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Pharmacy > Drug-Induced Pulm Disease > Flashcards

Drug-Induced Pulm Disease Flashcards

1
Q

most common drug-induced resp problem

A

bronchospasm

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2
Q

four methods of bronchospasm

A

Anaphylaxis (IgE)
COX inhibition
Pharmacologic effects
Direct airway irritation (smoke, n-acetylcysteine)

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3
Q

Samter’s syndrome

A

Asthma
nasal polyps
aspirin intolerance

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4
Q

aspirin/NSAIDs can cause

A

bronchospasm

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5
Q

what class is used to treat NSAID induced bronchospasm (DOC)

A

Leukotriene antagonists (Zileutron)

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6
Q

therapy options for aspirin/NSAID bronchospasm

A

COX2 selective NSAIDs

Acetaminophen

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7
Q

Cross sensitivity in NSAID induce BS

A

Ibuprofen/naproxen
yellow dye tartrazine
(colors food, drinks, cosmetics)

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8
Q

the use of this drug early in life may increase risk of asthma and allergic disease

A

Acetaminophen

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9
Q

beta blockers can cause

A

bronchospasm (by directly inhibiting B2 receptors)

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10
Q

what could you use to treat b blocker induced bronchospasm

A

anticholinergics (ipratropium)

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11
Q

management options for people with b blocker bronchospasm

A

inhaled bronchodilator

use selective b blockers, lowest dose possible

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12
Q

potassium metabisulfite, a preservative in food and wine and some injectable drugs, can induce what

A

bronchospasm

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13
Q

mechanisms of sulfite induced BS

A
  • sulfite converted to sulfur dioxide (parasymp)
  • IgE mediated
  • Reduced enzyme sulfite oxidase (which catalyzes sulfITES to sulfATES)
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14
Q

pretreatment for sulfite induced BS

A

cromolyn, anticholinergics, cyanocobalamin

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15
Q

inhaled agents can cause

A

bronchospasm

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16
Q

mechanism for inhaled agent BS

A

EDTA is a stabilizing agent. Has calcium chelation properties and causes buildup of benzalkonium chloride (a bacteriostatic agent) that causes MAST cell degranulaiton

17
Q

ACE inhibitors can cause what

A

cough

18
Q

ACE-I cough mechanism

A

attributed to accumul of substance P (bronchoconstriction) and bradykinin (stim cough reflex)

19
Q

management of ACEI cough

A

stop the medication

switch to an ARB

20
Q

fentanyl can cause

A

cough

21
Q

Fentanyl causes cough in old smokers mostly. T or F

A

FALSE. youngs who dont smoke

22
Q

narcotics can induce what

A

non-cardiogenic pulmonary edema

23
Q

treatment of narcotic induced NCPE

A

naloxone, O2, ventilatory support

24
Q

pulmonary eosinophilia is associated with what

A

nitrofurantion

para-aminosalicylic acid

25
Q

Chemotheraputic agents (bleomycin, busulfan, carmustine, methotrexate) can cause

A

pulmonary fibrosis

26
Q

Amiodarone can cause

A

pulmonary fibrosis

pulmonary toxicity

27
Q

time of onset PF with bleomycin

A

after 1st dose to 15 years later

28
Q

management of drug induced PF

A

DC med

can add prednisone

29
Q

rapidly progressive ARDS

A

pulmonary toxicity

30
Q

accumulation of this drug in lung tissue interferes with normal processing of phospholipids. Breaking of macrophages results in pulm inflam and fibrosis

A

Amiodarone

31
Q

monitoring for a pt on amiodarone

A

PFTs and CXR at baseline
CXR every year
PFTs if symptomatic

32
Q

treatment of pt with amio induced pulm tox

A

DC med

can add corticosteroids

33
Q

anorexic agents (fenfluramine and dexfenfluramine and phentermine) can cause

A

pulmonary HTN

34
Q

most common symptom of pulm HTN

A

exertional dyspnea

35
Q

management pt with drug induced pulm HTN

A

DC drug

36
Q

pt on a ventilator presents with cough, chest pain, dyspnea. you see that their fraction of inspired o2 is low. what do you suspect

A

oxygen toxicity

37
Q

excess oxygen does what

A

produces highly reactive o2 metabolites that overwhelm the antioxidant system and destroys tissues

38
Q

hyperoxia causes what in the lings

A

fibrosis

Pharmacy (22 decks)

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