Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology - Exam 3 > Asthma & COPD > Flashcards

Asthma & COPD Flashcards

1
Q

What is the pathophysiology of asthma?

A
  • reversible, chronic hyper-responsiveness leading to inflam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the etiology of asthma?

A
  • triggers

i. e. airborne allergens, virus, cold

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

What is the goal of asthma therapy?

A
  • reduce impairment & lung remodeling

- reduce risk

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

What are the steps of treatment in a 0-4 y/o with asthma?

A
  • step 1: SABA
  • step 2: low dose ICS (alt: montelukast or cromolyn)
  • step 3: med dose ICS
  • step 4: med dose ICS + montelukast or LABA
  • step 5: high dose ICS + montelukast or LABA
  • step 6: high dose ICS + montelukast or LABA + daily oral steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the steps of treatment in a 5-11 y/o with asthma?

A
  • step 1: SABA
  • step 2: low dose ICS (alt: cromolyn or theophilline as last line)
  • step 3: med dose ICS OR low dose ICS + either LABA, LTRA, or theophylline
  • step 4: med dose ICS + LABA (alt: med dose ICS + either LTRA or Theophylline)
  • step 5: high dose ICS + LABA (alt: high dose ICS + either LTRA or Theophylline)
  • step 6: high dose ICS + LABA + oral steroid (alt: high dose ICS + either LTRA or Theophylline + oral steroid)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When can you rx a LABA?

A
  • once the patient is on ICS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the steps of treatment in a patient over 12 y/o with asthma?

A
  • step 1: SABA
  • step 2: low dose ICS (alt: cromolyn, nedocromil, LTRA, or theophylline)
  • step 3: med dose ICS OR low dose ICS + LABA (alt: low dose ICS + either LTRA, theophylilne or Zileuton)
  • step 4: med dose ICS + LABA (alt: med dose ICS + either LTRA, theophylline, or Zileuton)
  • step 5: high dose ICS + LABA AND consider omalizumab in pts w/ allergies
  • step 6: high dose ICS + LABA + oral corticosteroids AND consider omalizumab in pts w/ allergies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the MOA of SABAs?

A
  • bind b-receptors in lungs –> smooth m. relaxation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the onset of SABAs?

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

What are adverse effects of SABAs?

A
  • heart palpitations
  • anxiety
  • tachycardia
  • tremor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What should be done when patient admits to using SABA >2d/w?

A
  • step up tx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are examples of SABAs?

A
  • albuterol

- levalbuterol

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

What is not a prefered step 1 asthma rx?

A
  • short acting bronchodilator anticholinergis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is an example of short acting bronchodilator anticholinergics?

A
  • ipatropium (Atrovent HFA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the MOA of anticholinergics?

A
  • inhibits cholinergic & muscarinic receptors

- causes bronchodilation

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

What are the ADEs of anticholinergics?

A
  • dry mouth

- increased wheezing

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

What is the MOA of inhaled corticosteroids (ICS)?

A
  • decrease number & activity of inflam cells
  • enhance effect of b-adrenergic rxs
  • inhibit bronchoconstriction
  • direct smooth m. relaxation
  • decrease mucous production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the ADEs of ICS?

A
  • cough, dysphonia MC

- oral thrush if no rinse & spit

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

What are the ADEs of high dose ICS?

A
  • adrenal suppression
  • osteoporosis
  • skin thinning
  • easy bruising
  • cataracts
  • growth suppression/retardation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the ADEs of low to med dose ICS?

A
  • growth suppression

- altered growth velocity

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

What are examples of ICSs?

A
  • suffix: -methasone
  • suffix: -esonide
  • suffix: -isolide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are examples of mast cell stabilizers?

A
  • cromolyn (Intal)

- nedocromil (Tilade)

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

What are examples of leukotriene receptor antagonist (LTRA)?

A
  • montelukast (Singulair)
  • zafirlukast (Accolate)
  • zileuton (Zyflo)
24
Q

What is the MOA of mast cell stabilizers?

A
  • stabilize mast cells

- blockade of chloride channels

25
Q

What are ADEs of mast cell stabilizers?

A
  • cough

- irritation

26
Q

What is the MOA of LTRAs?

A
  • interference w/ pathway of leukotriene mediators
27
Q

What are the ADEs of LTRA?

A
  • depression & suicidal ideation in children
28
Q

What is the MOA of Zileuton (Zyflo)

A
  • similar to LTRA

- only blocks enzyme not the receptor

29
Q

What are the drug interactions of zileuton (Zyflo)?

A
  • inhibits metabolism of warfarin & theophylline
30
Q

What interactions occur with zafirlukast?

A
  • food: take on empty stomach

- substrate and inhibitor of CYP2C9

31
Q

What is the MOA of theophylline?

A
  • mild to mod bronchodilator

- non-selective phosphodiesterase inhibitor

32
Q

What are the ADEs of theophylline

A
  • similar to caffeine

way to many to list

33
Q

What are drug interactions of theophylline?

A
  • metabolized and induced by CYP1A2 & 3A4

- increased clearance when smoking

34
Q

What is the MOA of LABAs?

A
  • tail binds to b-receptor at exosite
  • head binds to same spot as SABA
  • bronchodilation
35
Q

What are examples of LABA?

A
  • salmeterol (Serevent)
  • formoterol (Foradil)
  • suffix: -terol
36
Q

What are the ADEs of LABAs?

A
  • tachycardia
  • tremor
  • hypokalemia
  • bronchospasms & hyperresponsiveness
  • heart issues
37
Q

What must be done prior to rxing omalizumab?

A
  • IgE tested
38
Q

When is omalizumab recommended?

A
  • in steps 5 or 6 for pts with allergies & severe persistent asthma inadequadly controlled on high ICS + LABA
39
Q

What is the MOA of omalizumab?

A
  • binds IgE antibody preventing it to bind on mast cell or basophil receptor
  • leads to decrease release of mediators
40
Q

What are the ADEs of omalizumab?

A
  • urticaria
  • anaphylaxis
  • injection site pain/burning
41
Q

When are oral steroids recommended?

A
  • only for most severe difficult to control asthma d/t well documented risk for side effects
42
Q

What are the ADEs of short term use of oral steroids?

A
  • hyperglycemia
  • increased appetite
  • fluid retention
  • wt gain
  • mood alteration
  • HTN
43
Q

What are the ADEs of long term use of oral steroids?

A
  • growth suppresion
44
Q

When do you taper oral steroids?

A
  • over 10d used
45
Q

What is the 1st line tx for exercise induced bronchospasm?

A
  • SABA
46
Q

What is the 2nd line tx for exercise induced bronchospasm?

A
  • LTRA
47
Q

What is teh 3rd line tx for exercise induced bronchospasm?

A
  • cromolyn
48
Q

What might be a trigger of asthma?

A
  • GERD
49
Q

What are the steps of COPD tx?

A
  • step 1: flu vaccine, decrease risk factors, SABA
  • step 2: ADD LABA
  • step 3: ADD ICS
  • step 4: ADD O2
50
Q

What are other medications for COPD?

A
  • mucolytics
  • antioxidants
  • immunoregulators
  • antitussives
51
Q

What is the MC cause of COPD exacerbations?

A
  • infection

- air pollution

52
Q

What are the cardinal sx of COPD exacerbations from abx?

A
  • increased dyspnea
  • sputum volum
  • sputum purulence
53
Q

What is the tx of COPDers with mild infx exacerbations?

A
  • 1 cardinal sx = no tx

- PCN, amoxicillin, doxycline, bactrim

54
Q

What is the tx of COPDers with moderate infx exacertabitons?

A
  • augmentin (amox/clavulanic acid)
55
Q

What is the tx of COPDers with severe infx exacerbations?

A
  • high dose levofloxacin
56
Q

How long is tx for COPD exacerbated by infx?

A
  • 7-10 d abx

Pharmacology - Exam 3 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions