Bronchodilators Flashcards Preview

RESP II Exam 2 > Bronchodilators > Flashcards

Flashcards in Bronchodilators Deck (44):
1

prednisone

oral corticosteroid

2

montelukast

leukotriene antagonist

3

zafirlukast

leukotriene antagonist

4

anti-IgE Ab

obalizumab

5

bronchospasm

IgE on mast cells
-release histamine and other mediators

blocking single one - not very helpful

corticosteroids - block lots

6

preformed mediators

histamine
TNF alpha
protease
heparin

immediate

vasodilation, edema

7

lipid mediators

minutes
leukotrienes, prostaglandins

mucus secretion

8

cytokines

interleukins, GM-CSF

hours

inflammatory cell proliferation

9

IgE proliferation

IL-4, IL-5

Th2 cell

10

aerosol delivery

lots swallowed
-bets drugs - poor GI absorption

spacer - larger particles deposited before inhales - allows only smaller -which go to small airways

1-5 micrometers - get to small airways

11

DOC for rapid relief of bronchospasm

beta-adrenergic agonist

12

beta agonist overuse

side effect intensify

seek help as soon as decline in efficacy of tx noticed

13

asthma tx

control inflammatory component

bronchodialtor - sympomatic use PRN

14

COPD tx

focus on reversible component
-bronchodilation

15

no hand lung coordination

nebulizer

16

SABA

albuterol

17

LABA

formoterol
salmeterol

18

emergency use

epinephrine - subQ

19

beta agonist MOA

beta2 receptor

stimulate adenylyl cyclase and increase cAMP

relax bronchial smooth m, inhibit mediators of mast cells

20

prevention of nighttime asthma attacks

salmeterol

prophylactic bronchodilation

slow onset - not for acute tx

21

most effective long term treatment persistent asthma

inhaled corticosteroids

recommendations - long acting beta2 agonist in combination with inhaled corticosteroid

22

beta agonist side effect

muscle tremor, cramps, tachyarrythmias, metabolic disturbanceq

23

long term use of LABA

may down-regulate beta-2 receptors

lose protective effect

stop use once asthma control achieved and maintain use of an asthma-controller - inhaled corticosteroid

24

anaphylactic rxn

epinephrine subQ

25

quaternary muscarinic receptor antagonist

ipratropium bromide

inhaled aerosol

poor GI absorption** - swallowed little effect

26

COPD tx

ipratropium

27

long acting muscarinic antagonist

tiotropium

28

theophylline

methylxanthine

-adenosine receptor antagonist
-PDE inhibitor
-hyperpolarize cell membranes

29

intranasal ipratropium

allergic rhinitis
postnasal drip syndrome

30

methylxanthines

theophylline

cause bronchodilation

used to be first line for asthma - not less prominent role in therapy because benefits modest with narrow therapy index

31

noctural asthma improvement

with slow release theophylline

but corticosteroids and salmeterol are probably better option

32

PDE4 inhibitor

roflumilast
-for COPD

increased cAMP levels and reduce inflammation

reduced exacerbations

side effects - nausea, diarrhea, psych, weight loss

only pt not responding other therapy

33

corticosteroid MOA

steroid receptor agonist
-to nucleus and +/- regulate gene transcription - takes time

inhibit lots of inflammatory mediators

34

aerosol steroids

safer

35

systemic corticosteroids

IV/oral - for severe asthma in hospital

prednisone/methylprednisone - IV then oral tapered off dose

36

corticosteroid side effects

HPA suppression
bone resorption
carb/lipids
cataracts
purpura
dysphonia
candidiasis

37

combined products

fluticasone / salmeterol
budesonide / formoterol
mometasone / formoterol

38

reversible component COPD

inflammation and bronchospasm

this is drug therapy

39

irreversible component COPD

alveolar destruction

40

COPD tx

inhaled ipratropium / tiotropium with beta2 agonist

monotherapy with inhaled corticosteroids - not approved for COPD

41

growth retardation

concern with high dose corticosteroids in children

42

triple therapy

for COPD
-tiotropium, LABA, corticosteroid

superior to 1 or 2 agents in relieving symptoms such as dyspnea and in improving lung function

43

cromolyin

anti-inflammatory
-inhibit antigen-induced bronchospasm

inhibits release of histamine from mast cells

not effective in tx of ongoing or acute bronchospasm - primarly used as prophylactic**

44

LTD4 receptor antagonist

motelukast
-oral prophylaxis for exercise induced asthma

alt tx for mild persistant asthma