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GT BSN/CNL PHARM > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

1
Q

three drug classes given to prevent bronchoconstriction

A

B2 agonists
methylxanthines
anticholinergics

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2
Q

which drug class is most effective for acute bronchospasm

A

b2 agonists

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3
Q

Why should we given inhaled drugs for lung diseases?

A

decreased systemic effects

faster and more direct drug delivery to site of action

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4
Q

How much drug reaches the lungs when utilizing a metered dose inhaler?

A

10%

20% with spacer

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5
Q

Which drug delivery system results in the highest % of drug reaching the lungs?

A

nebulizers

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6
Q

List some short acting inhaled B2 agonists

A

albuterol
levoalbuterol

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7
Q

Which B2 agonists can be given PO

A

albuterol
terbutaline

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8
Q

List two methylxanthines

A

theophylline
aminophylline

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9
Q

List one short acting and one long acting inhaled anticholinergic

A

short = ipratropium
long = tiotropium

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10
Q

Can bronchodilators prevent future asthma attacks?

A

No - symptomatic relief only

no decrease in inflammation

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11
Q

What is a SABA

A

short acting beta2 agonist

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12
Q

What is the onset, peak, and duration of action of SABAs

A

onset = immediate
peak = 30mins
DOA = 3-5hrs

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13
Q

Are LABAs or SABAs administered PRN?

A

SABAs - immediate onset for acute attack

LABAs are administered on a schedule

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14
Q

Adverse effects of B2 agonists

A

inhaled - none/minimal

PO -
- tremors
- tachycardia
- nervousness
- hyperglycemia
- hypokalemia

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15
Q

Mechanism of action of methylxanthines

A

adenosine receptor blockade = relaxation of bronchial smooth m

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16
Q

How are methylxanthines metabolized?

A

CYP450

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17
Q

Why do methylxanthines require laboratory monitoring?

A

variable PK (variable metabolism)

low therapeutic index w/ serious adverse effects

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18
Q

route of administration of methylxanthines

A

PO or IV (not inhaled)

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19
Q

Adverse effects of methylxanthines

A

CNS excitation (even seizure)
cardiac stim (dysrhythmias)
vasodilation/hypotension
diuresis
N/V, diarrhea

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20
Q

How do anticholinergics work in asthma/COPD?

A

block M receptors in bronchi = decreased bronchoconstriction

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21
Q

What is a SAMA

A

short acting inhaled muscarinic antagonist

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22
Q

What is a LAMA

A

long acting inhaled muscarinic antagonist

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23
Q

Which inhaled anticholinergics are quaternary ammoniums?

A

ipratropium
tiotropium

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24
Q

What is the implication of an inhaled drug being a quaternary ammonium?

A

Drug cannot cross membranes - it stays in the lungs and has no systemic adverse effects

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25
Q

In asthma and COPD, treatment consists of two goals. What are these goals?

A

Anti-inflammation

Bronchodilation

26
Q

Which anti-inflammatory is the most effective for long term control of airway inflammation?

A

glucocorticoids

27
Q

Route of administration of glucocorticoids for asthma/COPD?

A

usually inhaled
acute exacerbations = PO/IV

28
Q

Adverse effects of inhaled glucocorticoids

A

thrush
hoarseness

(long term high dose can have systemic adverse effects)

29
Q

adverse effects of systemic glucocorticoids

A

adrenal suppression
osteoporosis
hyperglycemia
immunosuppression
fluid retention
hypokalemia
peptic ulcer disease
growth suppression (peds)

30
Q

List some inhaled glucocorticoids

A

beclomethasone
budesonide
fluticasone

31
Q

How do leukotriene receptor antagonists work?

A

Suppress effects of leukotrienes

decreased:
- smooth m constriction
- blood vessel permeability
-inflammation

32
Q

Route of administration of leukotriene receptor antagonists

A

PO

33
Q

adverse effects of leukotriene receptor antagonists

A

depression/SI

various depending on the specific drug (esp liver injury, CYP450 inhibition)

34
Q

List some leukotriene receptor antagonists

A

zileuton
zafirlukast
montelukast

35
Q

Which is the safest leukotriene receptor antagonist?

A

montelukast

36
Q

Name the mast cell stabilizer

A

cromolyn

37
Q

How do mast cell stabilizers work?

A

stabilize mast cell membrane = decreased histamine & inflammatory mediator release

–> decreased inflammation

38
Q

Which is the safest of ALL the anti-inflammatories used for asthma?

A

cromolyn

39
Q

How do monoclonal antibodies work?

A

Ab bind target substance, rendering it inert

40
Q

Adverse effect of all monoclonal antibodies used for any purpose

A

injection site reactions
hypersensitivity reactions (can be as serious as anaphylaxis)

41
Q

How do phosphodiesterase 4 inhibitors work for COPD?

A

inhibit PDE4 (enzyme that breaks down cAMP) –> increased cAMP

results in:
- suppression of cytokines
- decreased WBC infiltration

42
Q

List one PDE4 inhibitor

A

roflumilast

43
Q

Adverse effects of PDE4 inhibtors

A

diarrhea
anorexia
HA
back pain
insomnia

44
Q

List two glucocorticoid+LABA combinations

A

Symbicort
Advair

45
Q

List one SABA+anticholinergic combination

A

Combivent

46
Q

Most effective treatment of allergic rhinitis

A

intranasal glucocorticoids

47
Q

Do we use B2 agonists in allergic rhinitis

A

no - not a airway constriction issue

use anti-inflammatories primarily since it’s an inflammation issue

48
Q

Which type of sympathomimetics (which receptor) are used in allergic rhinitis & why?

A

a1 receptor agonists = vasoconstriction decreases swelling & vessel permeability in the nose.

49
Q

Which type of antihistamines are associated with sedation? List a coulple

A

1st generation

chlorpheniramine
diphenhydramine

50
Q

List a couple sympathomimetics used for allergic rhinitis

A

phenylephrine
pseudoephedrine

51
Q

Why is the use of sympathomimetics for allergic rhinitis limited to a couple days?

A

Rebound congestion can occur

52
Q

What type of cough is useful to be treated with a cough suppressant?

A

nonproductive
sleep-depriving

53
Q

What is another name for cough suppressants?

A

antitussives

54
Q

What is an expectorant? (definition)

A

promotes secretion of sputum

55
Q

What is a mucolytic (definition)?

A

breaks down thick mucus (so secretions can be expelled more easily)

56
Q

List an expectorant

A

guaifenesin

57
Q

List a couple mucolytics

A

hypertonic saline
acetylcysteine

58
Q

How do opioid antitussives suppress cough?

A

elevate the cough threshold in CNS

59
Q

Which is the most effective cough suppressant?

A

codeine

60
Q

What schedule drug is codeine when used for a cough suppressant

A

V

61
Q

List a couple nonopioid antitussives

A

dextromethorphan
diphenhydramine
benzonatate

GT BSN/CNL PHARM (26 decks)

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