Phamacology Summer > Lower Respiratory Tract.pdf > Flashcards

Lower Respiratory Tract.pdf Flashcards

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1
Q

• Short Acting Beta Agonists (SABA)

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline

A

– albuterol/levalbuterol

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2
Q

• Long Acting Beta Agonists (LABA)

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline

A

– salmeterol/arformoterol

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3
Q

• Short Acting Muscarinic Antagonists (SAMA)

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline

A

ipratropium

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4
Q

• Long Acting Muscarinic Antagonists (LABA)

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline

A

– Tiotropium, Aclidinium

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5
Q

• PDE-4 Inhibitor/ Xanthine Derivative

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline
f. montelukast
g. Fluticasone, beclomethasone, budesonide
h. Cromolyn

A

– Theophylline

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6
Q

• Leukotriene Receptor Antagonist

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline
f. montelukast
g. Fluticasone, beclomethasone, budesonide
h. Cromolyn

A

montelukast

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7
Q

Corticosteroid

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline
f. montelukast
g. Fluticasone, beclomethasone, budesonide
h. Cromolyn

A

– Fluticasone, beclomethasone, budesonide

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8
Q

• Mast Cell Stabilizer

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline
f. montelukast
g. Fluticasone, beclomethasone, budesonide
h. Cromolyn

A

– Cromolyn

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9
Q

– ANTI-INFLAMMATORY

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline
f. montelukast
g. Fluticasone, beclomethasone, budesonide
h. Cromolyn

A

f. montelukast
g. Fluticasone, beclomethasone, budesonide
h. Cromolyn

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10
Q

– BRONCHODILATORS

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline
f. montelukast
g. Fluticasone, beclomethasone, budesonide
h. Cromolyn

A

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline

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11
Q

Bronchodilators

Prevent or treat Constriction
(Dilate the Lungs)

A

(Dilate the Lungs)

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12
Q

• Anti-inflammatory drugs

Prevent or treat Constriction
(Dilate the Lungs)

A

(Prevent or treat Constriction)

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13
Q

• Short-acting beta2 agonist (SABA) inhalers

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline
f. montelukast
g. Fluticasone, beclomethasone, budesonide
h. Cromolyn

A

a. albuterol/levalbuterol

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14
Q

• Long-acting beta2 agonist (LABA) inhalers

a. albuterol/levalbuterol
b. salmeterol/arformoterol
c. ipratropium
d. Tiotropium, Aclidinium
e. Theophylline
f. montelukast
g. Fluticasone, beclomethasone, budesonide
h. Cromolyn

A

b. salmeterol/arformoterol

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15
Q

MDI- Metered Dose Inhaler

a. Shake before use
b. No need to shake

A

– Shake before use

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16
Q

• DPI- Dry Powder Inhaler

a. Shake before use
b. No need to shake

A

– No need to shake

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17
Q

For Both Inhalers: Order

  1. Exhale first (not into the inhaler!
  2. Hold breath for 5 to 10 seconds to allow
    drug to be deposited in lungs
  3. Deep slow inhale 3 to 5 seconds, getting full amount of drug deep in lungs
A
  1. Exhale first (not into the inhaler!
  2. Deep slow inhale 3 to 5 seconds, getting full amount of drug deep in lungs
  3. Hold breath for 5 to 10 seconds to allow
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18
Q

For Both Inhalers: Fill

  1. Exhale ? (not into the inhaler!
  2. Deep slow inhale ? to ? seconds, getting full amount of drug deep in lungs
  3. Hold breath for ? to ? seconds to allow
A

first
3 to 5
5 to 10

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19
Q

When using same inhaler-

Wait ? to ? minutes between puffs

A

1 to 2

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20
Q

When using different inhalers

Wait ? to ? minutes

A

2 to 5

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21
Q

– Use the SABA ? an ICS- Inhaled Corticosteroid

A

before

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22
Q

– SABAs are ?

RESCUE
CHRONIC

A

RESCUE

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23
Q

– Long acting are meant for ? use

RESCUE
CHRONIC

A

CHRONIC

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24
Q

Which is True about Spacers

a. Can be used to help children inhale more of the drug.
b. Can be used to help reduce how much of an inhaled corticosteroid adheres to a patient’s mouth/oropharyngeal tract.
c. Slower to use.
d. Turns liquid drugs into a mist to be inhaled.
e. Different from inhalers
f. Mainly used for bronchodilators.

A

a. Can be used to help children inhale more of
the drug?
b. Can be used to help reduce how much
of an inhaled corticosteroid adheres to a patient’s

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25
– COVID-19, some providers are using ? heparin due to higher risk of clotting (PE risk) nebulized Spacers
nebulized
26
True about nebulizers? a. Can be used to help children inhale more of the drug. b. Can be used to help reduce how much of an inhaled corticosteroid adheres to a patient's mouth/oropharyngeal tract. c. Slower to use. d. Turns liquid drugs into a mist to be inhaled. e. Different from inhalers f. Mainly used for bronchodilators.
c. Slower to use. d. Turns liquid drugs into a mist to be inhaled. e. Different from inhalers f. Mainly used for bronchodilators.
27
``` SHORT ACTING- meant to prevent or treat asthma attacks. a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
a. albuterol/levalbuterol
28
acute asthma exacerbation a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
a. albuterol/levalbuterol
29
``` prevention of exercise induced bronchospasm a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
a. albuterol/levalbuterol
30
Bind to the BETA 2 receptor and activate it (agonist), this causes BRONCHODILATION- opens the airways and allows better oxygen exchange a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
a. albuterol/levalbuterol
31
``` • ADVERSE EFFECTS • Tachycardia/palpitations, angina • Tremors (skeletal muscle), excitability/nervousness • Throat irritation/hoarseness • Hypokalemia a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
a. albuterol/levalbuterol | b. salmeterol/arformoterol
32
``` NURSING CONSIDERATIONS – Patients should report any heart related effects (concern for chest pain/jaw pain) a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
a. albuterol/levalbuterol
33
``` USED TO TREAT Chronic usage a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
b. salmeterol/arformoterol
34
``` USED TO TREAT – Asthma + COPD a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
b. salmeterol/arformoterol
35
– ? ONLY- PRN rescue inhaler a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
Formoterol
36
``` MECHANISM OF ACTION – Agonists at beta-2 receptors. These have SLOWER onsets and LONGER durations a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
b. salmeterol/arformoterol
37
``` Adverse reaction – QTc prolongation= Torsades de Pointes a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
b. salmeterol/arformoterol
38
``` BOXED WARNING: – Increased risk for asthma related death when used as a monotherapy a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
b. salmeterol/arformoterol
39
This is NOT fast acting • Does NOT treat an asthma attack a. albuterol/levalbuterol b. salmeterol/arformoterol
b. salmeterol/arformoterol
40
• PREVENTS asthma attacks a. albuterol/levalbuterol b. salmeterol/arformoterol
b. salmeterol/arformoterol
41
``` Short-acting muscarinic antagonist(SAMA) inhalers a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
c. ipratropium
42
``` Long-acting muscarinic antagonist (LAMA) inhalers a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
d. Tiotropium, Aclidinium
43
``` bronchospasm with COPD/Asthma – alternative use for patients who cannot tolerate a SABA c. ipratropium d. Tiotropium, Aclidinium ```
c. ipratropium
44
– alternative use for patients who cannot tolerate a SABA c. ipratropium d. Tiotropium, Aclidinium
c. ipratropium
45
block muscarinic cholinergic receptors found in the bronchi, preventing bronchoconstriction c. ipratropium d. Tiotropium, Aclidinium
c. ipratropium
46
– Most common is dry mouth – Throat irritation/hoarseness c. ipratropium d. Tiotropium, Aclidinium
c. ipratropium | d. Tiotropium, Aclidinium
47
This drug is very rarely absorbed systemically • Constipation/ Urinary Retention/Nausea • rarely- increased heart rate, anticholinergic c. ipratropium d. Tiotropium, Aclidinium
c. ipratropium | d. Tiotropium, Aclidinium
48
CONTRA-INDICATIONS: Glaucoma, Benign Prostatic Hyperplasia c. ipratropium d. Tiotropium, Aclidinium
c. ipratropium | d. Tiotropium, Aclidinium
49
``` USED TO TREAT – Inhaler: Inhaler: Prevent COPD/Asthma attacks (requires chronic usage!) c. ipratropium d. Tiotropium, Aclidinium ```
d. Tiotropium, Aclidinium
50
MECHANISM OF ACTION: – block muscarinic cholinergic receptors found in the bronchi, preventing bronchoconstriction c. ipratropium d. Tiotropium, Aclidinium
d. Tiotropium, Aclidinium
51
Take time to see effect? c. ipratropium d. Tiotropium, Aclidinium
d. Tiotropium, Aclidinium
52
``` anticholinergics Can’t see, Can’t pee, Can’t spit, can’t **** a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
c. ipratropium | d. Tiotropium, Aclidinium
53
Very similar to CAFFEINE a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
e. Theophylline
54
``` USED TO TREAT – chronic COPD/Asthma a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
e. Theophylline
55
``` Increases alertness (may help with respiratory alertness in brain) a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
e. Theophylline
56
- Inhibits PDE-4 PHOSPHODIESTERASE? Theophylline Milrinone PENIS- Erectile Dysfunction -Viagra
Theophylline
57
PDE-3 CHF-? Theophylline Milrinone PENIS- Erectile Dysfunction -Viagra
Milrinone
58
PDE 4- COPD- ? Theophylline Milrinone PENIS- Erectile Dysfunction -Viagra
Theophylline
59
PDE-5 ? Theophylline Milrinone PENIS- Erectile Dysfunction -Viagra
PENIS- Erectile Dysfunction -Viagra
60
– This normally destroys cAMP – Means longer duration of bronchodilation Theophylline Milrinone PENIS- Erectile Dysfunction -Viagra
PENIS- Erectile Dysfunction -Viagra
61
Methyl-xanthine/Xanthine Derivatives: a. albuterol/levalbuterol b. salmeterol/arformoterol c. ipratropium d. Tiotropium, Aclidinium e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
e. Theophylline
62
• ADVERSE EFFECTS • Nausea/Vomiting, Anorexia, headache, dizziness • Increased Urination • palpitations, tachycardia, dysrhythmias e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
e. Theophylline
63
``` • ADVERSE EFFECTS Seizures e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
e. Theophylline
64
• ADVERSE EFFECTS • Known to cause Stomach Pain (epigastric pain) e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
e. Theophylline
65
``` • ADVERSE EFFECTS epigastric pain e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
e. Theophylline
66
``` narrow therapeutic index drug • Know the range 5-15 mcg/ml e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
e. Theophylline
67
Theophylline narrow therapeutic index drug • Know the range ?-? mcg/ml
5-15
68
``` USED TO TREAT: – Approved in pediatrics and adults! e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
f. montelukast
69
``` • USED TO TREAT: prevention of exercise induced bronchoconstriction – Asthma – Seasonal Allergies e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
f. montelukast
70
This is a pill, not an inhaler. e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
f. montelukast
71
MECHANISM OF ACTION: – blocks leukotriene receptors located in the lungs e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
f. montelukast
72
Leukotriene Receptor Antagonist: e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
f. montelukast
73
``` Headaches (18% of users) – neuropsychiatric events such as depression/anxiety/sleep disorders e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
f. montelukast
74
``` BOXED WARNING to this drug about NEUROPSYCHIATRIC EVENTS e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
f. montelukast
75
– Take in the evenings e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
f. montelukast
76
Take 2 hours prior to exercise e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
f. montelukast
77
f. montelukast – Take in the ? Take ? hours prior to exercise
– Take in the evenings | Take 2 hours prior to exercise
78
``` • USED TO TREAT INHALED (PREVENTION) – chronic COPD/Asthma e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
g. Fluticasone, beclomethasone, budesonide
79
``` • USED TO TREAT IV (TREATMENT) – for serious ASTHMA Attacks e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
g. Fluticasone, beclomethasone, budesonide
80
• USED TO TREAT Oral (STABILIZE) – send you home on this after the IV dose e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
g. Fluticasone, beclomethasone, budesonide
81
``` • USED TO TREAT NASAL Sprays – LOCAL in nose for seasonal allergies!- this won’t help asthma/COPD e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
g. Fluticasone, beclomethasone, budesonide
82
``` • ADVERSE EFFECTS • Oral Candidiasis- "Thrush" e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
g. Fluticasone, beclomethasone, budesonide
83
• ADVERSE EFFECTS – Just like all inhalers: Throat irritation, Reflex Cough/ Bronchospasm e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
g. Fluticasone, beclomethasone, budesonide
84
``` • ADVERSE EFFECTS • Bone Mineral Density loss e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
g. Fluticasone, beclomethasone, budesonide
85
``` • ADVERSE EFFECTS • Delayed Growth in children/adolescents e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
g. Fluticasone, beclomethasone, budesonide
86
Inhaled Corticosteroids: (ICS) e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
g. Fluticasone, beclomethasone, budesonide
87
NURSING CONSIDERATIONS – Always use your fast acting inhaler first – Wash out mouth to prevent “thrush” – Spacer- reduces risk thrush development – Monitor for the systemic absorption e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
g. Fluticasone, beclomethasone, budesonide
88
– Hyperglycemia- Diabetes e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
g. Fluticasone, beclomethasone, budesonide
89
USED TO TREAT: – Intended to decrease inflammation associated with allergic rhinitis (reduces sneezing, itching, runny nose) e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
Fluticasone
90
• Nasal spray- LOCAL EFFECT ONLY e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
Fluticasone
91
``` • USED TO TREAT: Only for allergy purposes » Much lower risk of adverse effects (don’t need to rinse nostrils out after use) e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
Fluticasone
92
``` – NOT FOR ASTHMA/COPD – Only for allergy purposes e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
Fluticasone
93
``` USED TO TREAT – Canada- Food Allergies – Systemic Mastocytosis – Asthma – Prevent EIB (Exercise Induced Bronchospasms) d. albuterol, levalbuterol e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
h. Cromolyn
94
Prevent EIB (Exercise Induced Bronchospasms) d. albuterol, levalbuterol e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn
h. Cromolyn | d. albuterol, levalbuterol
95
``` – prevention of exercise induced bronchoconstriction d. albuterol, levalbuterol e. Theophylline f. montelukast g. Fluticasone, beclomethasone, budesonide h. Cromolyn ```
f. montelukast
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