Pulmonary Flashcards
(156 cards)
1
Q
Drug class for Fluticasone
A
Anti-inflammatory: inhaled glucocorticoid
2
Q
MoA for Fluticasone
A
anti-inflammatory, immunosuppresive, anti-proliferative activity
3
Q
Indications for Fluticasone
A
asthma, COPD
4
Q
SE/ADRs for Fluticasone
A
HA, oral thrush, URI, throat irritation, cough
5
Q
Contra-indications for Fluticasone
A
hypersensitivity, acute bronchospasm, latent TB, glaucoma, cataracts
6
Q
DX-DX interactions for Fluticasone
A
via inhalation minimal
7
Q
Monitoring for Fluticasone
A
spirometry (peak flow meter)
8
Q
PG category for Fluticasone
A
PG C
9
Q
How might Fluticasone affect children?
A
possibly growth slowing but ‘catch up’
10
Q
Drug class for Prednisone
A
Anti-inflammatory: oral glucocorticoid
11
Q
MoA for Prednisone
A
anti-inflammatory early after admin by decreasing migration of WBC, reversal of capillary permeability, immunosuppressant; later onset of inhibition of protein synthesis
12
Q
Indications for Prednisone
A
adjunct therapy in exacerbation of bronchospasms; multiple others
13
Q
SE/ADRs for Prednisone
A
short term: minimal
longer than 10-14 days: multiple systemic
14
Q
Contra-indications for Prednisone
A
hypersensitivity, acute bronchospasm (unless as adjunct), latent TB, glaucoma, cataracts
15
Q
DX-DX interactions for Prednisone
A
tNSAIDs
anti-diabetic meds
anti-HTN meds
16
Q
Monitoring for Prednisone
A
spirometry
17
Q
PG category for Prednisone
A
caution in PG
18
Q
Drug class for Cromolyn MDI
A
Anti-inflammatory: mast cell stabilizer
19
Q
MoA for Cromolyn MDI
A
stabilizes mast cell membrane to prevent degranulation & release of histamine, leukotrienes, slow-rxn substance of anaphylaxis
20
Q
Indications for Cromolyn MDI
A
childhood asthma
21
Q
SE/ADRs for Cromolyn MDI
A
HA, unpleasant taste, hoarseness, cough
22
Q
Contra-indications for Cromolyn MDI
A
hypersensitivity, acute asthma
23
Q
DX-DX interactions for Cromolyn MDI
A
none
24
Q
Monitoring for Cromolyn MDI
A
spirometry
25
PG category for Cromolyn MDI
PG B
26
Drug class for Zafirlukast
Anti-inflammatory: oral leukotriene receptor antagonist
27
MoA for Zafirlukast
selective & competitive antagonist of leukotriene receptors D4 & E4, SRSA
28
Indications for Zafirlukast
asthma
29
SE/ADRs for Zafirlukast
HA, N/D, hepatitis
30
Contra-indications for Zafirlukast
hypersensitivity
acute exacerbation of asthma
caution in alcoholic cirrhosis
31
DX-DX interactions for Zafirlukast
concomitant food decreases bioavailability by 40%
32
Monitoring for Zafirlukast
spirometry, LFT
33
PG category for Zafirlukast
PG B
34
Drug class for Salmeterol
Bronchodilator: inhaled long-acting Beta2 Adrenergic Agonist (LABA)
35
MoA for Salmeterol
selective, long-acting Beta2 adrenergic agonist
36
Indications for Salmeterol
long term control of COPD, asthma control; EIB
37
SE/ADRs for Salmeterol
HA, muscle pain, anxiety, insomnia
38
Contra-indications for Salmeterol
acute asthma/COPD; seizure d/o; CVD; diabetes, hyperthyroidism
39
DX-DX interactions for Salmeterol
increase levels of loop diuretics, sympathomimetics; levels increased by CYP3A4 inhibitors; impact decrease by Beta Blockers
40
Monitoring for Salmeterol
spirometry, HR, BP, glucose
41
PG category for Salmeterol
PG C
42
Drug class for Formoterol
Bronchodilators: inhaled long-acting Beta2 adrenergic agonist (LABA)
43
MoA for Formoterol
long acting Beta2 agonist
44
Indications for Formoterol
long term control COPD, asthma w/ steroid MDI
45
SE/ADRs for Formoterol
tremor, chest pain, palpitations, anxiety, insomnia, muscle cramps
46
Contra-indications for Formoterol
acute asthma/COPD, active CVD
47
DX-DX interactions for Formoterol
increase levels of loop diuretics, sympathomimetics, effect decreased by Beta Blockers
48
Monitoring for Formoterol
spirometry, HR, BP, glucose
49
PG category for Formoterol
PG C
50
Drug class for Albuterol
Bronchodilators: inhaled short-acting Beta2 adrenergic agonist (SABA)
51
MoA for Albuterol
bronchial smooth muscle Beta2 (sympathetic) receptor stimulation; racemic mix w/ R isomer active & S isomer inactive
52
Indications for Albuterol
bronchospasm in asthma & COPD, EIB
53
SE/ADRs for Albuterol
angina, increase/decrease BP, arrhythmias, palpitations, CNS stimulation, angioedema, restlessness, wakefulness
54
Contra-indications for Albuterol
caution w/ HTN, CHF, arrhythmias, seizure d/o, diabetes, glaucoma, hyperthyroidism, low serum K+
55
DX-DX interactions for Albuterol
beta blockers
56
Monitoring for Albuterol
spirometry
57
PG category for Albuterol
PG C
58
Drug class for Theophyline
Bronchodilators: Oral/IV PDE inhibitor/ methylxanthine
59
MoA for Theophyline
PDE blockade causes increased levels of cAMP which produces bronchodilation, diuresis, CNS & cardiac stimulation, release of epi
60
Indications for Theophyline
reversal of bronchospasm
61
SE/ADRs for Theophyline
tachycardia, HA, insomnia, seizures
62
Contra-indications for Theophyline
CVD, HTN, hyperthyroidism, peptic ulcers, seizure d/o
63
DX-DX interactions for Theophyline
levels increased by multiple CYP1A2, CYP3A4 inhibitor drugs
64
Monitoring for Theophyline
Theophylline level, spirometry, HR, BP, glucose
65
PG category for Theophyline
PG C
66
Drug class for Levalbuterol
Bronchodilators: inhaled Beta2 adrenergic agonist (SABA)
67
MoA for Levalbuterol
rapid acting selective Beta2 receptor agonist counteracts bronchospasm; pure R-isomer of drug
68
Indications for Levalbuterol
TX or prevention of bronchospasm in reversible airway disease (asthma, EIB, COPD
69
SE/ADRs for Levalbuterol
tremor, rhinitis, viral infection, HA, pharyngitis
70
Contra-indications for Levalbuterol
active cardiac disease
71
DX-DX interactions for Levalbuterol
increase levels of loop diuretics, sympathomimetics; levels decreased by beta blockers, combination alpha/beta blockers
72
Monitoring for Levalbuterol
spirometry, HR, BP
73
PG category for Levalbuterol
PG C
74
Drug class for Ipratropium HFA
Bronchodilators: inhaled anticholinergic
75
MoA for Ipratropium
blocks acetylcholine cholinergic receptors in bronchial smooth muscle to reduce bronchospasm
76
Indications for Ipratropium
acute & maintenance tx of bronchospasm in COPD, asthma
77
SE/ADRs for Ipratropium
URI, chest pain, palpitations, dyspepsia, xerostomia, dyspnea, flu-like syndrome
78
Contra-indications for Ipratropium
narrow angle glaucoma, paradoxical bronchospasm, acute asthma except in conjunction w/ SABA drug; urinary outflow obstruction
79
DX-DX interactions for Ipratropium
decrease effect of acetylcholinesterase inhibitors
80
Monitoring for Ipratropium
spirometry, HR
81
PG category for Ipratropium
PG C
82
Drug class for Tiotropium
Bronchodilators: inhaled long-acting anticholinergic
83
MoA for Tiotropium
blocks acetylcholine at parasympathetic receptors in bronchial smooth muscle producing bronchodilation
84
Indications for Tiotropium
maintenance tx bronchospasm in COPD, asthma
85
SE/ADRs for Tiotropium
URI, chest pain, palpitations, dyspepsia, xerostomia, dyspnea, flu-like syndrome
86
Contra-indications for Tiotropium
paradoxical bronchospasm, acute bronchospasm, narrow angle glaucoma, urinary tract outflow obstruction
87
DX-DX interactions for Tiotropium
decreases effect of acetylcholinesterase inhibitors
88
Monitoring for Tiotropium
spirometry, HR
89
PG category for Tiotripium
PG C
90
Drug class for Roflumilast
Phosphodiesterase 4 inhibitor
91
MoA for Roflumilast
drug & active metabolite inhibit PDE4 increased cAMP in inflammatory & structural cells; suppress cytokine release; inhibit lung infiltration by WBCs; decreases pulmonary remodeling
92
Indications for Roflumilast
adjunct therapy in COPD (chronic bronchitis)
93
SE/ADRs for Roflumilast
HA, wt loss, diarrhea, nausea
94
Contra-indications for Roflumilast
moderate to severe liver impairment
95
DX-DX interactions for Roflumilast
CYP3A4 inducers decrease serum concentration; Cipro increases serum concentration; Rifampin decreases concentration
96
Monitoring for Roflumilast
spirometry
97
PG category for Roflumilast
avoid use in PG
98
Drug class for Omalizumab
antibody agents
99
MoA for Omalizumab
binds to IgE antibody receptors on mast cells, blocking attachment of IgE antibody & preventing degranulation release of histamines & leukotrienes
100
Indications for Omalizumab
maintenance tx of allergic asthma not controlled by inhaled steroids
101
SE/ADRs for Omalizumab
HA, injection site rxn, URI, pain, anaphylaxis
102
How is Omalizumab administered?
Sub-Q every 2-4 weeks
103
Drug class for Nicoderm patch, Nicorette gum, Nicotrol inhaler/nasal spray
Nicotine replacement
104
MoA for Nicotine replacement
biphasic CNS & ANS nicotine receptor stimulant; low dose- stimulations ANS ganglia; large dose- stimulation follows by blockade of transmission
105
Indications for Nicotine replacement
tobacco cessation aid
106
SE/ADRs for Nicotine replacement
- HA, mucosal irritant, cough, rhinitis
| - toxicity= tremors, respiratory excitation, convulsions, respiratory failure
107
Contra-indications for Nicotine replacement
recent AMI, life-threatening arrhythmias, severe angina, TMJ d/o, hyperthyroidism, T1DM, bronchospastic d/o
108
DX-DX interactions for Nicotine replacement
concentration increased by Cimetidine
109
Monitoring for Nicotine replacement
HR, BP, insomnia
110
PG category for Nicotine replacement
PG D (for nasal spray)
111
Drug class for Varenicline
partial nicotine agonist oral
112
MoA for Varenicline
prevents nicotine stimulation of the mesolimbic dopamine system
113
Indications for Varenicline
tobacco cessation aid
114
SE/ADRs for Varenicline
insomnia, HA, abnormal dreams, nausea
115
Contra-indications for Varenicline
psychiatric disorders, decreased renal function, active CVD
116
DX-DX interactions for Varenicline
none known
117
Monitoring for Varenicline
psych changes, tobacco use
118
PG category for Varenicline
PG C
119
Drug class for Bupropion
atypical antidepressant: oral dopamine reuptake inhibitor
120
MoA for Bupropion
unknown
121
Indications for Bupropion
tobacco cessation; depression
122
SE/ADRs for Bupropion
tachy, HA, insomnia, nausea, xerostomia, wt loss, palpitations, agitation, constipation, diarrhea
123
Contra-indications for Bupropion
biopolar disorder, seizure disorder, active CVD, uncontrolled HTN
124
DX-DX interactions for Bupropion
MAO inhibitors, ethanol
125
Monitoring for Bupropion
psych sxs, tobacco use, BP
126
PG category for Bupropion
PG C
127
Drug class for Umeclindinium & Vilanterol
combination inhaled long-acting anticholinergic & LABA
128
MoA for Umeclidinium & Vilanterol
combination of 2 agents with different bronchodilating action (anti-muscarinic & beta2 agonism)
129
Indications for Umeclidinium & Vilanterol
COPD
130
SE/ADRs for Umeclidinium & Vilanterol
paradoxical bronchospasm, chest pain, limb pain, pharyngitis
131
Contra-indications for Umeclidinium & Vilanterol
severe milk protein allergy, caution w/ glaucoma, comorbid thyrotoxicosis, seizure disorder, prostatic hyperplasia, low K+, diabetes
132
DX-DX interactions for Umeclidinium & Vilanterol
multiple but lower risk of occurrence
133
Monitoring for Umeclidinium & Vilanterol
FEV1, peak flow, BP, HR, CNS stimulation, eye changes
134
PG category for Umeclidinium & Vilanterol
PG C
135
Drug class for Fluticasone/Salmeterol
combination product inhaled glucocorticoid & LABA
136
MoA for Fluticasone/Salmeterol
anti-inflammatory action of steroid & bronchodilation activity of beta2 agonist
137
Indications for Fluticasone/Salmeterol
asthma (maintenance of bronchodilation), asthma
138
SE/ADRs for Fluticasone/Salmeterol
- combo of both drugs
| - increased risk of death
139
Contra-indications for Fluticasone/Salmeterol
actue exacerbation of bronchospasm, status asthamticus
140
DX-DX interactions for Fluticasone/Salmeterol
combo of both
141
Monitoring for Fluticasone/Salmeterol
spirometry, HR, BP, CNS stimulation, frequency of use of SABA, growth velocity in children
142
PG category for Fluticasone/Salmeterol
PG C
143
Drug class for Ipratropium/Albuterol
combination product inhaled anticholinergic & beta2 adrenergic agonist (SABA) bronchodilators
144
MoA for Ipratropium/Albuterol
anticholinergic & beta2 agonist bronchodilators
145
Indications for Ipratropium/Albuterol
COPD patients requiring 2 bronchodilators
146
SE/ADRs for Ipratropium/Albuterol
combo of drugs
147
Contra-indications for Ipratropium/Albuterol
see individual drugs
148
Monitoring for Ipratropium/Albuterol
spirometry, HR, BP, frequency of use
149
PG category for Ipratropium/Albuterol
PG C
150
Drug class for Budesonide/Formoterol
combination product inhaled corticosteroid & beta2 adrenergic agonist (LABA) bronchodilators
151
MoA for Budesonide/Formoterol
anti-inflammatory action of steroid & bronchodilation activity of beta2 agonist
152
Indications for Budesonide/Formoterol
asthma (maintenance of bronchodilation), COPD
153
SE/ADRs for Budesonide/Formoterol
- combo of both drugs
| - increased risk of death
154
Contra-indications for Budesonide/Formoterol
acute exacerbation of bronchospasm, status asthmaticus
155
DX-DX interactions for Budesonide/Formoterol
combo of both
156
Monitoring for Budesonide/Formoterol
spirometry, HR, BP, CNS stimulation, frequency of use of SABA, growth velocity in children
