Week 6 Pulmonary Pharma Flashcards
what are the two biggest indications for drugs
reduce bronchospasm
reduce inflammatory allergic reactions
what are some other indications for using drugs
reduce mucus production
treat bacterial infection and improve oxygen. Laos, cough suppression and smoking cessation
what does the sympathetic system cause in terms of airway diameter?
bronchodilation
the SNS increases ___ which dos what to airways
cAMP and bronchodilation
what are the two ways the SNS cause bronchodilation
smooth muscle relaxation, and inhibition of mast cells.
the PNS causes ___ by increasing ____
bronchoconstriction by increasing cGMP.
the PNS causes bronchoconstriction by what two mechanisms?
smooth muscle constriction
facilitation of mast cells (inflammatory response and mucus production)
how are pulmonary drugs usually administered
inhalation
what are the benefits of the metered dose inhaler (MDI) and the dry powder inhaler (DPI)
rapid delivery and absorption
large SA
delivered directly to the tissues
less systemic effects
what are the limitations of MDI and DPI
can’t predict dosages
delivery depends on inspiratory flow
can irritate tissues
whats the difference between inhaled and orally administered drugs.
orally, you need to digest it. so 80-90% of the drug is digested with the first pass metabolism, need higher dose
inhalation: goes right to lungs, bypasses the GI system.
what is the correct usage of the inhalers
- shake for 2-5 seconds
- breathe out all the way
- start breathing in slowly through your mouth, and press the inhaler 1 times
- keep breathing in as slow and deep as you can
- hold breath and count to 10
- wait one minute for next puff
TF: you need to brush your teeth after using the inhaler
true
what is a spacer
AKA aerosol-holding chambers, add on devices, that slow the delivery of medication from the pressurized MDI. it will improve the delivery of medication
in what patient population and what kind of drug are spacers used for
corticosteroids, and younger patients.
what is a nebulizer
mix the drugs with air to form a fine mist, that is inhaled through a mask and prolonged the delivery of medication (10 minutes)
TF: it is conclusive that nebulizers improve delivery of medication to distal bronchial
fasle, inconclusive.
what populations are the nebulizers used
young patients and those in acute stress, you cannot use an MDI right.
TF: epinephrine is a bronchodilator
yes
what kind of drug class is an Epi-pen
non specific beta agonist.
TF: HR and BP will drop when you use an Epi-pen
true, because it is a non-specific beta agonist, so will target other tissues
when and how is an epi-pen delivered, and how long does it last
to anaphylaxis and IM, usually 3-15 minutes.
what kind of drug is a adrenergic agonist bronchodilator
beta 2 specific agonists.
what are the two types of beta 2 specific agonists.
SABA (short acting: rescue)
LABA (long acting: maintenance)
what are SABA (names, time to effect, duration)
short acting recuse inhalers. like albuterol (ventolin)usually takes 5-15 minutes to go into effect and lasts 3-6 hours.
what are LABA (names, time to effect, duration)
long acting maintenance. salmeterol (serevent). time to effect is 10-20 minutes but lasts 12 hours.
before a sporting event, would you take a SABA or LABA
SABA
what are the side effects of beta 2 specific agonists
tachy, tremors, nervousness, restlessness, weight loss
what are cholinergic antagonists (anti-cholinergic)
they block the muscarine receptors in the bronchioles (LAMA). long acting muscarinic antagonists.
cholinergic antagonists are the drug of choice for what condition
COPD
are cholinergic antagonists absorbed well into the blood stream
no
what are some drug names of cholinergic antagonists drugs
ipratropium (Atrovent)
Tiotropium (Spiriva)
what is combivent
a combination of ipratropium bromide and albuterol sulfate. you get benefits of both LAMA and SABA
what do methylaxanthines do
inhibit phosodiesterase enzyme (PDE). also, increases cAMP and may act as an adenosine antagonist.
what are common examples of methylaxanthines
theophylline, theobromine (think chocolate and dogs), caffeine.
what are side effects of methylaxanthines
tachy, HA, irritability, restlessness. Theophylline toxicity: arrhythmia and seizures.
what are glucocorticoids.
anti-inflammatory .
how do glucocorticoids work
they control inflammation mediated bronchospasm. inhibit the production of pre-inflammatory products and decrease vascular permeability, immunosuppression and increase the effects of beta agonists.
why would you use inhaled glucocorticoids, and what are some examples
long term maintenance of asthma.
budenoside (pulmicort), beclemethasone (belcovent), fluticasone (Flovent)
why would you use oral glucocorticoids, and what are some examples
acute infections, exacerbations, 1-3x/week like prednisone.
why would you use IV glucocorticoids, and what are some examples
severe asthma attacks, or respiratory distress. methylprednisone (medrol).
what are side effects of glucocorticoids.
hyperglycemia, HTN, osteoporosis, myopathy, mood swings,
name two examples of combination dugs of steroids and LABA
- symbicort (budesonide and fromoterol)
- advair (fluticasone, salmeterol)
