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CPR - Exam II - Pharm > Asthma and COPD Drugs (Izard) > Flashcards

Asthma and COPD Drugs (Izard) Flashcards

(85 cards)

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1
Q

What are the two goals of asthma therapy?

A

Reduction in impairment

Reduction in risk

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2
Q

Most widely used drug class in asthma/COPD treatment?

A

Beta-2 receptor agonists

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3
Q

Primary action of Beta-2 agonists

A

Relax airway smooth-muscle cells of all airways

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4
Q

Albuterol class?

A

Short acting beta agonist (SABA)

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5
Q

Albuterol contraindications/warnings?

A

Paradoxical bronchospasm

CV effects

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6
Q

Terbutaline class?

A

SABA with preferential effects on the beta-2 receptors

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7
Q

Terbutaline uniqueness?

A

Only beta-2 drug available by subQ injection.

Can’t give in patients with sulfa allergy

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8
Q

Age approved in use of terbutaline?

A

12

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9
Q

Metaproterenol class?

A

SABA

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10
Q

Metaproterenol indication?

A

bronchial asthma and reversible bronchospasm

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11
Q

Metaproterenol warnings?

A

paradoxical bronchospasm

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12
Q

Pirbuterol class?

A

SABA

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13
Q

Pirbuterol indication? Age?

A

prevention and reversal of bronchospasm in patients 12 and older

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14
Q

Pirbuterol cautions?

A

can produce a clinically significant CV effect

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15
Q

Levalbuterol class?

A

SABA

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16
Q

Levalbuterol indication?

A

treatment or prevention of bronchospasm

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17
Q

Levalbuterol age?

A

4 years or older

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18
Q

Levalbuterol caution/warning?

A

Paradoxical bronchospasm

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19
Q

Beclomethasone class?

A

ICS

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20
Q

Beclomethasone indication? Age?

A

maintenance/treatment of asthma and as prophylactic therapy in patients 5 and older

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21
Q

Beclomethasone cautions/warnings?

A

Deaths due to adrenal insufficiency have occured in asthmatic patients during and after transfer from systemic corticosteroids to less systemically available inhaled corticosteroids .

Several months are required for recovery of HPA function

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22
Q

Most effective class for controlling asthma?

A

ICS

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23
Q

Which cells to ICS remove in the airway?

A

Eosinophils, Mast cells, and T lymphocytes

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24
Q

Major effect of corticosteroids in asthma?

A

switch off the transcription of multiple activated genes that encode inflammatory proteins

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25
ICS dosing?
twice daily
26
If ICS does not control asthma, what is the next step?
LABA
27
Budesonide class?
ICS
28
Budesonide indication? Age?
Maintenance treatment of asthma as prophylactic therapy in patients 6 years and older
29
Budesonide caution/warning?
Should not be used where primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required.
30
Ciclesonide class?
ICS
31
Ciclesonide indication? Age?
Maintenance treatment of asthma as prophylactic therapy in patients 12 years and older
32
Ciclesonide cautions/warnings?
Not indicated for Asthma attacks Use not recommended when patient has presence of Candida albicans infection of mouth/pharynx
33
Flunisolide class?
ICS
34
Flunisolide indication? Age
Maintenance treatment of asthma as prophylactic therapy in patients 6 years and older. Asthma patients requiring oral corticosteroid therapy, where adding flunisolide therapy may reduce or eliminate the need
35
Fluticasone class?
ICS
36
Fluticasone indication? Age?
Maintenance treatment of asthma as prophylactic therapy in patients 4 and older.
37
Fluticasone cautions
Candida albicans infection of the mouth and pharynx may occur.
38
Mometasone class?
ICS
39
Mometasone indication? Age?
Asthma as prophylactic therapy in patients 4 and older.
40
Mometasone cautions?
hypersensitivity to milk proteins
41
Triamcinolone class?
ICS
42
Triamcinolone indications?
Asthma Patients who require systemic corticosteroid administration, where adding this agent may reduce or eliminate the need for the systemic corticosteroids
43
Triamcinolone cautions?
Status asthmaticus or other acute episodes of asthma where intensive measures are required. Care is needed in patients who are transferred from systemically active corticosteroids to Triamcinolone because deaths due to adrenal insufficiency have occurred.
44
Oral and parenteral corticosteroid uses?
used in combination with SABAs to treat moderate to sever asthma flare-ups. *More likely to cause side effects*
45
Prednisone class?
OCS
46
Prednisone indication?
Anti-inflammatory or immunosuppressive agent treatment of certain endocrine conditions
47
Prednisone cautions?
Adrenal Insufficiency *May lead to HPA axis suppression*
48
Fomoterol class?
LABA
49
Fomoterol indication? Age?
Add on to an inhaled corticosteroid in asthma patients >5 yeras old. COPD maintenance
50
Fomoterol Contraindications?
LABAs increase risk of asthma-related deaths and asthma related hospitalizations, must use with use of a long-term asthma control medication.
51
Salmeterol class?
LABA
52
Salmeterol indication? Age?
exercise-induced bronchospasm in patients aged 4 and older. COPD maintenance
53
Indaceterol and Vilanterol class?
LABAs
54
Indaceterol and Vilanterol indication?
breathing problems caused by COPD
55
Olodaterol class?
LABA
56
Olodaterol indication?
chronic bronchitis emphysema *Used in the long-term, once-daily maintenance bronchodilator treatment of airflow obstruction in patients*
57
MOA for anticholinergic drugs?
block acetylcholine from binding to its receptors on certain nerve cells. Inhibit parasympathetic nerve impulses *anti-muscarinic agents most widely used in asthma/COPD*
58
Atropine class?
anticholinergic
59
Atropine indication?
temporary blockade of severe or life threatening muscarinic effects.
60
Atropine cautions?
atropine-induced tachycardia Increased myocardial oxygen demand. *total dose should be restricted to 2 to 3 mg to avoid detrimental effects*
61
Ipratropium class?
anticholinergic
62
Ipratropium indicaiton?
maintenance treatment of bronchospasm *poorly absorbed after aerosol administration and is therefore relatively free of systemic atropine-like effects*
63
Tiotropium class?
anticholinergic
64
Tiotropium indication?
long-term, once-daily, maintenance treatment of bronchospasm
65
Aclidinium class?
Anticholinergic
66
Aclidinium indication?
long-term maintenance treatment of bronchospasm associated with COPD
67
Theophyline class?
Methylxanthine
68
Theophylline MOA?
Smooth muscle relaxation suppression of the response of the airways to stimuli
69
Theophylline cautions?
use extreme caution in patients with: active peptic ulcer disease seizure disorders cardiac arrhythmias
70
Leukotriene antagonist MOA?
Block cysteinyl leukotriene receptors and blocking their subsequent inflammatory cascade
71
Montelukast class
Leukotriene antagonist
72
Montelukast MOA
inhibit LTD4 at the CysLT1 receptor without any agonist activity
73
Montelukast indications
allergies and prevent asthma attacks
74
Montelukast cautions
Can't use in acute asthma attacks
75
Zafirlukast class?
Leukotriene antagonist
76
Zafirlukast MOA?
selective and competitive receptor antagonist of Leukotriene D4 and E4
77
Zafirlukast indication? Age?
Prophylaxis and chronic treatment of asthma in patients 5 years and older
78
Zafirlukast caution?
Hepatotoxicity
79
Zileuton MOA?
inhibitor of 5-lipoxygenase and thus inhibits LTB4, C4, D4, and E4 formation
80
Is zileuton IR or ER?
ER
81
Zileuton indication? Age?
Prophylaxis and chronic treatment of asthma in patients 12 years and older
82
Zileuton caution
Active liver disease/ liver enzymes 3x upper limit
83
Omalizumab class
Monoclonal antibody
84
Omalizumab MOA/indication?
anti-IgE antibody indicated for moderate to severe persistent asthma in patients 6 years of age and older with a positive skin test or in vitro reactivity to a perennial aeroallergen. Chronic idiopathic urticaria in patients 12 years and older if h1 antihistamine treatment isn't working.
85
Omalizumab caution
Anaphylaxis

CPR - Exam II - Pharm (7 decks)

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