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Pharmacology > Respiratory > Flashcards

Flashcards in Respiratory Deck (67):
1

Albuterol
Pirbuterol
Terbutaline
Metaproterenol
Description

Short acting beta 2 agonists

2

Albuterol, Pirbuterol, Terbutaline, Metaproterenol
Mechanism

Increase in cAMP ->relaxation of bronchial smooth muscle and subsequent bronchodilation

Inhalation minimizes side effects (poor absorption through the lungs)

3

Albuterol, Pirbuterol, Terbutaline, Metaproterenol
Indication

DOC for acute relief of bronchospasm

4

Adrenergic agonist drugs

Albuterol, Pirbuterol, Terbutaline, Metaproterenol
Salmeterol, Formoterol
Epinhephrine
Isoproterenol

5

Adrenergic agonist adverse

Tremor
Tachycardia
Arrhythmia

Tolerance with excessive use

6

Salmeterol and Formoterol description

Long acting beta 2 agonists

7

Salmeterol and Formoterol indication

LABA used mainly for prophylaxis

8

Salmeterol and Formoterol mechanism

Increase in cAMP -> relaxation of bronchial smooth muscle and subsequent bronchodilation

Inhalation minimizes side effects (poor absorption through lungs)

9

Epinephrine mechanism

Increase in cAMP -> relaxation of bronchial smooth muscle and subsequent bronchodilation

Inhalation minimizes side effects (poor absorption through lungs)

10

Isoproterenol mechanism

Increase in cAMP -> relaxation of bronchial smooth muscle and subsequent bronchodilation

11

Epinephrine description

Non specific beta agonist

12

Epinephrine indication

Asthma with anaphylactic shock or other specifric drugs have failed

13

Isoproterenol description

Non specific beta agonist
Not available via inhalation

14

Isoproterenol indication

Bronchodiolation via beta 2
Primary use: heart block and bradycardia (beta 1)

15

Theophylline class

methylxanthine derivative
bronchodilator

16

Theophylline description

PDE inhibitor
Also blocks adenosine receptors

17

Theophylline mechanism

Blocks the metabolism of cAMP resulting in bronchodilation

18

Theophylline indication

Limited role due to small TI
Metabolized by CYP -> inducers decrease effect, inhibitors increase effect

19

Theophylline adverse

Seizure and arrhythmia
Tremor, insomnia and GI issues
Hypokalemia
Hyperglycemia

20

Ipratropium class

muscarinic antagonist
bronchodilator

21

Ipratropium description/mechanism

inhaled
block PS -> decrease bronchoconstriction and mucus secretion

22

Ipratropium indication

drug induced bronchospasm
Tx of asthma and COPD

23

Ipratropium adverse

Dry mouth and sedation (poor adsorption)

24

Tiotropium class

muscarinic antagonist
bronchodilator

25

Tiotropium description/mechanism

long acting
Block PS -> decrease bronchoconstriction and mucus secretion

26

Anti inflammatories for respiratory (classes)

Corticosteroids
Leukotriene antagonists
Antibody

27

Mast cell stabilizers

Cromolyn and Nedocromil

28

Cromolyn and Nedocromil description

Mast cell stabilizers
Oral, aerosol and droplets
Also used for food allergies and hay fever and rhinitis

29

Cromolyn and Nedocromil mechanism

Mast cell stabilizers
Prevent release of inflammatory mediators from mast cells

30

Cromolyn and Nedocromil indication

Prophylaxis: allergen and exercise induced bronchoconstriction
NOT for acute attacks

31

Cromolyn and Nedocromil adverse

Cromolyn: laryngeal edema, cough, wheezing
Nedocromil: unpleasant taste

32

Beclomethasone, Flunisolide, Fluticasone, Budesonide
Description

Inhaled steroids used in the treatment of chronic asthma

33

Beclomethasone, Flunisolide, Fluticasone, Budesonide
Mechanism

Inhibit PLA2 -> decrease AA -> decreased synthesis of cytokines, prostaglandins and other inflammatory mediators

Bind to glucose response elements (GRES) -> decrease inflammation

34

Beclomethasone, Flunisoloide, Fluticasone, Budesonide
Indication

Maintenance: inhalation steroids are used to suppress inflammation and reduce risk of exacerbation

Acute exacerbation: systemic steroids for severe attacks (status asthmaticus)

Can also treat chronic rhinitis (beclomethasone and flunisolide) -> improvement not seen for two weeks

35

Dexamethason, Prednisolone, Hydrocortisone indication

Maintenance: inhalation steroids are used to suppress inflammation and reduce risk of exacerbation

Acute exacerbation: systemic steroids for severe attacks (status asthmaticus)

36

Dexamethasone, Prednisolone, Hydrocortisone Mechanism

Inhibit PLA2 -> decrease AA -> decreased synthesis of cytokines, prostaglandins and other inflammatory mediators

Bind to glucose response elements (GRES) -> decrease inflammation

37

Dexamethasone, Prednisolone, Hydrocortisone description

IV steroids

38

Dexamethasone, Prednisolone, Hydrocortison Adverse

Abnormal glucose metabolism
Increase appetite and weight gain
HTN
Adrenal suppression

39

Beclomethasone, Flunisolide, Fluticasone, Budesonide adverse

Cough
Oral Thrush
Dysphonia

40

Zileuton description

inhibits 5-lipoxygenase

41

Zileuton mechanism

PO administration -> block synthesis of LT's or block LT receptors -> decrease constrictionand inflammation

42

Zileuton indication

Exercise, Ag, or *aspirin induced* asthma
Chronic maintenance
NOT useful for acute bronchospasm

43

Zileuton adverse

overall safe
But
can increase LFT's

44

Zafirlukast and Montelukast description

LTD4 receptor antagonists

45

Zafirlukast and Montelukast Mechanism

PO administration -> block synthesis of LT's or block LT receptors -> decrease constriction and inflammations

46

Zafirlukast and Montelukast indication

Exercise, Ag, or *aspirin* induced asthma
Chronic maintenance
NOT useful for acute bronchospasm

47

Zafirlukast and Montelukast adverse

Vasculitis with EOS (rare, similar to Churg Strauss)

48

Omalizumab (antibody) description

expensive, parenteral

49

Omalizumab (antibody) mechanism

Binds IgE on sensitized mast cells preventing release of mediators

50

Omalizumab (antibody) indication

Prophylaxis when ICS are inadequate (over age 12)

51

Omalizumab adverse

anaphylaxis

52

Cough and rhinitis drug classes

Opioids
Mucolytic agent
H1 antagonist
Alpha agonists

53

Codeine and Dextromethorphan description

Cough medications aka:
Antitussives
Dextromethorphan -> synthetic

54

Codeine and Dextromethorphan mechanism

Depress CNS cough center sensitivity to peripheral stimuli (low dose)

55

Codeine and Dextromethorphan indication

Severe cough that disrupts sleep

56

Codeine and Dextromethorphan adverse

Dextromethorphan has no analgesic or addictive potential, less constipating

57

N-acetylcysteine (NAC) mechanism

mucolytic agent
Breaks disulfide bonds in mucus making it easier to cough out

58

N-acetylcysteine (NAC) indication

Cystic fibrosis*
Acetaminophen overdose*

59

Diphenhydramine and Chlorpheniramine description

First generation H1 antagonist -> crosses BBB and cause drowsiness

60

Diphenhydramine and Chlorpheniramine mechanism

Block histamine release

61

Diphenhydramine and Chlorpheniramine indication

allergic rhinitis

62

Loratadine, Fexofenadine, Cetirizine description

second generation H1 antagonist -> non drowsy

63

Loratadine, Fexofenadine, Cetirizine mechanism

blocks release of histamine

64

Loratadine, Fexofenadine, Cetirizine indication

allergic rhinitis

65

Phenylephrine and Pseudoephedrine description

alpha agonists
Constrict dilated arterioles in the nasal mucose
Aerosol -> rapid onset and few systemic effects

66

Phenylephrine and Pseudoephedrine indication

Rhinitis

67

Phenylephrine and Pseudoephedrine adverse

Prolonged use can lead to rebound nasal congestion after discontinuation