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Flashcards in Exam 2 respiratory Deck (37):
1

What is the association between nasal decongestants and epinephrine?

Decongestants are sympathomimetics and may enhance cardiac stimulation (tachycardia) and elevate BP

2

MOA for beta adrenergic agonists

targets beta 2 receptors in airway - bronchodilation

3

3 short acting beta adrenergic agonists

1. albuterol
2. levalbuterol
3. pirbuterol

4

2 long acting beta adrenergic agonists

1. salmeterol
2. salmeterol with fluticasone (Advair) - contains a steroid

5

2 diseases Advair treats

1. asthma
2. COPD associated with chronic bronchitis

6

Name of the "reserve" drug used for patients who new better asthma medications are ineffective

methylxanthines - treats chronic asthma, chronic bronchitis, COPD

7

MOA for methylxanthines

blocks phophodiesterase which increases cAMP

8

main preparation of methylxanthines

theophylline

9

4 side effects of theophylline

1. arrhythmias
2. tachycardia
3. seizures
5. GI effects

10

Why is theophylline considered a red flag drug in dentistry?

Causes CNS stimulation (nausea/vomiting), adverse cardiac effects, and increasing risk for seizures when mixed with certain antibiotics and or system antifungals

11

Specifically what antibiotics and antifugal cause a reaction when mixed with theophylline?

erythromycin
Cipro
clarithromycin
doxycycline
Antifungal = ketoconazole

12

Why are glucocorticoid medications used to manage asthma?

Reduce inflammation and decrease frequency and severity of asthma attacks

13

MOA for glucocorticoids treating asthma

reduce cytokine production and inhibit accumulation of basophils/eosinophils/leukocytes

14

What is the name of the 1st OTC intranasal steroid?

Nasacort

15

3 main dental considerations associated with inhalers

1. taste alterations
2. candidiasis
3. overuse can lead to hyper-reflexive airway

16

4 main dental considerations associated with steroids

1. candidiasis
2. susceptibility to infection
3. delayed wound healing
4. adrenal suppression

17

What chemical mediators produce a similar effect to histamine?

Leukotrienes (bronchoconstrictors)

18

Name 3 medications primarily used for seasonal allergies and are associated with leukotrienes

1. Accolate - blocks leukotriene receptors
2. Singulair - blocks leukotriene receptors
3. Zyflo - Inhibits leukotriene synthesis

19

MOA for anti-tussive medications

depresses cough center in medulla, chemical relative of morphine - lacks narcotic properties except in overdose

20

generic name for anti-tussive medications

dextromethorphan

21

generic name for expectorants?

guaifenesin

22

MOA for expectorants?

irritation of stomach while stimulating respiratory fluid (lubricates) decrease mucus viscosity

23

What drug may contribute to pulmonary disease is given too much?

Oxygen - may induce apnea/acute respiratory failure

24

What disease: recurrent bronchial SM spasm, inflammation, swelling of bronchial mucosa, hypersecretion of mucous?

Asthma - widespread narrowing of airways, decreased ventilation with increased airway resistance, and decreased expiratory outflow

25

What is the most common type of asthma and what causes it?

Extrinsic - inhaled seasonal allergens, seen in children and young adults, IgE mediated

26

Intrinsic asthma makes up 30% of cases, what is it associated with?

Endogenous causes like emotional stress or GERD, normal IgE levels

27

Besides extrinsic and intrinsic, what are 4 other types of asthma?

1. drug induced
2. food allergens
3. exercise induced
4. infectious asthma

28

5 common drugs that may induce asthma

1. ASA
2. NSAIDS
3. cholinergics
4, beta blockers
5. ACE inhibitors

29

What 3 things make up the aspirin hypersensitivity triad?

1. aspirin hypersensitivity
2. asthma
3. nasal polyps

30

MOA for aspirin allergy

inhibits bronchodilating PGE2 and the formation of leukotrienes

31

Name for persistent life threatening bronchospasm despite drug therapy/intervention?

Status Asthmaticus - attack lasts for more than 24 hours

32

In Status Asthmaticus, dyspnea, cyanosis, fall in systolic pressure with inspiration all occur, what are 4 end points?

1. exhaustion
2. severe dehydration
3. peripheral vascular collapse
4. death without intervention

33

6 symptoms of asthma

1. shortness of breath
2. wheezing
3. expanded chest
4. sinusitis
5. failure to grow
6. thick stringy mucous

34

If you get asthma attacks about twice a week, what classification would that be?

Moderate (mild = only when exposed to trigger, and severe = frequent or ongoing)

35

medication for mild persistent asthma

anti-inflammatory drug with low dose inhaled corticosteroid

36

What level of asthma would get one medium dose of inhaled corticosteroid or 2 daily medications

Moderate persistent asthma

37

What level of asthma would get daily high dose inhaled corticosteroids with long acting bronchodilator?

severe persistent asthma