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Flashcards in Asthma and COPD Deck (64):
1

MDI

metered dose inhalers
- propellant
- spacer increases amount

2

DPI

dry powder inhalers
- diskus
- no propellant or spacer
- capsule that should not be swallowed

3

CFC

chlorofluorocarbons
- no longer allowed in MDI because of ozone

4

HFA

hydrofluoralkane
- 12/31/18 safe alternative

5

Respiclick

- no spacer, primer, time window

6

long term meds

corticosteroids

7

corticosteroids

- most potent
- inhaled

8

MOA corticosteroids

- anti-inflammatory/glucocorticoid
- salt-retaining/mineralcorticoid
- reduce hyper-responsive and inhibit cytokine

9

inhaler corticosteroids

 Beclomethasone HFA/QVAR
 Triamcinolone acetonide/Azmacort
 Fluticasone propionate/HFA and diskus
 Flunisolide MDI/Aerobid
 Flunisolide HFA
 Budesonide DPI/Pulnicort Flexhalers
 Budesonide nebs
 Monetasone furoate DPI

10

oral corticosteroids

- severe
 Methylprednisolone/Medrol
 Prednisone
 prednisolone

11

AR MDI

- throat irritation/hoarseness/oral candiasis (throat infection)

12

therapeutic for AR steroids

spacer and mouth washing after use decrease local side effects

13

mast cell stabilizer drugs

- cromolyn
- nedrocril

14

moa mast cell stabilizers

inhibits allergen reactions, release of mediators and acute response

15

administration mast cell stabilizers

MDI, nasal, aerosol, oral, ophthalmic

16

how long until mast cell stabilizers are beneficial

2 weeks but 4-6 weeks is needed to see max
- very safe and nebs preferred

17

immunomodulators

- long term
- Omalizumab/xolair

18

moa immunomodulators

binds to ciruclating IgE to prevent binding to basophils and mast cells

19

ar immunodulators

- pain/bruising
- anaphalxis
- neoplasms

20

treatment for ar immunodulators

montor
- SC q 2 or 4 weeks

21

LABA

- long acting beta agonist
- sympathomimetic (vasodilation)
- long term and added to ics

22

warning with LABA

do not use for acute asthma exacerbation

23

LABA FDA approved

 Salmeterol xinofoate/serevent diskus
 Formoterol/foradil aerolizer

24

LABA not FDA approved

 Arformoterol nebulizer solution/brovana
 Formoterol nebulizer solution/performoist

25

moa LABA

- bronchodilation = smooth muscle relaxation
adenylate cyclase activation and increase cyclic AMP = antagonism of bronchospasm

26

administration LABA

inhalaed

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ar LABA

- (don't really use them)
- cardiac arrhythmias from tachycardia or heart block
- glaucoma
- tremor
- dizziness
- vomiting
- hypoalkemia
black box warning

28

drug interactions with LABA

beta blocker my be decreased

29

methylxanthines

theophylline SR - tablets or capsules

30

moa methylxanthines

smooth muscle relaxor (bronchodilatino) from phosphodiesterase inhibition
- increases diaphragm contractility and mucociliary clearance

31

administration methylxanthines

PO and IV

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ar methlxanthines

tachcardia, restlessness, convulsions, insomnia
- dose related
- risk vs. benefit
- placed after sympathomimetics

33

dose ar methlxanthines with theophylline

- 20 = headache
- 35 = hypotension, cardiac arrhythmias

34

leukotriene modifers

long-term and prevention of symptoms

age prevention symptoms
1 = montelukast
7 = zafirlukast
12 = zileuton

35

leukotriene drugs

montelukast sodium/singulair

36

moa leukotriene

leukotriene receptor antagonist

37

administration leukotriene

PO

38

leukotriene ar

suicide

39

SABA

- acute asthma and COPD
- sympathomimetic
- rescue medications

40

SABA drugs

o Albuteraol/Proventil and Ventolin
o Levalbuterol HFA MDI and nebulizer/Xopenex HFA

41

dose albuterol proventil

2 -4 mg tabs
2mg/5 mL syrup
200 mcg caps - venolin

42

dose albuterol ventolin

200 mcg caps - venolin

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dose levalbuterol

45 mg

44

moa SABA drugs

smooth muscle relaxation and increase cyclic AMP producing antagonism of bronchoconstriction

45

administration SABA

MDI, PO, AEROSOL

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bad reactions with SABA

cardiac arrhythmias and narrow angle glaucoma

47

ar SABA

tachycardia, tremor, dizzines

48

drug interaction with SABA

HTN and beta blocker may be drcreased

49

treatment for SABA interactions

brochospam drug and inhaled is faster with fewer ADRs

50

what does increase in use of SABA mean

greater than 2 days/ week = inadequate astma control

51

which SABA drug is better

levalbuteron 1/2 mcg dose = bronchodilation with less side effects

52

anticholinergics

bronchodilator alternative
- concern = chlinergically mediated bronchospasm

53

anticholinergics drug

o Ipratropium bromide/Atrovent hfa
o Ipratropium nebulizer solution/Atrovent
o Ipratropium bromide/albuterol sul
o Ipratropium/albuterol nebulizer
o Triotropium DPI - NOT FDA approved

54

anticholinergics moa

competive inhibition of cholinergic receptors

55

administration anticholinergics

MDI aerosol

56

ar anticholinergics

dizziness, dry mouth, constipation, urinary retention

57

purpose of systemic corticoidsteroids

moderate to severe exacerbations

58

purpose of spacer

decrease amount of drug that sticks to the back of the throat and oral thrush from inhaled corticosteroids and amount of propellant exposure

59

goals of COPD treatment

- stop smoking
- improve obstructive state
- prevent exacerbations
- reduction disease rate
- improve well being

60

first line of defence for COPD

anticholinergics

61

bronchodilator of choie

sympathomimetics = LA and SA

62

most effective monotherapy

anticholinergic and sympathomimetic

63

when to use corticosteroids

when sympathomimetic and methylxanthine fail

64

what corticosteroids are used generally

methylprednisoloe 0.5-1 mg/kg IV q 6 hours and can be switched to prednisone 40-60 mg when stabilized