?

A

ipratropium bromide, tiotropium

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35
Q

what drug class is ipratropium bromide?

A

anticholinergic

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36
Q

how does ipratropium bromide work?

A

blocking the effects of acetylcholine, a neurotransmitter that causes muscles to contract

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37
Q

when is ipratropium used?

A

bronchodilator! used for COPD/asthma.. not first line, usually used in combo

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38
Q

side effects of ipratropium bromide

A

cough, hoarseness, GI side effects, dry mouth, headache

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39
Q

contraindications for ipratropium bromide

A

contraindicated for patients with sensitivity to atropine, bromide sensitivity

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40
Q

what drug class is tiotropium in?

A

anticholinergic

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41
Q

mechanism of action of tiotropium

A

blocking the effects of acetylcholine, a neurotransmitter that causes muscles to contracth

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42
Q

how is tiotropium used?

A

BRONCHODILATOR add on agent for asthma not well controlled (spiriva)

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43
Q

is tiotropium a first line agent?

A

Not first line! Used in combo w/ other med- dry powder

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44
Q

side effect of tiotropium

A

Dry mouth

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45
Q

is tiotropium for acute asthma attacks?

A

no

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46
Q

what drug class is montelukast?

A

leukotriene modifiers

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47
Q

how does montelukast work?

A

inhibition of airway cysteinyl leukotriene receptors

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48
Q

is montelukast short acting or long acting

A

long acting- not a rescue medication

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49
Q

what is montelukast used for?

A

treatment of persistent asthma, exercised induced bronchoconstriction, seasonal allergic rhinitis

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50
Q

side effects of leukotriene modifiers

A

headache, GI upset, myalgia

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51
Q

DDI of montelukast

A

Interacts w/ CYP450 inhibitors: rifampin, phenobarb

52
Q

adverse reactions of montelukast

A

risk of neuropsychiatric events in kids

53
Q

which drugs are corticosteriods?

A

beclomethasone dipropionate, budesonide, mometasone furoate, budesonide, fluticasone

54
Q

how do corticosteroids work?

A

Inhibit IgE and mast cell mediated migration of inflammatory cells into bronchial tissue

55
Q

how does beclomethasone work?

A

Inhibit IgE and mast cell mediated migration of inflammatory cells into bronchial tissue

56
Q

what is beclomethasone’s route?

A

oral inhalation

57
Q

what is beclomethasone used for?

A

long term control of asthma

58
Q

side effects of beclomethasone

A

Xerostomia, tongue irritation, oral candidiasis (rinse mouth)

59
Q

contraindications of beclomethasone

A

CI: acute asthma attack

Death d/t adrenal insufficiency, avoid w/ cushing’s syndrome

60
Q

what class is budesonide?

A

corticosteroids

61
Q

how does budesonide work?

A

Long acting- Inhibit IgE and mast cell mediated migration of inflammatory cells into bronchial tissue

62
Q

route of budesonide?

A

oral inhalation or intranasal

63
Q

what is budesonide (inhaled) used for?

A

long-term control of asthma

64
Q

side effects of budesonide (inhaled)

A

Xerostomia, tongue irritation, oral candidiasis (rinse mouth)

65
Q

Adverse reactions/contraindications of budesonide (inhaled)

A

CI: acute asthma attack

Death d/t adrenal insufficiency, avoid w/ cushing’s syndrome

66
Q

use of budesonide (intranasal)

A

allergic rhinitis

67
Q

side effects of budesonide (intranasal)

A

Nasal itching, irritation, sneezing, dryness

68
Q

med instructions for budesonide (intranasal)

A

Clear nasal passages before taking medication- not immediate

69
Q

what class of drug is Mometasone furoate

A

corticosteroid

70
Q

how does Mometasone furoate work?

A

Inhibit IgE and mast cell mediated migration of inflammatory cells into bronchial tissue

71
Q

what route is Mometasone furoate

A

Oral inhalation

72
Q

what is Mometasone furoate used for

A

Long-term control of asthma

73
Q

side effects of Mometasone furoate

A

Xerostomia, tongue irritation, oral candidiasis (rinse mouth)

74
Q

contraindications and precautions of Mometasone furoate

A

CI: acute asthma attack

Death d/t adrenal insufficiency, avoid w/ cushing’s syndrome

75
Q

what kind of drug is fluticason

A

corticosteroid

76
Q

how does fluticasone work

A

Inhibit IgE and mast cell mediated migration of inflammatory cells into bronchial tissue

77
Q

what routes are available for fluticasone

A

intranasal and oral inhalation

78
Q

what is intranasal fluticasone used for

A

Allergic rhinitis

79
Q

what is oral inhalation fluticasone used for

A

Long-term control of asthma

80
Q

side effects of intranasal fluticasone

A

Nasal itching, irritation, sneezing, dryness

81
Q

side effects of oral inhaled fluticasone

A

Xerostomia, tongue irritation, oral candidiasis (rinse mouth)

82
Q

adverse reactions/ddi for fluticasone (inhaled)

A

Caution w/ ritonavir

CI: acute asthma attack

Death d/t adrenal insufficiency, avoid w/ cushing’s syndrome

83
Q

what drugs are inhaled anti-inflammatory agents

A

cromolyn

84
Q

what class is cromolyn nebulizer soln

A

Inhaled Anti-inflammatory agents

85
Q

how does cromolyn nebulizer soln work?

A

Inhibits mast degranulation, prevents release of histamine

86
Q

what is Cromolyn nebulizer soln used for

A

for Asthma or bronchospasm prophylaxis

87
Q

what class is cromolyn intranasal

A

Inhaled Anti-inflammatory agents

88
Q

adverse rxn/side effects to cromolyn nebulizer soln

A

May c/ bronchospasm—avoid beta-agonist bronchodilator, throat irritation, cough

89
Q

how does cromolyn intranasal work?

A

Inhibits mast degranulation, prevents release of histamine

90
Q

what is cromolyn intranasal used for

A

For Allergic Rhinitis

91
Q

side effects of cromolyn intranasal

A

Nasal irritation and sneezing

92
Q

which drugs are 1st gen antihistamines

A

diphenhydramine, hydroxyzine

93
Q

which drugs are 2nd gen antihistamines

A

certirizine, fexofenadin, loratadine

94
Q

what class is diphenhydramine?

A

antihistamine

95
Q

how does diphenhydramine work?

A

H1 agonist- reduce histamine at H1 receptor site/

96
Q

how is diphenhydramine taken/route?

A

1st gen- PO work peripheral H1, nonselective

97
Q

what is diphenhydramine used for?

A

Respiratory allergies, pruritis, conjunctivities , hypersensitivity, night time sleep aid,

98
Q

side effects of diphenhydramine?

A

Sedation, dizziness, tinnitus, dry mouth, urinary retention

99
Q

adverse reactions/DDI of diphenhydramine

A

Potentiate CNS depressants, DDI: MAOs, SSRIs

100
Q

what drug class is hydroxyzine

A

Antihistamines

101
Q

how does hydroxyzine work?

A

H1 agonist- reduce histamine at H1 receptor site

102
Q

how is hydroxyzine taken/route?

A

1st gen- PO work peripheral H1, nonselective

103
Q

side effects of hydroxyzine

A

Sedation, dizziness, tinnitus, dry mouth, urinary retention

104
Q

what is hydroxyzine used for

A

Allergic/vasomotor rhinitis, pruritis, nausea/vomiting

105
Q

what drug class is cetirizine

A

antihistamine

106
Q

what is another name for cetirizine

A

zyrtec

107
Q

how does cetirizine, fexofendadine and loratadine work?

A

H1 agonist- reduce histamine at H1 receptor site

108
Q

what is cetirizine, fexofendadin and loratadine’s route?

A

2nd Gen-PO

more selective, less sedating

109
Q

what is cetirizine, fexofenadine and loratadine clinically used for?

A

Seasonal allergies, itching

110
Q

side effects of 2nd generation antihistamines

A

Less side effects than 1st gen- some drowsiness

111
Q

what drug class is fexofenadine?

A

antihistamine

112
Q

what drug class is loratadine

A

antihistamine

113
Q

what is another name of loratadine?

A

claritin

114
Q

what is another name for fexofenadin?

A

allegra

115
Q

what are some specific medications and DDI for loratidine/claritin

A

CYP450 Inhibitor

TAKE ON EMPTY STOMACH

116
Q

which drugs are antitussives?

A

dextromethorphan, bezonatate, guaifenesin

117
Q

what drug class is dextromethorphan

A

antitussive

118
Q

what drug class is bezonatate?

A

antitussive

119
Q

what drug class is guaifenesin

A

antitussive

120
Q

how does dextromethorphan work?

A

Acts centrally in the cough center in the medulla to elevate threshold for coughing

121
Q

what is dextromethorphan used for?

A

Nonproductive cough (no asthma)

122
Q

side effects of dextromethorphan

A

Drowsiness, dizziness, nausea, GI upset, heaache

123
Q

DDI and adverse reactions with dextromethorphan

A

Caution w/ hepatic impairment DDI: CNS depressants, no MAOIs

124
Q

how does benzonatate work?

A

anesthetize the stretch receptors in the respiratory passages, thereby decreasing their activity and calming the cough peripherally at its source

125
Q

what is benzonatate used for

A

Nonproductive, dry cough

(no asthma)

126
Q

side effects of benzonatate

A

Drowsiness, dizziness, nausea, GI upset, heaache

127
Q

DDI/adverse reactions to benzonatate

A

Caution w/ hepatic impairment DDI: CNS depressants, no MAOIs

128
Q

how does Guaifenesin work

A

Increase output of resp tract, decrease adhesiveness and surface tension

129
Q

what is Guaifenesin used for

A

Cough (not persistant cough)

130
Q

what are the side effects of Guaifenesin

A

GI upset, nausea, vomiting, drowsiness

APRN A. Pharm- Test 1 (5 decks)

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