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Resp II > Bronchodilators > Flashcards

Bronchodilators Flashcards

(66 cards)

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1
Q

inhaled corticosteroids

A

budesonide

fluticasone

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2
Q

oral corticosteroids

A

prednisone
methyprednisolone
prednisolone

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3
Q

cromolyn compounds

A

cromolyn sodium

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4
Q

leukotriene inhibitors

A

montelukast

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5
Q

short acting beta 2 agonists

A

alburerol

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6
Q

long acting beta 2 agonists

A

formoterol

salmeterol

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7
Q

other beta agonists

A

Epi

racemic epi

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8
Q

muscarinic antagonits

A

ipratropium bromide

tiotropium

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9
Q

combivent

A

albuterol +ipratropium

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10
Q

methyxanthines

A

theophylline

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11
Q

anti IgE

A

omalizumab

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12
Q

decongestants

A

alpha-agonists-phyenlephrine

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13
Q

antitussives

A

opioids (codeine, dextromethorphan)

non opioids

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14
Q

expectorants

A

guaifenesin

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15
Q

mucolytics

A

n-actylcysteine

DNAase

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16
Q

> 10um

A

deposit in mouth and oropharynx

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17
Q

<.5um

A

inhaled then exhaled

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18
Q

1-5um

A

deposit in small airways

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19
Q

MDI

A

metered dose inhaler
delivers drug w/HFA, co-solvents, and/or surfactants
low cost
hand held coordination

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20
Q

spacer devices

A

attach to MDI improve ratio of inhaled to swallowed drug and reduce need for coordination

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21
Q

VHCs

A

valved holding chambers

have one way valves to prevent patient from exhaling into device, better for kids

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22
Q

nebulizers

A

severe asthma exacerbations w/poor inspiratory capacity or unable to coordinate

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23
Q

dry powder inhalers

A

require high air flow and can be irritating

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24
Q

beta 2 agonists

A

preferred therapy for bronchoconstriction

immediately effective for acute attacks

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25
MOA beta agonists
stimulate AC and increase cAMP -> decrease Ca -> smooth mm relaxation and inhibit mast cells
26
albuterol
onset <15min | lasts 2-6hrs
27
levalbuterol
R isomer of racemic albuterol
28
Epi
nebulized solution in kids and infants drug of choice for emergency Tx of anaphylactic rxns via SQ injection causes bronchodilation and vasoconstiction
29
Salmerterol
long acting 12hours not suitable for acute bronchospasm prevention of nighttime asthma attacks
30
formoterol
long acting dry powder for maintence of asthma and COPD | NOT for acute attacks
31
arformoterol
COPD
32
long term use of LABA
may down regulate expression of beta 2 R and loss of drug effectiveness -> more death and hospitalizations should be combined w/corticosterioid
33
oral administration of beta agonists side effects
``` skeletal mm tremor mm cramps cardiac tachyarrhythmias metabolic disturbances hypokalemia (especially with diuretics) hyperglycemia ```
34
indications for oral beta agonists
<5yrs who cannot use inhalers | severe asthma exacerbations may be unable to tolerant nebulizer or inhaler
35
most common adverse effect of beta agonists
skeletal mm tremors
36
CNS side effects of beta agonists
restlessness, apprehension, anxiety, tremors
37
CVS side effects of beta agonists
tachycardia, dsyrhymias, hyper or hypotension
38
drug interactions of beta agonists
potentiate cardiotoxcity of thyroid, digitals, and methylaxthines
39
ipratropium bromide and tiotropium
quaternary amine muscarinic agonists COPD little to no side effects b/c not well absorbed
40
ipratropioum
exclusively as aerosol lasts for 6hrs can be used intranasal or allergic rhinitis and chronic post nasal drip
41
combivent
albuterol + ipratropoum | treatment of choice for COPD patients
42
methylxanthines
adenosine R antagonists inhibits cyclic nucleotide phosphodiesterases -> increase cAMP and cGMP decrease Ca-> hyperpolerize cell membranes
43
effects of theophylline
``` bronchodialtion CNS stimulation (HA, nausea, vommiting, anxiety) cardiac stimulation modest peripheral vasodilation improved skeletal m contractility thiazide like diuresis ```
44
clinical theophylline
narrow therapeutic index must use slow release formulas should not be used unless blood levels can be regularly monitored can be used for nocturnal asthma, but not first line
45
roflumilast
severe COPD | oral PDE4 inhibitor -> increase cAMP -> reduce inflammation
46
roflumilast side effects
``` nausea diarrhea psychiatric symptoms weight loss last resort ```
47
corticosteroids
asthmatics who require inhaled beta agonists 4+/wk
48
high dose corticosteroids
spacer device to reduce risk of adverse effects mandatory | dose can often be reduced over time
49
corticosteroids MOA
``` bind intracellular cortisol Rs -> TF inhibit production and release of: cytokines vasoactive and chemoattractive factors lipolytic and proteolytic enzymes decrease mobilization of leukocytes antiinflammatory ```
50
adverse effects of corticosteroids
``` oral candidasis and dysphonia (spacer) hypothalamic-pituitary-adrenal axis suppression bone resorption cataracts and skin thinning purpura growth retardation in children glucose intolerance weight gain HTN osteoporosis immunosupression mood disorders ```
51
cromolyn sodium
inhibits release of histamine indirectly inhibits Ag-induced bronchospasm suppress chemoattractants-> decrease Eos, neutrophils, and monocytes does not directly relax smooth m primary prophylactic
52
LTB4
neutrophil attractant
53
LTC4 and LTD4
bronchoconstriction increased bronchial reactivity mucosal edema mucus hypersecretion
54
zafirlukast and montelukast
``` selective for LTD4 oral peak 1-3hrs useful for aspirin induced asthma dyspnea most common side effect ```
55
zarfirlukast
kids >12 | liver damage
56
montelukast
6-12yrs | safe for long term use
57
zyflo
>12yrs
58
omalizumab
anti-IgE serious and life-threatening hypersensitivity rxns to drug can occur expensive
59
allergic rhinits
topical corticosteroids-> nasal spray croolyn sodium antihistaimines nasal decongestants
60
nadal decongestants
alpha agonists -> vasoconstrict
61
COPD
inhaled ipratropoum or tiotropoum w/beta agonists (combivent) monotherpay w/corticosteroids not approved
62
triple therapy for COPD
tiotropium formoterol/salmeterol fluticasone or budesonide)
63
opioids
act at CNS suppress cough reflec
64
adverse effects of opioids
CNS- euphoria, depression of respiratory and vasomotor centers GI- constipation, nausea, vomiting GU- hesitancy or retention
65
opioid drug interaction
additive CNS depression w/sedative hypnotics, phenotiazines and tricyclic antidepressents
66
non-opioids
local anesthetics and demulcents act directly on nn endings in pharynx

Resp II (15 decks)

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