Pharmocology Test 3 Flashcards Preview

Pharmocology > Pharmocology Test 3 > Flashcards

Flashcards in Pharmocology Test 3 Deck (61)
Loading flashcards...
0
Q

Ipratropium bromide

A

Atrovent-brand name

Keep out of the face because it can cause pupil dilation

Ask if patient has a soy or peanut allergy

1
Q

What does Atropine sulfate do?

A

Relaxes bronchial smooth muscles

Inhibits mucus production

2
Q

Tiotropium Bromide

A

Spiriva- brand name

Maintenance drug for COPD

Not indicated for use during acute exacerbations

Dry mouth is the most common side effect

3
Q

Tudorza

A

aclidinium bromide- trade name

LAMA

Not a rescue drug

12hr drug

4
Q

Combivent is what 2 drugs combined?

A

Ipratropium bromide (Atrovent) & albuterol

Given by a pMDI or Respimat inhaler

5
Q

DuoNeb is what 2 drugs?

A

Ipratropium bromide & albuterol

Given by SVN

6
Q

Respimat inhaler technique

A
  1. Assemble
  2. Prime-
    Twist 1/2 turn with cap closed
    Open cap push spray button
    Repeat until a spray is visible
    Repeat 3X there should be 120 sprays available.
    If not used >3 days prime 1X
    If not used >21 days prime until spay is visible and then 3 more times
    3.twist
    4.ensure cap is off & no obstructions
  3. Exhale slow & complete toward RV
    6.place in mouth don’t obstruct vents on the side of the mouth piece
    7.inhale, slowly, deeply toward TLC
  4. Press spray button
  5. Continue to inhale deeply
  6. Hold breath (glottis open)
  7. If another dose is to be given wait 2 minutes
  8. Discard after 120 sprays (see counter on side) or after 3 months
  9. Clean with damp cloth weekly
7
Q

When should you not use sterile water?

A

For inhalation

Collecting sputum

8
Q

Hypertonic saline

A

Can cause bronchospasm

Used for sputum collection & induction

May need Beta 2 before or with solution.

Sodium retention when in large dose

9
Q

What are mucolytics?

A

Alter the structure of mucous( causing them to be thinner & more liquid)

10
Q

n-acetylchsteine, NAC

A

Mucomyst & Mucosol

Breaks disulfide bonds in mucous

Common to use with a bronchodilator

After opened discard after 96 hours

Giving the bronchodilator then the Mucomust may be a better method

Smells like rotten eggs. (Mix with cola)

11
Q

dornase alfa

A

Pulmozyme

Breaks down DNA in mucous making it thinner

Take very day

Keep refrigerated and shield from light

12
Q

What can also be used as an antidote to protect the liver from acetaminophen (Tylenol) overdose?

A

Mucomyst

13
Q

Ivacaftor

A

Kalydeco

Targets the genetic defect that causes a protein to malfunction of CF

14
Q

Sodium bicarbonate

A

Weekends the polysaccharide chain in mucus

Give every 4-8 hrs

15
Q

Expectorants

A

Guaifenesin & hypertonic saline are the most common drugs

Increase production and expectoration of mucus by increasing the amount of fluid in the respiratory tract in stimulating a cough

16
Q

Antitussive/ cough suppressant

A

It’s a cough suppressant

Codine- narcotic

Dextromethorphan- non-narcotic

17
Q

Ethanol

A

Ethyl alcohol

Decrease surface tension of the froth causes the bubbles to rupture.

This is thought to improve oxygenation (maybe)

18
Q

respiratory bronchioles are composed of?

A

Alveolar ducts
Alveoli
Pulmonary capillaries

19
Q

Alveolar macrophages

A

Phagocytic cells destroy digest bacteria and other material

Produced in bone marrow and transported throughout the body via the bloodstream

20
Q

Hey how are the surface tension?

A

Greater the force to contract

21
Q

Law of LaPlace

A

The smaller the sphere the greater the forces are to continue it to decrease in size

22
Q

Surfactant administration

A

Ensure the drug is at room temperature

Pre and post oxygenate

Swirl the vial to mix prior to use DO NOT shake because shaking will cause it to foam

Infant is turned onto one side to administer half the dose followed by manual ventilation and assessing for hypoxemia

The infant is then turned onto the other side to administer the other half dose followed by more manual ventilations

This encourages the surfactant to move it to each lung. However there is a little data that this improves the effectiveness of the drug

If effective PIP will drop rapidly VC or volume will increase rapidly PC. The infant and ventilator must be monitored closely and adjusted as needed.

23
Q

Beractant

A

Survanta

From Cow lung

Every 6 hrs up to 4 doses

24
Q

Calfactant

A

Infasurf

A natural surfactant

Ever 12 hrs total of 3 doses

25
Q

Poracant alfa

A

Curosurf

Naturally occurring surfactant from pig lung

Every 12 hrs up to 3 doses

26
Q

Cells lining the airway that have cilia on them are responsible for moving mucus towards the pharynx

A

Ciliated pseudostratified columnar epithelial cells

27
Q

Cells that secrete mucus into the airways and form the jail later

A

Goblet cells

28
Q

Cells that secrete less viscous mucus into the airway that formed the sol layer where the cilia beat

A

Serous cells

29
Q

Connective tissue

A

Lamina propria layer

30
Q

Produce most of the mucus in the airways. These glands increasing number with chronic pulmonary disease resulting in large quantities of secretion and increasing the risk of mucous plugging the airways?

A

Bronchial glands

31
Q

Bronchial glands and goblet cells combined produced about how much mucous per day?

A

100 ml

About 90 ml is reabsorbed

32
Q

Cells that release vasoactive substances such as histamine

A

Mast cells

33
Q

Catecholamines are either sympathetic or parasympathetic?

A

Sympathetic

34
Q

These types of drugs directly cause bronchodilation by increasing Cyclic AMP (cAMP)

Which cause bronchial smooth muscle relaxation

A

Sympathomimetic, beta-adrenergics

35
Q

What drug blocks the bronchoconstricting effects of cyclic GMP (cGMP)

A substance produced by the parasympathetic system that causes bronchoconstriction?

A

Anticholinergics, parasympatholytics

36
Q

What is thought to cause bronchodilation increasing cAMP I inhibiting phosphodiesterase an enzyme that deactivates cAMP?

A

Xanthines

37
Q

Catecholamine benzene ring

A

Hydroxy your group (OH) at position 3 & 4

38
Q

Resorcinol benzene ring

A

Hydroxyl groups at positions 3 & 5

39
Q

Saligenin benzene ring

A

Hydroxyl group at position 3 & a hydroxyl H2C at position 5

40
Q

Catecholamines are deactivated by what?

A

COMT

MAO

41
Q

Why can’t catecholamines be given by mouth ( P.O) ?

A

Because MAO will be deactivated in the gut

42
Q

Isoproterenol

A

Isuprel

43
Q

Isoetharine

A

Bronkosol, Bronkometer

Inactivated by heat and light

May turn sputum pink

Has a 10 fold decreased broncodilating effect compared to Isoproterenol

Had a 300 fold decreased cardiac stimulating affect compared to isoproterenol

44
Q

Racemic epinephrine

A

Vaponefrin, Micronefrin

Has an alpha & beta affect

A synthetic epinephrine

45
Q

Bitolterol

A

Tornalate

A “pro-drug” meaning it is administered in and in active form and converted to an active form when metabolized

Muscle tremors are a common side effect

46
Q

Resorcinol bronchodilators

A

Longer-lasting then catecholamines

Maybe used as a RESCUE DRUG for an Attack and as maintenance

Examples: Metaproterenol &. Terbutaline

47
Q

Metaproterenol

A

Alupent,

Metaprel

48
Q

Terbutaline

A

Brethine

Bricanyl

Given as an IV to stop premature labor

49
Q

Albuterol

A

Proventil

Ventolin

AccuNeb

Also referred to as racemic albuterol

50
Q

Pirbuterol

A

Maxair

51
Q

Salmeterol

A

Serevent

Uses the Diskus

LABA- long acting beta agonist

Poor rescue drug

52
Q

Levalbuterol

A

Xopenex

It can be used as a rescue drug

53
Q

Formoterol fumarate

A

Foradil & Perforomist

NOT a rescue drug

54
Q

Arformoterol tartrate

A

Brovana

NOT a rescue drug

55
Q

Arcapta

A

Indacarerol maleate

LAMA

NOT a rescue drug it’s a maintenance drug.

56
Q

Ultra- short acting

A

2-3 hrs

Isoproterenol

Isoetharine

57
Q

Short-acting

A

5-6 hrs

Metaproterenol

Terbutaline

Pirbuterol

58
Q

Intermediate- acting

A

Up to 8 hrs

Albuterol

Levalbuterol

Bitolterol

59
Q

Long-acting

A

12 hrs

Salmeterol

Formoterol

Arformoterol

60
Q

Anticholinergic Bronchodilators examples

A

Atropine

Ipratropium bromide

Tiotropium bromide