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Flashcards in Pharm 4 Resp pt5 Deck (17)
1

Someone has Asthma and COPD. What’s the ideal inhaler?

MDI containing Albuterol + Ipratropium Bromide (an anticholinergic)

2

Prototypical Anticholinergic
Example
Indications

Ipratropium Bromide
Indications: Bronchospasm associated with chronic bronchitis and emphysema (COPD)

3

**With the rise of peanut, soy, lecithin allergies rising which drug is contraindicated?

Ipratropium Bromide.

4

What allergies contraindicate Ipratropium Bromide? (3)

soy, peanut, lecithin (a thickening agent used in cooking, baking ..used in chocolate. Ask if they are allergic to chocolate)

5

Indication of ORAL steroids
What patient would go on these?

Bronchial asthma, including status asthmaticus not responsive to inhaled steroids; can be a quick relief medication or for chronic therapy
The patient who goes on these: a 50 pack of cigarettes/year.

6

What does GOLD stand for?

GOLD: global obstructive lung disease guidelines

7

Prototypical Inhaled Corticosteroid
Example
Indication

Fluticasone
Indications: maintenance treatment of asthma as prophylactic therapy; to reduce the need for systemic corticosteroids

8

Fluticasone
Contraindications, Precautions, Side Effects

Not for treatment of primary attack
Caution in drugs that lower K+, maintain regular regimen
If exposed to chicken pox, measles, consider prophylaxis
Avoid MAOIs, TCAs w/in 14 days
Pregnancy Cat. C (breathing takes priority)
Rinse mouth after use
Monitor digoxin, for growth suppression in peds, hypercorticism, HPA axis suppression
Antagonized by -blockers
Adverse reactions include pharyngitis, rhinitis, dysphonia, URI, bronchospasm

9

Prototypical Systemic IV Corticosteroid
Example
Indications

Methylprednisolone (IV)
Indications: steroid responsive disorders, including bronchospasm

10

any acute disease that has an inflammatory/allergic component: __ will likely help it.

Steroids aka Glucocorticoids aka Methylprednisolone

11

*common global long-term side effects of systemic steroids (3)

Cataracts, Osteopenia, Osteoporosis

12

Methylprednisolone's IV form has no faster onset of action than oral form, but preferable in acute exacerbations because (2)

hazards of vomiting, inability of patient to take PO meds while undergoing continuous nebulizer treatments (if kids are wheezing badly, they can't swallow a pill)

13

Prototypical Systemic ORAL Corticosteroid

Methylprednisolone
Indications: steroid responsive disorders, including bronchospasm
(same as the systemic iv info)

14

Methylprednisolone
Contraindications, Precautions, Side Effects

Precautions: ocular herpes simplex (they’ll lose their eyesight), renal insufficiency, TB, diabetes (sugar will go up)
Avoid abrupt discontinuation (taper
May cause/worsen glaucoma, electrolyte imbalances, psychic disorders (roid rage

15

Prototypical Leukotriene Receptor Antagonist
Example
Indication

Monoleukast (Singulair®)
Indications: Prophylaxis and chronic treatment of asthma
(taken in the evening)

16

Probably one of the most underused and lowest side-effect profile bronchospastic drugs available as an adjunct therapy

Leukotriene Receptor Antagonist - Monoleukast

17

Leukotriene Receptor Antagonist - Monoleukast
Contraindications, Precautions, Side Effects

Very few drug-drug interactions. The ones that exist are pretty inconsequential.
Not for primary treatment of acute attack, monotherapy in exercise-induced asthma