Pharmacology Flashcards
(47 cards)
1
Q
What are the 4 administration techniques for asthma medications?
A
MDI (meter dose inhaler) Nebulizer (liquid med in machine) Inhaled powder (rotacaps, disc-inhaler) Systemic admin (ora or parenteral routes IV, IM, SQ)
2
Q
Albuterol, Proventil, Ventolin Class MOA Onset/duration Route
A
Class: SABA
MOA: bronchodilator
Onset: 15 min before activity or for acute attacks
Duration: 4-6 hours
Route: inhalation (can do IV but no advantages)
3
Q
How do the sympathomimetics bronchodilators (beta-2 agonists) work?
A
- produce airway dilation
- vasodilation of smooth muscle in lungs!!!
- improve mucocilliary transport
- stimulate beta-andrenergic receptors
4
Q
What are the SABA used for?
A
- prevention of exercise induced bronchospasm (asthma)
- help with ACUTE attacks
- inhibit smooth muscle contraction
5
Q
What are the LABA used for?
A
Maintenance medication
inhibit smooth muscle contraction
NOT for acute attacks
Do NOT use alone, need to use with ICS
6
Q
Levalbuterol (Xopenex) Class MOA Onset/duration Route
A
class: SABA MOA: bronchodilator --inhibit smooth muscle contraction Onset: less than 5 min Duration 6-8 hours Route: nebulizer
7
Q
Salmeterol (Serevent) Class MOA Onset/duration Route Uses
A
Class: LABA MOA: bronchodilator --inhibit smooth muscle contraction Onset: 20 min Duration: 12 hours Route: diskus Uses: asthma/bronchospasm
8
Q
Formoterol (Foradil) Class MOA Onset/duration Route Uses
A
Class: LABA MOA: bronchodilator--inhibit smooth muscle contraction Onset: 20-30 min Duration: 12 hours Route: inhaler Uses: asthma
9
Q
Ipratropium (Atrovent) Class MOA Onset/duration Route Uses
A
Class: anticholinergic MOA: anticholinergic, reverses acetylcholine-induced bronchospasm (inhibiting parasympathetic nervous system) --inhibit smooth muscle contraction Onset: ? Duration: Q6 Route: inhaler Uses:bronchospasm for COPD
10
Q
Parasympathetic vs. sympathetic in asthma. What does what and what are you inhibiting/stimulating?
A
Parasymphathetic = constricts the airway, so want to inhibit acetylcholine
Sympathetic = opens the airways, so you want to stimulate the beta-2 receptors
So: either can stimulate sympathetic and or inhibit the parasympathetic
11
Q
Tiotropium (Spiriva) Class MOA Onset/duration Route Uses
A
Class: anticholinergic MOA: reverses acetylcholine induced bronchospasm (parasymp)--inhibit smooth muscle contraction Onset: ? Duration: 24 hours Route: diskus Uses: bronchospasm w/ COPD
12
Q
Theophylline (Theo-Dur) Class MOA Route Uses Monitoring
A
Class: methylxanthine
MOA: prevents and/or reverse inflammation
Route: liquids, tablets, capsules
Uses: maintenance therapy -moderate–severe asthma, COPD
Monitoring: small TI, blood draws, can be toxic
13
Q
Fluticasone (Flovent) Class MOA Onset/duration Route
A
Class: ICS
MOA: prevent, reverse inflammation
Onset/duration: 2-4 weeks
Route: inhaler
14
Q
Budesonide (Pulmicort) Class MOA Onset/duration Route
A
Class: ICS
MOA: prevent, reverse inflammation
Onset/duration: 2-4 weeks
Route: Flexhaler, (nebulizer for kids)
15
Q
Beclamethasone (Vanceril, Beclovent, QVAR) Class MOA Onset/duration Route
A
Class: ICS
MOA: reverse, prevent inflammation
Onset/duration: 2-4 weeks
Route: inhaler
16
Q
Thiamcinolone (Azmacort) Class MOA Onset/duration Route
A
Class: ICS
MOA: reverse, prevent inflammation
Onset/duration: 2-4 weeks
Route: inhaler
17
Q
Flunisolide (Aerobid) Class MOA Onset/duration Route
A
Class: ICS
MOA: reverse, prevent inflammation
Onset/duration: 2-4 weeks
Route: inhaler
18
Q
Advair (salmeterol + fluticasone) Class MOA Onset/duration Route
A
Class: LABA + ICS
MOA: reverse, prevent inflammation and smooth muscle relaxation
Onset/Duration: maintence med
Route: diskus
19
Q
Dulera (mometasone + formoterol)
Class
Onset/duration/uses
Route
A
Class: ICS + LABA
Used: maintenance med
Route: inhaler
20
Q
Symbicort (budesonide + formoterol)
Class
Use
Route
A
Class: ICS + LABA
Used: maintenance med
Route: inhaler
21
Q
Combivent (Ipratropium + albuterol)
Class
use
route
A
Class: ATC + SABA
Use: maintenance med
Route: inhaler or nebulizer
22
Q
Cromolyn (Intal) Class MOA Onset/duration Route used
A
Class: mast cell stabilizer (MCS) MOA: prevent, reverse inflammation Onset/duration: 4-6 weeks Route: nasal or nebulizer used: prophylaxis
23
Q
Nedocromil (Tilade) Class MOA Onset/duration Route used
A
Class: MCS MOA: prevent, reverse inflammation Onset/duration 4-6 weeks Route: inhalation and neb used: prophylaxis
24
Q
What do MCS prevent?
A
release of inflammatory mediators (histamine) from mast cells, macrophages, neutrophils, and eosinophils
25
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Montelukast (Singulair)
Class
MOA
Onset/duration
Route
CI
```
```
Class: Leukotriene inhibitor
MOS: competitive agonist of leukotriene receptors = prevent, reverse inflammation
Onset/duration: 1-3 hours
Route: po
CI: p-450 inhibitor!!!!
```
26
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Asfrilukast (Accolate)
Class
MOA
Onset/duration
Route
```
Class: leukotriene inhibitor
MOA: competitive agonist of leukotriene receptors = prevent, reverse inflammation
Onset/duration: 1-3 hours
Route: po
27
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Zileuton (Zyflo)
Class
MOA
Onset/duration
Route
```
```
Class: BLOCKS leukotriene production
MOA: blocks leukotriene production
onset/duration: 1-3 hours
route: pa
REMEMBER that this med, still is a leukotriene inhibitor, but it BLOCKS the production of leukotrienes, while the other two are competitive antagonists
```
28
Diphenhydramine (Benadryl), Atarax
Class
Indications
AE
Class: 1st gen antihistamine (more cross BBB and produce more sedation and other CNS effects)
Indications: Type I allergies = urticaria, pruritus, conjunctivitis, angioedema, sneezing, rhinorrhea
AE: drowsiness, anticholinergic effects
29
What are anticholinergic effects?
no shit, spit, pee, see
| dry mouth, blurred vision, urinary hesitancy, constipation, confusion, mental cloudiness
30
Loratadine (Claritin)
Class
Indications
AE
Class: 2nd generation antihistamine
Indications: itching, sneezing, rhinorrhea, long-lasting, non-drowsy (seasonal AR)
AE: anticholinergic effects (less than 1st generation)
31
Fexofenadine (Allegra)
Class
Indications
AE
Class: 2nd generation antihistamine
Indications: itching, sneezing, rhinorrhea, long-lasting, non-drowsy (seasonal AR)
AE: anticholinergic effects (less than 1st generation)
32
Cetirizine (Zyrtec)
Class
Indications
AE
Class: 2nd generation antihistamine
Indications: itching, sneezing, rhinorrhea, long-lasting, non-drowsy (seasonal AR)
AE: anticholinergic effects (less than 1st generation)
33
Pseudoephedrine (Sudafed) oral (wean 7-10 days)
Pseudoephedrine (Afrin) intranasal (not used over 3 days)
Class
MOA
SE
CI
Class: nasal decongestant
MOA: alpha-adrenergic agonist-- vasoconstriction to nasal mucusa (no help with itching, sneezing or nasal secretion)
SE: HA, Nervousness, irritability, tachy, palpitations, insomina
CI: HTN, CVD, Hyperthyroidism, glaucoma, CO USE WITH MAOIs = malignant HTN
34
Fexofenadine and pseudo (Allegra-D)
Class
SE
Class: 2nd gen antihistamine, nasal decongestant
non-sedating
SE: (from decongestant = HA, nervousness, irritability, tachy, palpitations, insomnia)
35
Loratadine and pseudo (Claritin-D)
Class
SE
Class: 2nd gen antihistamine, nasal decongestant
non-sedating
SE: (from decongestant = HA, nervousness, irritability, tachy, palpitations, insomnia)
36
Cetirizine and pseudo (Zyrtec-D)
Class
SE
Class: 2nd gen antihistamine, decongestant
non-sedating
SE: (from decongestant = HA, nervousness, irritability, tachy, palpitations, insomnia)
37
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Cromolyn sodium ( Nasalcrom)
Class
MOA
effects
use
```
Class: MCS--reduces release of histamine and other mediators
Efffects: reduces nasal pruritus, sneezing,rhinorrhea and congestion
use: intranasal spray
prophylactic use (q4 hours) good when don't want to use steroids
38
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Fluticosone proprionte (Flonase)
Class
MOA
Effects
Onset
AE
```
Class: intranasal glucocorticoid
MOA: effective for inflammation of AR -- interfere with ag-ab reaction reducing mast cell degranulation, inflammation, mild vasoconstrictor, reduce intracellular edema, suppress neutrophil chemotaxis
Effects: reduce nasal blockage, pruritus, sneezing, rhinorrhea
Onset: 1-3 days, up to 3 weeks
AE: nasal irritation/bleeding, septum perforation
39
```
Mometason (Nasonex)
Class
MOA
Effects
Onset
AE
```
Class: intranasal glucocorticoid
MOA: effective for inflammation of AR -- interfere with ag-ab reaction reducing mast cell degranulation, inflammation, mild vasoconstrictor, reduce intracellular edema, suppress neutrophil chemotaxis
Effects: reduce nasal blockage, pruritus, sneezing, rhinorrhea
Onset: 1-3 days, up to 3 weeks
AE: nasal irritation/bleeding, septum perforation
40
```
Beclomethasone diproprionate Aqueous (Beconase)
Class
MOA
Effects
Onset
AE
```
Class: intranasal glucocorticoid
MOA: effective for inflammation of AR -- interfere with ag-ab reaction reducing mast cell degranulation, inflammation, mild vasoconstrictor, reduce intracellular edema, suppress neutrophil chemotaxis
Effects: reduce nasal blockage, pruritus, sneezing, rhinorrhea
Onset: 1-3 days, up to 3 weeks
AE: nasal irritation/bleeding, septum perforation
41
```
Budesonide (Rhinocort, Rhinocort Aqua)
Class
MOA
Effects
Onset
AE
```
Class: intranasal glucocorticoid
MOA: effective for inflammation of AR -- interfere with ag-ab reaction reducing mast cell degranulation, inflammation, mild vasoconstrictor, reduce intracellular edema, suppress neutrophil chemotaxis
Effects: reduce nasal blockage, pruritus, sneezing, rhinorrhea
Onset: 1-3 days, up to 3 weeks
AE: nasal irritation/bleeding, septum perforation
42
```
Flunisolide (Nasarel)
Class
MOA
Effects
Onset
AE
```
Class: intranasal glucocorticoid
MOA: effective for inflammation of AR -- interfere with ag-ab reaction reducing mast cell degranulation, inflammation, mild vasoconstrictor, reduce intracellular edema, suppress neutrophil chemotaxis
Effects: reduce nasal blockage, pruritus, sneezing, rhinorrhea
Onset: 1-3 days, up to 3 weeks
AE: nasal irritation/bleeding, septum perforation
43
```
Triamcinolone acetonide (Nasacort AQ, Nasacort, Trinasal)
Class
MOA
Effects
Onset
AE
```
Class: intranasal glucocorticoid
MOA: effective for inflammation of AR -- interfere with ag-ab reaction reducing mast cell degranulation, inflammation, mild vasoconstrictor, reduce intracellular edema, suppress neutrophil chemotaxis
Effects: reduce nasal blockage, pruritus, sneezing, rhinorrhea
Onset: 1-3 days, up to 3 weeks
AE: nasal irritation/bleeding, septum perforation
44
```
Ipratroprium Bromide (Atrovent) intranasal and Nontelukast (Singular)
what do these meds also do?
```
Atrovent reduces release of substance P, good for runny nose
singulair is not first line therapy, but helps with runny nose and congestion
both are ok if pts not getting relief from INGC
45
Azelastine (Optivar)
Class
MOA
use
Class: MCS
MOA: inhibits histamine release from mast cells
Use: eye allergies
46
Oloptadine (Patanol)
Class
MOA
Use
Class: MCS
MOA: inhibits histamine release from mast cells
Use: eye allergies
47
Naphazoline/pheniramine (Opcon-A)
Class
MOA
Uses
Class: naphazoline is sympathomimetic which decreases congestion
pheniramine is a antihistamine MCS
Used: eye allergies
