Pharm2 Mod 3: pulmonary > agents for respiratory illness > Flashcards

agents for respiratory illness Flashcards

(60 cards)

Start Studying
1
Q

what is asthma

A

chronic inflammation of airways
contraction of bronchial smooth muscle
acute bronchospasm
increased secretion of mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the presentation of asthma

A

SOB
cough
chest tightness
wheezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is intermittent asthma

A

less than two days per week
near normal peak flow or spirometry
no daily medication
quick relief: short-acting B2 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is mild persistent asthma

A

more than 2 days per week, not daily
near normal peak flow or spirometry
long term: low dose inhaled corticosteroids
quick: short acting B2 agnoist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is moderate persistent asthma

A

daily bronchoconstricitve episodes
60-80% or normal for peak flow or spirometry
long term: low to medium dose corticosteroids and long-acting B2 agonists
quick: short acting B2 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is severe persistent asthma

A

continual bronchoconstrictive episodes
less than 60% of normal peak flow or spirometry
high dose inhaled coricosteroids and long acting b2 agonist
quick: short acting B2 agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is well controlled asthma

A

<2 days/week of symptoms/
< 2x/month nigh-time awakenings
no interference with ADL
short acting b2 agonist use <2 days/week
>80% of peak flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is not well controlled asthma

A

> 2 days/week of symptoms
1-3x/week of night time awakenings
some limitation with ADLs
2 days/week use of short acting b2 agonists
60-80% peak flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is very poorly controlled asthma

A

symptoms throughout the day
nighttime awakenings > 4x/week
extremely limited ADLs
short acting b2 antagonist used several times per day
< 60% peak flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what determines normal values for peak expiratory flow (PEF)

A

age and height

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the target of respiratory drugs

A

‘conducting zone’
Sympathetic innervation, parasympathetic innervation and mucous secreting and ciliated cells that remove inhaled particles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the sympathetic innervation of the respiratory system

A

sympathetic adrenergic neurons which activate B2 receptors -> bronchial dilation (B2 receptors activated by circulating epinephrine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the the parasympathetic innervation of the respiratory system

A

parasympathetic cholinergic neurons which activate muscarinic receptors -> bronchial constriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is within the conducting zone

A

trachea
bronchi
bronchioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is within the respiraotry zone

A

respiratory bronchioles
alveolar ducts
alveolar sacs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is albuterol

A

short acting beta 2 agonists - bronchodilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the MOA for albuterol

A

activation of adenylate cyclase and increase in intracellular concentration of cAMP causing bronchodilation, relieves bronchospasm, increase mucous drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the indication for albuteral

A

management of acute bronchospasm in asthma and other chronic obstructive airway diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the adverse effects of albuterol

A

sympathomimetic effects: tachycardia, hyperglycemia, hypokalemia
tremor (common)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is metaproterenol (orciprenaline)

A

moderately selective b2 agonist
inhaled or tablet forms available (only oral in USA)
not recommended for routine use given slow onset of action
known to exist but dont plan to prescribe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is levalbuterol

A

another short-acting b2 agonists
inhaled (MDI and nebulizer forms)
deemed inferior to albuterol for management of acute asthma symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are leukotriene modifiers

A

zafirlukast and montelukast (leukotriene receptor antagonists)
zileuton (5-lipoxygenase inhibitors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are the properties of leukotrienes

A

chemoattractant for eosinophils and neutrophils
constrict bronchiolar smooth mm
increased endothelial permeability
promote mucus secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are the indications for leukotriene modifiers

A

prophylaxis and treatment of asthma, allergic rhinitis, exercise-induced broncoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
when are leukotriene modifiers contraindicated
pehnylketonuria hepatic disease
26
what is Zafirlukast
first FDA approved leukotriene receptor antagonist in US 2 doses - oral tablets less effective than inhaled glucocorticoids for management of persistent asthma preferred in asthma tx in children - not useful for treatment of acute asthma attacks
27
what is montelukast
phophylaxis and maintenance of asthma and more commonly prescribed in US can be used to treat chronic urticaria usually added on after initiation of ICS in adults
28
what is Zileuton
inhibits 5-liopoxygenase -> inhibits formation of leukotrienes used for chronic asthma management only common adverse effect = elevation of liver enzymes infrequently used, 4x daily dosing interferes with CYP metabolism
29
what is the indication for methyxanthines
use for both orally and IV in treatment of asthma, bronchospasm and COPD (rarely); also in infant apnea alternate treatment for asthma; not first line
30
what is the MOA for methylxanthines
structurally similar to caffeiene sympathomimetic -> increase HR, inotropy, BP relaxes smooth muscle anti-inflammatory and immunomodulatory effect
31
what is theophylline
methylxanthine competitive nonselective PDEi which increases intracellular cAMP, activates PKA, inhibits TNF-alpha, inhibits leukotriene synthesis (reduce inflammation and innate immunity) also nonselective adenosine receptor antagonists - cardiac effects
32
whar are concerns with theophylline
narrow TRUTH IS toxic side effects: N/D, Heart arrhythmias, CNS excitations, seizures many drug-drug interactions (fluoroquinolone, erythromycin, some SSRIs)
33
what needs to be monitored with theophylline
LFTs, PFTs and serum theophylline concentration
34
what is aminophylline
only available outside the US compound of theophylline with ethylenediamene less potent and shorter acting same MOA as theophylline
35
what are the inidcations for inhaled corticosteroids
acute and or persistent asthma (mild to severe); COPD
36
what is the MOA for inhaled corticosteroids
suppress inflammatory and immune response, and reduce edema and secretions by the following mechanisms; controls the rate of protein synthesis depresses the migration of polymorphonuclear leukocytes and fibroblasts reverses capillary permeability and lysosomal stabilization at the cellular level to prevent or control inflammation
37
what are the toxic effects of inhaled corticosteroids
cough cataracts, thrush, hoarseness HPA suppression growth suppression reduction in bone density
38
what are the inhaled corticosteroids
budesonide (nebulized, MDI or Intranasal) beclomethasone (nebulized or intransal) fluticasone (propionate) (inhaled only; sub-type available for intranasal use) mometasone (inhaled and intranasal)
39
what are oral corticosteroids
methylprednisolone prednisolone prednisone
40
what are long acting beta agnoists used for
maintenance of asthma and prevention of asthma attacks, exercise-inducted bronchoconstriction prevention and COPD management- not used in acute attack of COPD/asthma
41
are long acting beta agonists monotherapy or combo therapy
CANNOT BE mono-therapy in asthma treatment can be used as mono-therapy in COPD
42
what is the difference from LABA and SABA medications
duration of action
43
what are LABA drugs
Salmeterol formoterol (in combo)
44
what is salmeterol
LABA drug available in combo with ICS and as mono-therapy (in a dry powder inhaler form)
45
what is formoterol
only available as nebulized solution or in combo with LABA in the US faster onset of action than salmeterol as a result of lower lipophilicity more potent
46
what are combonidation inhalers
LABA/ICS SABA/anticholinergic
47
what are LABA/ICS combination inhalers
advair (salmeterol/fluticasone) symbicort (formoterol/budesonide) Dulera (formoterol/mometasone)
48
what is combivent
(albuterol/ipratropium) SABA/anticholinergic combination inhaler
49
what are mast cell stabilizers/modulators used for
to prevent or control certain allergic disorders block mast cell degranulation, stabilizing the cell and thereby preventing release of histamine and related mediators
50
what is Cromolyn
mast cell stabilizer formerly non-steroid medication of choice for asthma tx prior to advent of LTRA taken 4x/day not seen to provide additive benefit with co-administered with steroids infrequently used
51
what is Omalizumab
recombinanat DNA-dervied humanized IgG1k monoclonal antibody that specifically binds to free human immunoglobulin E (IgE) in the blood and interstitial fluid beings to membrane-bound for of IgE on surface of mlgE-expressing B lymphocytes
52
what is omalizumab used for
to control severe allergic forms of asthma that are steroid resistant
53
what are the AE of Omalizumab
anaphylaxis in 1-2/1000 cases; increase stroke and MI risk significantly (by 60%)
54
what is COPD
chronic, irreversible obstruction to the airway progressive associated with decrease in FEV1.
55
what are the severities of airflow limitation in COPD
GOLD 1 - mild (>80) GOLD 2 - moderate (<80) GOLD 3 - severe (<50) COLD 4 - very severe (<30)
56
what are the COPD GOLD guidelines
categorize -> initiate first line therapy - > follow up based on further DYSPNEA or EXACERBATIONS
57
what are the indications for Ipratropium
COPD management, specifically to block cholinergic (vagal) mediated bronchospasm and mucus production
58
what is the MOA for ipratropium
anti-muscarinic activity on the bronchial smooth muscle that results in decreased contractility of smooth muscle
59
what are the toxic effects of ipratropium
local and systemic anticholinergic effects xerostomia urinary retention overall well tolerated
60
what is tiotropium
more costly alternative to ipratropium, with same indications "long acting" anti-muscarinic medications, so only needed once daily available in inhaled powder form

Pharm2 Mod 3: pulmonary (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions