Asthma/COPD Deck 2 Flashcards

1
Q

Cromolyn Class

A

mast cell stabalizer

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2
Q

Cromolyn is for

A

prevention, inhaled, prevention. Not quickl relief!!

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3
Q

Cromolyn MOA

A

Stabilizes cytoplasmic membrane of mast
cells, thereby preventing release of histamine and
other mediators; in addition, inhibits eosinophils,
macrophages, and other inflammatory cells

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4
Q

Cromolyn uses and route

A

Route: nebulizer
• Uses: chronic asthma, exercise-induced
bronchospasm (EIB)

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5
Q

Cromolyn AE

A

cough or bronchospasm.

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6
Q

Omalizumab [Xolair] MOA

A

– Antagonism of immunoglobulin E (IgE)

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7
Q

Omalizumab [Xolair] USE

A

– Patients age 12 years or older with moderate to
severe asthma that (1) is allergy related and (2)
cannot be controlled with an inhaled glucocorticoid

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8
Q

Omalizumab [Xolair] ADR

A

injection-site reactions, viral infection, URI,

sinusitis, HA, pharyngitis, CV events, malignancy

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9
Q

Omalizumab [Xolair] Black Box

A
  • life-threatening anaphylaxis
    (most likely with first dose, period of observation in
    office).
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10
Q

Omalizumab [Xolair] is used in a

A

allergists office

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11
Q

Bronchodilators use

A
Symptomatic relief, do not alter underlying
disease process (inflammation)
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12
Q

Beta 2 agonist MOA

A

• Through activation of beta2 receptors in the smooth
muscle of the lung, these drugs promote
bronchodilation, relieving bronchospasm

• Beta2 agonists have a limited role in suppressing
histamine release in the lung and increasing ciliary
motility

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13
Q

SABA take

A

PRN

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14
Q

Exercize endused take SABA

A

before exercise

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15
Q

SABA ADR

A

– tachycardia, angina, tremor

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16
Q

Inhaled long-acting beta2-agonists (LABA) when are they given

A

Long-term control in patients who experience frequent attacks

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17
Q

LABA dosing is

A

is on a fixed schedule, not PRN

18
Q

LABA effective in treating

19
Q

LABA when used to treat asthma must always be combined with

A

glucocorticoid

20
Q

Use of what alone in asthma is contraindicated

21
Q

LABA ADR

A

tachycardia, agina, tremor

22
Q

LABA black box warning

A

risk for asthma-related deaths.

– Salmeterol [Serevent Diskus], formoterol [Foradil Aerolizer], and arformoterol [Brovana)

23
Q

Vilanterol – available in

A

combination – flucticasone/vilanterol

[Breo Ellipta] and umeclidinium/vilanterol [Anoro Ellipta]

24
Q

Rule of Two (5 items) Should know this for the exam

A

• No symptoms more than twice per
week.
• Should not use a short-acting beta agonist no more than twice per week.
• No interference with normal activity.
• No more than one to two flare-up in the
past year.
• Peak flow levels should be higher than

80% of the predicted or personal bests.

25
Theophylline produces
brochodialtion by relaxing smooth muscle from the bronki
26
Theophylline has a
narrow therapeutic indix
27
Theophylline plasma levels should be between
10 to 20 mcg
28
Theophylline Toxcicity is related to
levels
29
Theophylline the drug is usually
administered by mouth, but may be given IV
30
Theophylline is uesed for
maintenic therapy of chronic stable asthma
31
Theophylline plasma levels below 20 mcg
adverse effects uncommon
32
Theophylline plasma 20 to 25 mcg
n/v diarrhea, insomnia, restless ness
33
Theophylline plasma above 30 mcg
severe dysrhymias and convulions death may occr from cardio respiroarty collapse
34
Theophylline no (methylxanthines) no longer recommended for
COPD
35
Theophylline toxicity treatment
– Stop theophylline – Activated charcoal together with a cathartic – Dysrhythmias respond to lidocaine – Intravenous diazepam may help control seizures
36
Theophylline interactions
– Caffeine – Tobacco and marijuana – Cimetidine – Fluoroquinolone antibiotics
37
Anti-Cholinergics improve lung functions
by blocking muscarinic receptors in the bronchi
38
Anti-Cholinergics approved fro only
COPD. Off label for asthma
39
Ipratropium and tiotropium have a
longer duration of action
40
Ipratropium action and use
– Administered by inhalation to relieve bronchospasm – Therapeutic effects begin within 30 seconds, reach 50% of maximum in 3 minutes, and persist about 6 hours
41
Ipratropium ADR
– Dry mouth and irritation of the pharynx – Glaucoma – Cardiovascular events