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343 Pharm Exam 2 > Chapter 39 Lower Respiratory > Flashcards

Chapter 39 Lower Respiratory Flashcards

1
Q

What are some lower respiratory illness ?? Examples

A

Asthma
COPD
Chronic bronchitis

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2
Q

What are Bronchodilation and bronchonstriction controlled by?

A

The autonomic nervous system
And
Parasympathetic nervous system

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3
Q

How does the autonomic nervous system control the bronchodikation or constriction?

A

By the stimulation of beta2 adrenergic receptors which dilations it

Parasympathetic nervous system will constrict it

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4
Q

What is bronchial asthma?

What is the patho of this?

A

Recurrent and reversible shortness of breath

Alveolar ducts are open but the airflow to them are obstructed

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5
Q

What are the 4 things that causes bronchial asthma?

A

Bronchospams
Inflammation
Edema
Production of viscous mucus

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6
Q

If someone has asthma what’s the emergency medication?

A

Albuterol
( beta agonist )

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7
Q

What is COPD, chronic bronchitis?

Pathology?

Occurs how?

A

Continuous inflammation and low grade infection of the bronchi

Excessive secretion of mucus and certain pathologic changes in the bronchial structure

Prolonged exposure to bronchial irritants

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8
Q

What is COPD, emphysema?

Caused by?

Meaning that the surface area where gas exchange takes place is reduced
Causing respiration to be impaired

Barrel chest

A

Air spaces enlarge as a result of the destruction of alveolar walls

Effect of proteolytic enzymes released from leukocytes in response to alveolar inflammation

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9
Q

What are SABA inhalers?
What does short acting mean?

Short acting beta agonist

A

Albuterol
Last 4-6 hours & use again
Rescue inhalers

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10
Q

What is LABA inhalers?

A

Long acting
Serevent ! Example
Last longer
Prevents it from happening, take it in the very morning & night

Maintenance

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11
Q

What are SABA side effects?

A

Bronchospams
Nervousness

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12
Q

Can we use laba on an emergency?

A

No!!!
Just prevention

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13
Q

If they have to use there bronchodilator more than two a week to help with there asthma, what does that mean?

A

That there asthma is not under control

Meaning they need to carry it with them !!!

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14
Q

What are the 3 types of beta adrenergic agonists?

A

Nonselective - epinephrine
- stimulate alpha and beta 1 ( cardiac )
- stimulus beta 2 ( respiratory )

Nonselective beta adrenergics
- both beta 1 and beta 2
Metaproternol

Selective
- stimulate only beta 2
Albuterol

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15
Q

What is the mechanism of action of beta adrenergic agonists?

A

Behind with specific receptor stimulated and ends with dilation of the airway

Activation of beta 2 receptors relax smooth muscle and increase airflow

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16
Q

What does beta adrenergic agonists do to the body? What system?

A

Sympathetic system

Bronchial smooth muscle relaxation

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17
Q

Does beta adrenergic agonists have anti inflammatory properties?

A

No

18
Q

Short acting time?
Immediate acting time?
Long acting time?

A

2-6
8 hours
12 hours

19
Q

Adverse effects of nonselective adrenergic agonists

Alpha and beta receptors : epinephrine

A

Insomnia
Restlessness
Anorexia
Tremors
Cardiac stimulation & tachy

20
Q

Nonselective beta adrenergic agonists
Adverse effects
Beta 1 and beta 2

A

Tachycardia
Tremor
Anginal pain
Hypotension
Broncho constriction

21
Q

Beta adrenergic agonists does the opposite of what?

A

Beta blockers!!

Think of it like, beta agonists increase respiratory

But beta blockers
It blocks respiratory!

22
Q

What is anticholinergic used for?

We don’t use it for!!?
Example why^

A

Prevent bronchosonctriction

Acute asthma exacerbations
Because it drys them out

23
Q

Main difference between beta adrenergic and anticholinergic are?

A

Beta adrenergic agonist
- bronchodilators

Anticholinergic
- prevent broncho constriction

24
Q

What is the mechanism of action of anticholinergic drugs?

A

It blocks acetylcholine that causes bronchial constrictions

Pretty much preventing the constriction and allowing the airways to be dilated by the albuterol

25
Q

What are some side effects of anticholinergic?

A

Dry mouth
Nasal congestion’s
Heart palpitations
Coughing
Anxiety

26
Q

What is methylaxanghines?

Does this have a narrow therapeutic window?

This interacts with so many drugs??!!
And not used with seizure disorders, cardiac and renal and liver disorders

A

Related to caffeine- used to be the drugs of choice for controlling asthma

Yes

Don’t use for hypertension cardiac cause it increases!!

27
Q

What decreases the effect methylxanthines ?

A

Tobacco
( smoking ! )

28
Q

What is xanthine
- causes Bronchodilation by relaxing smooth muscle
- relief of bronchosspams and greater airful

Stimulates the force of contractions and heart rate resulting in better blood to the kidneys ( diuretic effects )

A
29
Q

What are some adverse effects of methylxanthines?

A

Dizziness
Restless
Hypotension
Tachycardia

30
Q

What are the 3 drug interactions with xanthine?

A

Beta blockers
Cimetidine
Erythromycin

31
Q

What is leukotriene receptor antagonists?

A

Suppress leukotrienes !!
From attaching to receptors in the lungs and in the circulation

Reduce inflammatory process and decrease

32
Q

What is the biggest side effect of leukotriene receptor antagonists??

A

Weird dreams!!!

33
Q

LTRA do anything for acute asthma attack?

A

Nope!!!
Just long work treatment

34
Q

All steroids have the same side effects?

A

Yes!

All increase blood sugar
Fluid retention
Thrush!
Suppers immune system = infection
Insomnia
Hungry
Ulcers

35
Q

Long term steroid use can cause what to our bones?

A

Osteroporosis

36
Q

What do we use inhaled corticosteroid ?

A

To help with inflammation

Further into the airways and decrease inflammation

37
Q

Albuterol first and then corticosteroids?

A

Yes!

Open it with albuterol

Corticosteroid will go in more and decrease inflammation

38
Q

corticosteroid take a long time to work?

A

Yes!!

39
Q

What does cromolyn do?

A

Bronchial asthma prophylaxis

Suppress mast cell reaction

Decreases asthma symptoms !!
Pre excerise inhaler

40
Q

Should you shake the inhaler?
Should you rinse your mouth after?

A

Yes

Yes!!

41
Q

When a patient says there inhaler doesn’t working what do you say?

A

Show me how to do it!!

Many people are uneducated

42
Q

Notes
Cromolyn is mainly used in kids

A

343 Pharm Exam 2 (9 decks)

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