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pulm moa Flashcards

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1
Q

Goal of therapy asthma and bronchitis

A

dec airways resistance by increasing diameter of bronchi and decrease mucous secretion

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2
Q

Early phase response asthma

A

inflammatory mediators such as leukotrienes, histamine, and prostaglandin D2s are released

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3
Q

late phase response asthma

A

fibrin and collagen are deposited in tissue

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4
Q

Mast cells- release

A

histamine and leukotrienes

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5
Q

Eosinophils-

A

release enzymes when foreign cells are encountered

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6
Q

Leukotrienes- cause

A

bronchoconstriction

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7
Q

IL4 and IL5 are

A

cytokines that signal molecules between cells

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8
Q

line of trmt for asthma

A
  1. saba
  2. ics
  3. laba
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9
Q

Albuterol moa

A

B2 agonist in airway smooth muscle causing muscle relaxation and bronchodilation

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10
Q

levalbuterol moa

A

B2 agonist in airway smooth muscle causing muscle relaxation and bronchodilation

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11
Q

saba cautionary

A

paradoxical bronchospasm, hx CV disorders

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12
Q

Primatene Mist moa

A

Same as EPI- activates B1, B2, and A1 causing bronchodilation, inc HR, and vasoconstriction

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13
Q

Ipratropium
Ipratorpium + albuterol
moa

A

Competitive antagonists for ACh at muscarinic receptors- inhibit ACh from constricting the bronchial airways

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14
Q

Ipratropium

Ipratorpium + albuterol se

A

dec sludge

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15
Q

Contraindications
Ipratropium
Ipratorpium + albuterol

A

soy and peanuts

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16
Q

Cautionary
Ipratropium
Ipratorpium + albuterol

A

paradoxical bronchospasm, hx of CV disorders, worsening of urinary retention

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17
Q

Short term asthma: Systemic corticosteroids moa

A

Inhibits release of antiinflammatory mediators- reduces synthesis of Phospholipase A2 so arachidonic acid can’t be made which causes lipoxygenase and cyclooxygenase to not be able to be made. This all causes leukotrienes and PG to be reduced. This means that inflammation is reduced and bronchodilation occurs over time

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18
Q

Short term asthma: Systemic corticosteroids se

A

glucose metabolism and fluid retention

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19
Q

diff btwn systemic and inhaled corticosteroids

A

theyre not systemic… they bypass 1st pass effect

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20
Q

se inhaled corticosteroids

A

candida albicans thrush

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21
Q

Contraindication inhaled corticosteroids

A

acute asthma attack

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22
Q

Caution inhaled corticosteroids

A

NOT a bronchodilator… not used for instant relief

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23
Q

inhaled corticosteroids moa

A

Inhibits release of antiinflammatory mediators- reduces synthesis of Phospholipase A2 so arachidonic acid can’t be made which causes lipoxygenase and cyclooxygenase to not be able to be made. This all causes leukotrienes and PG to be reduced. This means that inflammation is reduced and bronchodilation occurs over time

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24
Q

Salmeterol

A

MOA: B2 agonist in airway smooth muscle causing muscle relaxation and bronchodilation
Same as SABA, but longer duration (12 hrs vs 4-6)

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25
Formoterol
MOA: B2 agonist in airway smooth muscle causing muscle relaxation and bronchodilation Same as SABA, but longer duration (12 hrs vs 4-6)
26
Contraindication long term asthma LABA
asthma trmt with LABA alone
27
NEVER use____ alone in asthma… it’s a BBW… increased risk of asthma related death
LABA
28
Contraindications Long term asthma meds: Inhaled corticosteroids + LABA
acute asthma attacks
29
Fluticasone/salmeterol moa
MOA: dec inflammation and bronchodilation
30
Postmarketing SE for Mometasone/formoterol and Budesonide/formoterol:
angina pectoris, cardiac arrhythmias, and QT prolongation
31
Long term asthma meds: Inhaled corticosteroids + LABA | cautions
candida albicans infection, not bronchodilator
32
Fluticasone/vilanterol | moa
MOA: dec inflammation and bronchodilation
33
BBW: removed in 2017
Long term asthma meds: Inhaled corticosteroids + LABA
34
Mometasone/formoterol moa
MOA: dec inflammation and bronchodilation
35
Montelukast moa
antagonizes leukotriene receptors which prevent airway edema, smooth muscle contractions, and help secretions of thick mucus
36
Budesonide/formoterol | moa
MOA: dec inflammation and bronchodilation
37
Zafirlukast moa
antagonizes leukotriene receptors which prevent airway edema, smooth muscle contractions, and help secretions of thick mucus
38
Contraindications Montelukast and Zafirlukast
not used to acute asthma attacks
39
Theophylline moa
causes bronchodilation either by... | Adenosine receptor antagonist OR inhibiting phosphodiesterase (PDE 3 and PED4)
40
Zileuton moa
inhibits lipoxygenase which converts arachidonic acid to leukotrienes thus inhibiting leukotriene formation
41
Aminophylline moa
causes bronchodilation either by... | Adenosine receptor antagonist OR inhibiting phosphodiesterase (PDE 3 and PED4)
42
Zileuton se
elevates liver enzymes
43
Structurally similar to caffeine
Theophylline and aminophylline
44
se Theophylline and aminophylline
CNS side effects such as HA, insomnia, irritability, restlessness, seizures, tachycardia, difficulty urinating in males (bc its like caffeine)
45
Long term asthma meds: Methylxanthines | contra
not for acute asthma attacks
46
Narrow therapeutic index!
Long term asthma meds: Methylxanthines
47
There are inhibitors and inducers (remember inhibitors dec Cl and inc F)
Theophylline
48
Cromolyn sodium | moa
mast cell stabilizer- prevents release of histamine, leukotrienes, and cytokines
49
ContraindicationsCromolyn sodium
acute asthma attack
50
Omalizumab moa
blocks binding of IgE to mast cells, basophils, and other cells associate with allergic response
51
Omalizumab bbw
anaphylaxis, bronchospasm, hypotension, syncope, urticaria, angioedema of the tongue or throat… can occur yrs after taking the medication
52
Indacaterol moa
MOA: works on B2 to relax bronchial smooth muscle
53
laba 2 cautions
can produce paradoxical bronchospasms and cv effects such as inc hr or bp
54
Aclidinium moa
MOA: Competitive antagonists for ACh at muscarinic receptors- inhibit ACh from constricting the bronchial airways
55
Arformoterol moa
MOA: works on B2 to relax bronchial smooth muscle
56
Reslizumab
IL5 receptor antagonists- reduces eosinophils
57
Olodaterol moa
MOA: works on B2 to relax bronchial smooth muscle
58
Mepolizumab
IL5 receptor antagonists- reduces eosinophils
59
Dupilumab
IL 4 receptor antagonist- inhibits release of proinflammatory cytokines, chemokines, and IgE
60
Benralizumab
IL5 receptor antagonists- reduces eosinophils
61
BBW Reslizumab:
anaphylaxis
62
Glycopyrrolate
MOA: Competitive antagonists for ACh at muscarinic receptors- inhibit ACh from constricting the bronchial airways
63
Aclidinium/formoterol | moa
MOA: block ACh which leads to bronchodilation; longer acting bronchodilation
64
Umeclidinium/ vilanterol | moa
MOA: block ACh which leads to bronchodilation; longer acting bronchodilation
65
Glycopyrrolate/formoterol | moa
MOA: block ACh which leads to bronchodilation; longer acting bronchodilation
66
Umeclidinium
MOA: Competitive antagonists for ACh at muscarinic receptors- inhibit ACh from constricting the bronchial airways
67
COPD: anticholinergic + LABA | contra
Contraindications: contraindicated in asthma pts without use of long term asthma control medication
68
Tiotropium
MOA: Competitive antagonists for ACh at muscarinic receptors- inhibit ACh from constricting the bronchial airways
69
Glycopyrrolate/Indacterol | moa
MOA: block ACh which leads to bronchodilation; longer acting bronchodilation
70
COPD: anticholinergic + LABA | cautions
Cautions: paroxysmal bronchospasms, LABA can cause significant CV effects (inc hr and bp)
71
COPD: anticholinergic + LABA | bbw
in risk asthma related death
72
Tiotropium/olodaterol | moa
MOA: block ACh which leads to bronchodilation; longer acting bronchodilation
73
Roflumilast moa
MOA: Selective inhibitors of phosphodiesterase type 4, an enzyme that metabolizes cAMP; leads to relaxation of bronchial smooth muscles
74
Roflumilast se
SE= mental health issues
75
Roflumilast contra
moderate to severe liver impairment
76
Mast cells
store histamine; highest conc. In nose and eye
77
where are Basophils located
blood and deeper tissue
78
Histamine acts on
H1 receptor
79
histamine causes
Causes vasodilation, sneezing, itching, edema, contraindication of bronchial smooth muscle
80
In the drink Lean or Purple Drank | Commonly combined with codeine cough syrup
Promethazine
81
Most OTC sleep aids are ___ generation antihistamines
1st
82
Lipophilic and easily cross the BBB
1st generation antihistamines
83
SE 1st generation antihistamines
SE= sedation and CNS depression, VERY anticholinergic so they dec sludge, can cause paradoxical CNS stimulation in kids
84
Fexofenadine moa
selective for H1 receptors;
85
Diphenhydramine moa
MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine
86
Cetirizine moa
selective for H1 receptors;
87
Bromopheniramine moa
MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine
88
Chloropheniramine moa
MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine
89
Loratadine moa
selective for H1 receptors;
90
Levocetirizine moa
selective for H1 receptors;
91
Clemastine moa
MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine
92
Desloratadine moa
selective for H1 receptors;
93
Doxylamine moa
MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine
94
Dimenhydrinate moa
MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine
95
Azelastine moa
MOA: competes with histamine for H1 receptor sites
96
Hydroxyzine moa
MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine
97
Olopatadine moa
MOA: competes with histamine for H1 receptor sites
98
Cyproheptadine moa
MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine
99
cough assoc with underlying inflammatory process
productuve
100
cough stimulated by irritant or inflammation; can damage respiratory structures
nonprod
101
Meclizine moa
MOA: nonselective for histamine at the H1 receptor in the GI tract, BV, and resp tract; block vasodilator action of histamine
102
mucinex moa
MOA: inc resp tract fluid and reduces viscosity
103
Lipophobic and does NOT cross the BBB; CNS penetration is minimal to none
2nd generation antihistamines
104
2nd generation antihistamines se
SE= non sedating and non anticholinergic properties
105
Guaifenesin moa
MOA: inc resp tract fluid and reduces viscosity
106
Dextromethorphan moa
MOA: acts on cough receptor in medulla; interrupts cough impulse transmission
107
Contraindications dxm
MAOI- can lead to serotonin syndrome
108
Currently a drug of abuse: robotripping | Drinking excessive amts of _____ and overdose
Dextromethorphan
109
Tessalon perles/ Benzonatate | moa
MOA: non narcotic antitussive- anesthetizes receptors in resp passages and lungs
110
Codeine/Guaifenesin | moa
MOA: narcotic analgesic that acts in the medulla to inc urge to cough
111
Codeine/Guaifenesin/ PSE | moa
MOA: narcotic analgesic that acts in the medulla to inc urge to cough
112
hydrocodone/chlorpheniramine | moa
MOA: narcotic analgesic that acts in the medulla to inc urge to cough
113
bbw Codeine Cough suppressants/ antitussives
BBW: respiratory depression and death have occurred in kids; ultra rapid metabolizers of codeine dt CYP2D6
114
hydrocodone/homatropine | moa
MOA: narcotic analgesic that acts in the medulla to inc urge to cough

pharmacology (16 decks)

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