Drug-Induced Pulm Disease Flashcards Preview

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Flashcards in Drug-Induced Pulm Disease Deck (38):
1

most common drug-induced resp problem

bronchospasm

2

four methods of bronchospasm

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

3

Samter's syndrome

Asthma
nasal polyps
aspirin intolerance

4

aspirin/NSAIDs can cause

bronchospasm

5

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

Leukotriene antagonists (Zileutron)

6

therapy options for aspirin/NSAID bronchospasm

COX2 selective NSAIDs
Acetaminophen

7

Cross sensitivity in NSAID induce BS

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

8

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

Acetaminophen

9

beta blockers can cause

bronchospasm (by directly inhibiting B2 receptors)

10

what could you use to treat b blocker induced bronchospasm

anticholinergics (ipratropium)

11

management options for people with b blocker bronchospasm

inhaled bronchodilator
use selective b blockers, lowest dose possible

12

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

bronchospasm

13

mechanisms of sulfite induced BS

- sulfite converted to sulfur dioxide (parasymp)
-IgE mediated
- Reduced enzyme sulfite oxidase (which catalyzes sulfITES to sulfATES)

14

pretreatment for sulfite induced BS

cromolyn, anticholinergics, cyanocobalamin

15

inhaled agents can cause

bronchospasm

16

mechanism for inhaled agent BS

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

17

ACE inhibitors can cause what

cough

18

ACE-I cough mechanism

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

19

management of ACEI cough

stop the medication
switch to an ARB

20

fentanyl can cause

cough

21

Fentanyl causes cough in old smokers mostly. T or F

FALSE. youngs who dont smoke

22

narcotics can induce what

non-cardiogenic pulmonary edema

23

treatment of narcotic induced NCPE

naloxone, O2, ventilatory support

24

pulmonary eosinophilia is associated with what

nitrofurantion
para-aminosalicylic acid

25

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

pulmonary fibrosis

26

Amiodarone can cause

pulmonary fibrosis
pulmonary toxicity

27

time of onset PF with bleomycin

after 1st dose to 15 years later

28

management of drug induced PF

DC med
can add prednisone

29

rapidly progressive ARDS

pulmonary toxicity

30

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

Amiodarone

31

monitoring for a pt on amiodarone

PFTs and CXR at baseline
CXR every year
PFTs if symptomatic

32

treatment of pt with amio induced pulm tox

DC med
can add corticosteroids

33

anorexic agents (fenfluramine and dexfenfluramine and phentermine) can cause

pulmonary HTN

34

most common symptom of pulm HTN

exertional dyspnea

35

management pt with drug induced pulm HTN

DC drug

36

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

oxygen toxicity

37

excess oxygen does what

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

38

hyperoxia causes what in the lings

fibrosis