Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

pulmonary > pharm drug list > Flashcards

pharm drug list Flashcards

(63 cards)

Start Studying
1
Q

short acting beta agonist

A 
SABAs
albuterol (aka salbutamol)
levalbuterol
isoproterenol
terbutaline
epinephrine/ephedrine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

SABA purpose

A

rescue meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Long acting beta agonists

A 
salmeterol
formoterol
indacaterol
arformoterol
olodaterol
vilanterol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

LABAs purpose

A

some have a relatively fast onset and can reduce symptoms quickly but NOT a rescue medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

oral albuterol

A

oral syrups and tablets are available, but rarely used

  • slower onset <30 min peak effect 2-3 hours, duration 6-8 hours NOT a rescue med
  • more pronounced systemic side effects than inhalation due to large dose and systemic distribution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

albuterol inhalation

A

onset 5 min
both inhaler and nebulizer are rescue

peak action:
ventolin 25 min
nebulizer: 1-2 hrs

duration 4-6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

SABAs can be used alone

A

with mild intermittent asthma or in patients with exercise induced bronchoconstriction
-good for occasional symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

indications that asthma is not well controlled

A

needing rescue medication more than twice a week - means enhance the controller medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

frequent use of SABA or routine use of LABAs

A

can result in tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

frequent use and poor response to SABAs

A

can indicate poor adherence to controller or incorrect technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

rescue medications

A

rapid acting bronchodilators are appropriate for rescue and should be made available to all patients with asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

LABA box warning

A

can be useful in asthma as add on therapy to inhaled corticosteroids but should not be used as only controller therapy
-monotherapy increases risk of asthma related death and hospitalization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SAMA lists

A

ipratropium bromide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ipratropium dosing

A

quick action but not a rescue medication: onset 15 min
half life 1.6 hours/duration 4 hours
continuous treatment requires minimum of q6h dosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

indications for inhaled muscarinic antagonists

A

primary use: important bronchodilators in COPD

-some are approved as bronchodilators in asthma but are less effective than beta 2 agoinists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

side effects of muscarinic antagonists

A

due to quarternary ammonium structure if swallowed may cause constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Long acting muscarinic antagonists lists

A

tiotropium bromide
aclidinium bromide
umeclidinium bromide
glycopyrronium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

tiotropium

A 
LAMA
onset 60 min 
duration 24-48 hrs
peak 5-7 min 
half life 5-6 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

aclindinium

A

LAMA
longer acting than tiotropium
plasma half live of 5-8 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Phosphodiesterase inhibitor (non-specific) list

A

theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

theophylline side effects

A 
non-specific PDE inhibitor
is a methylxanthine
side effects:
CNS stimulation
bronchodilation
diuresis

compared with caffeine it causes less CNS stimulation and more bronchodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

tobacco and theophyllines

A

theophylline is metabolized by CYP1A2

tobacco induces CYP1A2

the typical half-life of theophylline is 8 hours in smokers it is 4.5 hrs -problems of toxicity occur when patient quits smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

theophylline toxicity reason

A

narrow therapeutic range (5-15 mg/L)

therapeutic index ED50/TD50 only 1 to 1.5 - toxic symptoms may occur at normal doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

theophylline toxic symptoms

A

Initial toxic symptoms: nausea/vomiting/abdominal pain, coarse muscle tremor.

Severe toxic symptoms: seizures, hypotension, and dysrhythmias.

If death occurs, usually due to intractable ventricular dysrhythmias.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
MOA theophylline
inhibits phosphodiesterase isozymes and blocks the degradation of cAMP to 5’-AMP.
26
MOA ipratropium and tiotropium
block the stimulation of muscarinic receptors by acetylcholine (ACh) released from the vagus nerves and thereby attenuates reflex bronchoconstriction. The effect of ACh is mediated by IP3-induced calcium release and leads to smooth muscle contraction.
27
PDE-4 inhibitors
roflumilast
28
roflumilast MOA
phosphodiesterase (PDE) enzymes degrades cAMP PDE-4 is a major isoform of PDE found in the lung tissue this is a PDE-4 inhibitor
29
roflumilast clinical role
prevent COPD exacerbation used after LAMA and LABA and ICS Very expensive
30
roflumilast adverse effects
like the leukotrene antagonists may be associated with neuropsychiatric effects -may decrease appetite/weight may cause nasuea and vomiting
31
oral/systemic corticosteroids ie glucocorticoids list
prednisone prednislone methylprednisolone dexamethasone
32
risk of long term system glucocorticodids
- infection risk - risk for developing diabetes, osteoporosis, weight gain, abnormal fat distribution - adrenal suppression (crisis) - hypertension - glaucoma, cataracts - restlessness/anxiety, insomnia/euphoria/psychosis - GI upset - hyperglycemia
33
use of systemic oral glucocorticoids
acceptable and often required for SHORT term use in asthma or COPD exacerbation -limit long term use
34
Inhaled corticosteroids list
beclomethasone, Triamcinolone, budesonide, fluticasone
35
inhaled corticosteroids are
the most effective controllers | -because with proper technique 20-30% of dose is deposited at the site of action
36
inhaled corticosteroids and the need for a rescue medication
inhaled corticosteroids exert a delayed onset of action. Acute exacerbations require “rescue” medication, and may require systemic glucocorticoids
37
ICS adverse effects
``` -thrush; candidias of the mouth/esophagus rinse mouth with water after use -dysphonia -throat irritation -URI -osteoporosis ```
38
rare but serious side effects of ICS
hypercortisolism, anaphylaxis, hypersensitvity reaction, raised intraocular pressure, penumonia
39
fluticasone
one of the most potent and most commonly ICS used 'flovent -when alone 'advair when in combination with salmeterol LABA
40
budesonide
the only FDA ICS for pregnancy | lowest oral bioavalibilty
41
triamcinolone
ICS lower potency than others, may requires more puffs to achieve moderate to high dose (3-4 per day)
42
properties of ICS
full response can take 8 weeks | -not started during exacerbation (systemic are helpful not inhaled during exacerbation)
43
regular use of ICS
Asthma symptoms nearly ---absent, and prevent progression. - Reduce bronchial hyper-reactivity. - Decrease airway mucus production. - Increase the number of bronchial beta2 receptors as well as their responsiveness to beta2 agonists.- this reverses the tolerance and maintain B2 effect
44
Degranulation inhibitors drug list
cromolyn | mast cell stabilizer
45
antibody therapy drug list
omalizumab
46
leukotriene inhibitor drug list
zileutin (a 5-lipoxygenase inhibitor) montelukast (leukotriene receptor antagonists) zafirlukast
47
cromolyn MOA
inhibits mast cell degranulation - prevents histamine release - reduce the release of inflammatory leukotrienes
48
cromolyn onset and use
onset may take 1-2 weeks full benefit 3-4 weeks for asthma, now only used by nebulizer (usually not used at all)
49
omalizumab MOA
IgE binders | binds IgE and prevents activation of mast cells and basophils
50
omalizumab limitations
only for refractory "allergic" asthma -eosinophilia EXPENSIVE and only administered in healthcare setting 3 injections in office for two hours
51
omalizumab only in health care settings reason
Should only be administered in a healthcare setting by providers who are prepared to identify and treat anaphylaxis -delayed hypersensitivity can occur (should dispense an epinephrine auto injector)
52
omalizumab dose and frequency
based on serum IgE levels | 300 mg injected SC every 2-4 weeks
53
omalizumab pharmacokinetics
degraded in liver - excreted in bile half life in 25 days peak time after single SC injection 8 days
54
montelukast MOA
cysLT1 receptor antagonists cysLT1 creates sustained bronchoconstriction, mucus secretion and edema.
55
montelukast in asthma
Prophylaxis and chronic treatment of asthma in patients 12 months of age and older. Once daily in the evening.
56
montelukast for EIB
Acute prevention of exercise-induced bronchoconstriction (EIB) in patients 6 years of age and older. Dose = once daily PRN, 2 hours before exercise.
57
montelukast for AR
Relief of symptoms of allergic rhinitis (AR): seasonal allergic rhinitis (SAR) in patients 2 years of age and older, and perennial allergic rhinitis (PAR) in patients 6 months of age and older. Once daily.
58
clinical role of leukoriene
Less effective than inhaled corticosteroids for asthma. An accepted asthma-controller medication alternative to ICS (or adjunct) in mild, persistent asthma. (people or parents that don’t want to or don’t want their kids to take a inhaled corticosteroid) receptor
59
montelukast clinical role
For allergic rhinitis usually combined with an antihistamine and/or intranasal glucocorticoid… - A “compelling indication” for patients with allergic asthma? - Leukotrienes are released from nasal mucosa in response to allergen exposure symptoms: sneezing, nasal itching, & congestion
60
zileuton MOA
inhibits 5-lipxygenase | only approved for asthma
61
drugs for TB
rifampin, isoniazid, ethambutol, pyrazinamide, and bedaquiline
62
Parameters to monitor when taking fluticasone
- Bone mineral density (at baseline and periodically thereafter) - Ocular changes (IOP, catatracts) - Signs/symptoms of oral/systemic infection - Hypercotrisolism for adrenal suppression
63
Parameters to monitor when taking a beta agonist (umeclidinium)
BP, HR, serum K+, glucose

pulmonary (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions