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Module 3: Mali: Pulmonary > pharm chart > Flashcards

pharm chart Flashcards

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1
Q

what drug class does fluticasone belong to?

A

anti-inflammatory: inhaled glucocorticoid

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2
Q

what is the MOA of fluticasone?

A

decrease smooth muscle irritability, anti-inflammatory, immunosuppresive, and anti-proliferative activity

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3
Q

what is the indications for fluticasone?

A

asthma primarily, but also COPD

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4
Q

what are SE of fluticasone?

A

thursh, URI, throat irritation

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5
Q

what are contras for fluticasone?

A

latent TB
gluacoma
cataracts

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6
Q

what interesting thing do you need to monitor in fluticasone?

A

growth in children

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7
Q

what is the long term prophylaxis use of fluticasone?

A

bronchspasm

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8
Q

what is interesting about the use of fluticasone in children?

A

may cause slow 1st growth year, but they can catch up if they discontinue use, and risne mouth after to prevent thrush

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9
Q

what is the benefit of using budesonide (pulmocort inhalers) [I think a subset of fluticasone]?

A

it is less systemically absorbed

this was in the interesting column of the drug table under fluticasone and blessington said it was something we should know…so KNOW IT

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10
Q

what drug class does prednisone belong to?

A

anti-inflammatory: oral glucocorticoid

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11
Q

what is the MOA of prednisone?

A

decrease smooth muscle irritability and anti-inflammatory

decreases migration of WBC, reverses capillary permeability, immunosuppressany

later onset of inhibition of protein synthesis in nucleus of cell

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12
Q

what is the indication for prednisone?

A

adjunct therapy in exacerbation of bronchospasm; many others…duh, its prednisone

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13
Q

when do you worry about systemic side effects from prednisone?

A

10-14 days of use

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14
Q

what are contras for prednisone?

A

latent TB, glaucoma, catarcts

duh, same as fluticasone because they are both anti-inflammatory gluccocorticoid, one is inhalled and one is PO

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15
Q

what can the oral or IV prednisone be used as a “short burst” treatment for? (3 things)

A

bronchospasm
asthma
COPD

DONT USE LONG TERM!!!

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16
Q

what drug class does cromolyn MDI belong to?

A

anti-inflammatory mast cell stablizer

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17
Q

what is the MOA of cromolyne MDI?

A

decrease smooth muscle irritability, stabalizes the mast cell membrane to prevent degranulation and release of histamine, leukotrienes

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18
Q

what is the indication for cromolyn MDI?

A

childhood asthma

this works better in children that adults….so use for children! duh

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19
Q

what are the SE of cromolyn MDI?

A

headache, unpleasent taste

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20
Q

what is the contraindications for cromolyn MDI?

A

acute asthma

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21
Q

what is the PO route of cromolyn MDI being investigated for?

A

food allergy, IBD

Not there yet, just investigating

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22
Q

what is the drug class for zafirlukast?

A

anti-inflammatory oral leukotriene receptor antagonist

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23
Q

what is the MOA for zafirlukast?

A

decrease smooth muscle irritability, selective and competitive antagonist of leukotriene receptors D4 and E3, slow reacting substance of anaphylaxsis

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24
Q

what is the indication of zafirlukast?

A

asthma

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25
what are contra associated with zafirlukast?
caution with alocholic cirrosis
26
what should you not take with zafirlukast?
FOOD it decreases the bioavaliabiltiy by 40% wow thats a lot
27
when should you not start this medication?
don't start during an acute exacerbation, but can continue it if already on it
28
how is zafirlukast used?
as a long term prophylatic type of med
29
what is the drug class for salmeterol?
bronchodilators: inhaled long acting Beta2 adrenergic agonists
30
what is the MOA of salmeterol (LABA)?
selective, long-acting beta2 adrenergic agonist
31
what are 3 side effects experience by those on salmetrol (LABA)l?
muscle pain, anxiety, insomnia
32
what are the drug to drug intereactions with salmetrol (LABA)?
increases diuretics, CYP34A inhibitors decreased bet beta blockers
33
salmetrol has a ______
BLACK BOX WARNING!!!! AHHHH
34
what are the two LABA drugs?
salmeterol | formoterol
35
what form is salmeterol administered in?
DRY POWDER INHALER **make sure to rinse mouth after***
36
what should you consider or know about with LABA drugs?
asthma deaths CVD outcomes discouraged in excercise induced bronchospasm
37
what is the drug class for formoterol?
bronchodilators: inhaled long acting beta2 adrenergic agonist
38
what is the MOA of formoterol?
long acting beta2 agonist
39
what is the indication for formoterol?
long term control of COPD, asthma with steroid meter inhaler
40
what are SE of formoterol? (6)
``` tremors chest pain palpitations anxiety insomnia muscle cramps ```
41
what are the drug-drug interactions of formoterol?
increase loop diuretics | decreased by beta2 blockers
42
what do you need to monitor in LABA drugs?
glucose
43
what two inhaled forms does this come in?
dry powder inhaler and nebulizer
44
what do you not want to use formoterol in?
asthma deaths CVD exercise induced bronchospasm
45
what is the drug class for albuterol?
bronchodilators: inhaled short-acting beta2 adrenergic agonist SABA
46
what is the MOA of albuterol?
bronchial smooth muscle beta2 (sympathetic) receptor stimulation, racemic mixture with active R isomer
47
what is the indication for albuterol?
acute bronchospasm in asthma and COPD, pre-exercise excercise induced bronchospams
48
what are the SE of albuterol? (7)
``` angina BP changes arrythmias palpations CNS stimulation restless,wakefulness angioedema ```
49
what patient disorders do you need to be cautious in when prescribing albuterol? (7)
HTN, CHF, seizure disorder, diabetes, glaucoma, LOW serum K, hypothyroidism
50
what is contraindicated for in patient taking albuterol?
Beta blockers dont' use these two together
51
what formulations does albuterol come in?
oral, nebulizer, IV, spacer
52
when using albuterol in prohphylaxis, what other drug do you want to combine it with?
anti-inflammatory agent for long term use other than mild asthma
53
does asthma tolerance develop when using albuterol?
YES.... so remember that!!
54
what drug class does theophyline belong to?
bronchodilators: PDE inhibitor/methlxanthine
55
what is the MOA of theophyline?
PDE blockade causes increased levels of cAMP which produces bronchdilation, diuresis, DNA and cardiac stimulation, and release of epinephrine
56
what is the indication of theophyline?
reversal of bronchospasm
57
what are three SE of theophyline?
tachy, insomnia, seizuers
58
what are four contraindications for theophyline?
CVD, HTZ, HYPERTHYROIDSM, peptic ulcer disorder and seizure disorder
59
what are contras for theophyline? (2...thing systems)
1. CYP1A2 (increases level) | 2. CYP34A drugs
60
what do you need to measure when taking theophyline?
theophyline levels! woah thats hard
61
what is a caution when using theophyline? what can the toxicity of this include?
NARROW therapeutic index, if toxic amounts are reached can cause persistent vomiting and agitations
62
what is the drug class for levalbuterol?
bronchodilators: inhaled beta2 adrenergic agonist (SABA)
63
what ist eh MOA of levalbuterol? which form of the drug do we use?
rapid acting selective beta2 receptor agonist counteracts bronchospasm, PURE R ISOMER FORM
64
what are the SE of levalbuterol?
temors rhinitis VIRAL INFECTION PHARYNGITIS
65
what should you not use levalbuterol in?
active heart disease!
66
what are the drug interactions with levalbuterol? (4)
increase loop diuretics sympathmimetics decreased by beta blockers combination alpha/beta blocker
67
what forms does levalbuterol come in?
nebulizer and inhaler forms
68
is levalbuterol more or less expensive than albuterol?
MORE EXPENSIVE!!!
69
what do you use levalbuterol in conjunction with?
anti-inflammatory agent for long term use for other than mild asthma or exercise induced bronchospasm (EIB)
70
what is the drug class for ipratropium?
bronchodilators: inhaled anticholinergic
71
what is the MOA of ipratropium?
blocks acetylcholine cholinergic receptors in bronchial smooth muscle to reduce bronchospasm (short term)
72
what is the indication for ipratropium?
acute and maitenance TX of bronchospasm in COPD or asthma **those that haven't responded to beta 2 adenergic agents for asthma control**
73
what are the SE of ipratropium?
URI, chest pain, dyspepsia, xerostomia, FLU-like syndrome
74
what are the contraindications for ipratropium?
NARROW ANGLE glaucoma paradoxical bronchspasms, URINARY TRACT OUTFLOW OBSTRUCTION
75
what does ipratropium decrease the effects of?
acetylcholinesterase inhibitors
76
what is the dose for the ipratropium?
17 mcg/inh
77
what is ipratropium the first line treatment for?
COPD
78
what is the drug class for tiotropium?
bronchodilators: inhaled long acting anticholinergic
79
what is the MOA of tiotropium?
blocks acetylcholine at parasympathetic receptors in bronchial smooth muscle producing bronchodilation
80
what is the indication of tiotropium?
maitenance TX in bronchospasm in COPD, asthma
81
what are the SE of tiotropium?
URI, chest pain, palpitations, dyspneia, xerostoma, flu-like symptoms
82
what are the contra indications of tiotropium?
bronchospasm, narrow angle glaucoma, urinary tract flow obstruction
83
what does tiotropium interact with for drugs?
decreases effect of acetylcholinesterase inhibitors
84
how many more times potent is tiotropium than ipratropium?
10 times as strong!!!
85
what is tioptropium used for first line treatment? when is this treatment appropriate?
first line treatment of COPD when its not reacting to Beta2
86
what is the drug class for umeclidinium and vilanterol?
combination inhaled long-acting anticholingeric and LABA
87
what is the MOA of umeclidinium and vilanterol?
combination of bronchodilating agents, anti-muscarinic and beta2 agonism
88
what is the indication ofr umeclidinium and vilanterol?
COPD!!!
89
what patients should you not prescrive umeclidinium and vilanterol?
SEVERE MILK PROTEIN ALLERGY prostatic hyperplasia low K diabetes
90
what do you need to monitor when taking umeclidinium and vilanterol? (3)
FEV1 peak flow, CNS stimulation, eye changes
91
what is the half life of umeclidinium and vilanterol?
11 hours
92
what is the drug class for fluticasone/salmeterol HFA MDI
combination product inhaled glucocorticoid and LABA (beta2 agonist)
93
what is the MOA of fluticasone/salmeterol HFA MDI?
anti-inflammatory action of steroid and bronchodilation actvitiy of Beta2 agonist
94
what is the indication for fluticasone/salmeterol HFA MDI?
asthma (maitenance of bronchodilation)
95
what is a interesting thing you need me measure when a patient is on fluticasone/salmeterol HFA MDI
growth velocity in children
96
what is a real caution with fluticasone/salmeterol HFA MDI?
BLACK BOX WARNING re asthma-related death
97
what is the drug class of ipratropium/albuterol
combination product inhaled anticholingeric/beta2 adrenergic agonist (SABA) bronchodilators
98
what is the MOA of ipratropium/albuterol ?
anticholingeric and beta2 agonist bronchodilating mechanisms
99
what is the indication for ipratropium/albuterol
COPD patients requiring two bronchodilators?
100
what is the drug class for budesonide/formterol?
inhaled corticosteroid/beta2 adrenergic agonist (LABA) bronchodilators
101
what is the MOA of budesonide/formterol?
anti-inflammatory steroid and bronchodilation activity of Beta2 agonist
102
what is the indication for budesonide/formterol?
maitenance of asthma and COPD
103
what do you need to monitor when taking budesonide/formterol?
growth velocity in children/
104
what is the advantage of taking budesonide/formterol over fluticasone?
it is less systemically absorbed
105
what do you need extreme caution when using budesonide/formterol
BLACK BOX WARNING, ASTHMA RELATED DEATHS
106
what is the drug class for roflumilast?
phosphodiesterase-4 inhibitor antiinflammatory
107
what is the MOA of roflumilast? (4 unique things0
inhibits BDE4 increasing cAMP in inflammation and cells supress cytokine release inhibit lung infiltration by WBC decreases pulmonary remodeling in COPD
108
what is the indication for roflumilast?
adjunct therapy in COPD (chronic bronchitis)
109
what drug interactions do you need to caution in roflumilast?
CYP34A inducers decrease [ ] cipro increase [ ] rifampin decreases [ ]
110
when do you ONLY use roflumilast?
ADJUNCT TO BRONCODILATOR ONLY, NOT USED ON ITS OWN!!!
111
do you take roflumilast with or without food
EITHER....happy day
112
what is the drug class for omallizumab?
antibody agents: anti IgE antibody; immunomodulator
113
what is the MOA of omallizumab?
binds IgE antibody receptors on mast cells, blocks IgE antibody from activating it and degranulating
114
what is the indication for omallizumab?
maitenance tx allergic asthma not controlled by inhaled steroids
115
what is one thing you need to be cautious of when using omallizumab?
ANAPHYLAXSIS
116
how is omallizumab administered?
SQ ONLY Q 2-4 WEEKS
117
what are the four forms that nictoteine replacement can come in?
nicroderm patch nicroette gum nictrol inhaler nicotrol nasal spray
118
what is the MOA of nicoteine replacements? what is the difference between the low and high dose treatment?
Biphasic CND and ANS nicotine receptor stimulant low dose: stimulation ANS ganglia Large dose: stimulation folowed by blockage of transmission
119
what is the indication of nicotine replacement?
tabacco cessation aid
120
what is the SE of nicotine replacement? (7)
``` mucosal irritation cough rhinitis tremors respiratory EXCITATION convulsions RESPIRATORY FAILURE ```
121
what are 4 contras for nicotine replacement?
AMI life threatening arrythmias T1DM TMJ disorder
122
what drug increases the effect of nicotine replacement?
cimetidine
123
what do you want to monitor in a patient takine nicotine replacement?
insomnia
124
can you use more than one formulation of nicotine replacement?
YES
125
what is the drug class for varenicline?
partial nicotine agonist oral
126
what is the MOA for varenicline?
prevents nicotine stimulation of the mesolimbic dopamine system
127
what is the indication for varenicline?
smoking cessation aid
128
what is the SE of varenicine?
ABNORMAL DREAMSS!!!! nausea
129
what are the contras for varenicline? (3)
psychiatric disorders, decreased renal function, active CVD
130
what should you monitor when taking varenicline?
psych changes
131
what is one major caution of varenicline?
BLACK BOX WARNING; psychiatric events, depression, suicide, and agitation be reall careful who you prescribe this in!
132
what is the dosing regiment for varenicline?
5. mg 1x daily 1 mg 2x daily for 11 weeks with addition 12 weeks if needed
133
what is the drug class for bupropion?
atypical antidepressant, oral dopamine reuptake inhibitor
134
what two other names is bubpropion called for marketing purposes?
wellbrutin | zyban
135
what is the MOA bupropion?
unknown MOA woah that's werid, but it just works!!
136
what are four contraindications for a patient taking bupropion?
1. BIPOLAR DISORDER 2. SEIZURE DISORDER 3. active CVD 4. uncontrolled HTZ
137
what do you not want to take bupropion with?
ethanol
138
what is a major caution when taking bupropion?
BLACK BOX WARNING FOR DREPRESSION AND SUICIDAL THOUGHTS!!!
139
what is the order of drugs you want to use when trying to help a patient quit smoking?
1. nicotine replacement 2. bupropion 3. varenicline

Module 3: Mali: Pulmonary (3 decks)

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