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NUR 326 Exam 1B > Pulmonary Pharm > Flashcards

Pulmonary Pharm Flashcards

1
Q

which meds dilate the bronchioles?

A

–Beta-2 adrenergics
–inhaled anticholinergics
–Xanthine derivatives

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2
Q

which meds decrease bronchial inflammation?

A

–glucocorticoids
–mast cell stabilizers
–LTRAs

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3
Q

examples of Beta-2 adrenergic agonist meds

A

–albuterol
–levalbuterol
–salmetrol
–formoterol

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4
Q

short acting beta-2 adrenergic agonists

A

–albuterol
–levalbuterol

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5
Q

long acting beta-2 adrenergic agonists

A

–salmetrol
–formoterol

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6
Q

how often should short acting beta agonist meds be taken?

A

every 4-6 hours

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7
Q

how often should long acting beta agonist meds be taken?

A

every 12 hours

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8
Q

which are considered rescue drugs?

A

short acting

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9
Q

which are considered preventer drugs?

A

long acting

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10
Q

MOA of beta-adrenergic agonists

A

relax and dilate the airways by stimulating the beta-2 adrenergic receptors throughout the lungs
–mimic action of SNS (fight or flight)

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11
Q

non-selective adrenergic drugs

A

stimulate both beta-1 and beta-2 receptors AND alpha receptors

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12
Q

non-selective beta adrenergic

A

stimulate both beta-1 and beta-2 receptors

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13
Q

selective beta-2 receptors

A

preferred meds to treat pulmonary conditions

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14
Q

what do non-selective drugs stimulate? And what does this cause?

A

–alpha receptors, vasoconstriction (decreases swelling in mucous membranes, limits amt of secretions)
–beta-1, cardiovascular effects

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15
Q

what do beta-1 receptors trigger?

A

heart

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16
Q

what do beta-2 receptors trigger?

A

lungs

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17
Q

indications for beta agonists

A

prevention or relief of bronchospasm related to asthma/bronchitis/other pulm conditions

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18
Q

contraindications for beta agonists

A

–uncontrolled HTN
–cardiac dysrhythmias
–high risk for stroke

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19
Q

specifics of beta agonists

A

–can be given with beta blockers, but may diminish effect
–avoid use with MAOIs and sympathomimetics = HTN
–diabetics may need more meds because raises blood sugar

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20
Q

adverse effects of beta agonists

A

–insomnia
–restlessness
–anorexia
–cardiac stimulation
–hyperglycemia
–tremor
–vascular headache

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21
Q

relationship between beta agonists and beta blockers

A

beta agonists can reverse OD of beta blockers

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22
Q

who is a DPI best for?

A

cognitively impaired or children

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23
Q

indications for albuterol

A

–asthma
–bronchitis
–emphysema
–acute episodes of wheezing, chest tightness, SOA

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24
Q

indications for salmeterol

A

–worsening of COPD
–moderate-severe asthma
–always given with inhaled corticosteroid

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25
Q

warning for salmeterol

A

has been associated with increased asthma-related deaths

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26
Q

MOA of anticholinergics

A

type of bronchodilator that works on acetylcholine receptors, not adrenergic receptors. Creates bronchodilation.

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27
Q

what does giving anticholinergic agents result in?

A

–turning off cholinergic response (PNS)
–turning on SNS (bronchodilation)

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28
Q

example of anticholinergic

A

ipatroprium

29
Q

indications for ipatroprium

A

prophylaxis and maintenance therapy

30
Q

anticholinergic effects

A

–dry as a bone
–hot as a hare
–blind as a bat
–red as a beet
–mad as a hatter

31
Q

examples of xanthine derivatives

A

–theophylline
–aminophylline

32
Q

MOA of xanthine derivatives

A

increasing levels of cAMP enzyme by inhibiting phosphodiesterase

33
Q

what level of treatment are xanthine derivatives used at?

A

second line d/t high risk of toxicity and drug-drug interactions

34
Q

indication for theophylline/aminophylline

A

preventative treatment of asthma attacks and COPD exacerbation

35
Q

what happens to theophylline in the body?

A

metabolized to caffeine

36
Q

side effects of xanthine derivatives

A

Toxicity
–N/V/D
–insomnia
–HA
–tachycardia
–dysrhythmias
–seizure disorders

37
Q

contraindications for xanthine derivatives

A

–uncontrolled cardiac dysrhythmias
–seizure disorders
–hyperthyroid
–peptic ulcers

38
Q

interactions with xanthine derivatives

A

–caffeine –> may increase side effects
–smoking –> decreased absorption

39
Q

what to give with xanthine derivative toxicity

A

activated charcoal

40
Q

drug interactions with xanthine derivatives

A

–macrolides
–allopurinol
–cimetidine
–quinolones
–flu vaccine
–oral contraceptives

41
Q

what do leukotrienes cause?

A

inflammation, bronchoconstriction, mucus production

42
Q

examples of leukotriene receptor antagonists (LTRAs)

A

–montelukast
–zafirlukast

43
Q

MOA of LTRAs

A

prevent leukotrienes from attaching to receptors located on immune cells and within the lungs –> prevents inflammation

44
Q

route for LTRAs

A

PO

45
Q

indications for LTRAs

A

oral prophylaxis and chronic treatment of asthma in adults and children
–NOT for acute attacks

46
Q

adverse effects of LTRAs

A

–HA
–nausea
–dizziness
–insomnia
–diarrhea

47
Q

examples of inhaled corticosteroids

A

–beclomethasone
–budesonide
–fluticasone

48
Q

route for inhaled corticosteroids

A

via neb or MDI

49
Q

MOA of inhaled corticosteroids

A

reduce inflammation and enhance activity of beta agonists
–help with bronchodilation

50
Q

timeline for inhaled corticosteroids

A

can take several weeks before full effects are realized

51
Q

teaching for inhaled corticosteroids

A

for asthma:
–take on regular schedule
–give bronchodilator first for more thorough absorption

52
Q

adverse effects of inhaled corticosteroids

A

–pharyngeal irritation
–coughing
–dry mouth
–oral fungal infections
RINSE MOUTH AFTER USE

53
Q

what combinations are used for moderate to severe asthma (maintenance)?

A

–budesonide and formoterol
–fluticasone and salmeterol

54
Q

MOA of mast cell stabilizers

A

stabilize membranes of mast cells and prevent release of broncho-constrictive inflammatory substances

55
Q

indications for mast cell stabilizers

A

prevention of acute asthma attacks

56
Q

example of mast cell stabilizer

A

cromolyn

57
Q

time frame for giving cromolyn

A

15-20 minutes prior to known triggers

58
Q

example of monoclonal antibody anti-asthmatic

A

omalizumab

59
Q

MOA for omalizumab

A

monoclonal antibody that selectively binds to IgE and limits release of mediators of allergic response

60
Q

route for omalizumab

A

injection

61
Q

indication for omalizumab

A

add-on therapy for asthma

62
Q

monitoring for omalizumab

A

monitor closely for hypersensitivity reactions (anaphylaxis)

63
Q

MOA for selective PDE-4 inhibitor (roflumilast)

A

selectively inhibits PDE4 enzyme in lung cells (anti-inflammatory effects)

64
Q

indication for roflumilast

A

COPD exacerbations

65
Q

route for roflumilast

A

PO

66
Q

side effects of roflumilast

A

–N/V/D
–HA
–muscle spasms
–decreased appetite
–uncontrollable tremors

67
Q

long term control medications (preventers)

A

–anticholinergics
–xanthine derivatives
–inhaled corticosteroids
–leukotriene modifiers
–mast cell stabilizers
–LABA

68
Q

quick relief medications (rescue)

A

–SABA
–albuterol/Proventil

NUR 326 Exam 1B (9 decks)

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