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Respiratory Drugs Flashcards

(61 cards)

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1
Q

three drug classes given to prevent bronchoconstriction

A

B2 agonists
methylxanthines
anticholinergics

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2
Q

which drug class is most effective for acute bronchospasm

A

b2 agonists

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3
Q

Why should we given inhaled drugs for lung diseases?

A

decreased systemic effects

faster and more direct drug delivery to site of action

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4
Q

How much drug reaches the lungs when utilizing a metered dose inhaler?

A

10%

20% with spacer

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5
Q

Which drug delivery system results in the highest % of drug reaching the lungs?

A

nebulizers

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6
Q

List some short acting inhaled B2 agonists

A

albuterol
levoalbuterol

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7
Q

Which B2 agonists can be given PO

A

albuterol
terbutaline

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8
Q

List two methylxanthines

A

theophylline
aminophylline

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9
Q

List one short acting and one long acting inhaled anticholinergic

A

short = ipratropium
long = tiotropium

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10
Q

Can bronchodilators prevent future asthma attacks?

A

No - symptomatic relief only

no decrease in inflammation

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11
Q

What is a SABA

A

short acting beta2 agonist

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12
Q

What is the onset, peak, and duration of action of SABAs

A

onset = immediate
peak = 30mins
DOA = 3-5hrs

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13
Q

Are LABAs or SABAs administered PRN?

A

SABAs - immediate onset for acute attack

LABAs are administered on a schedule

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14
Q

Adverse effects of B2 agonists

A

inhaled - none/minimal

PO -
- tremors
- tachycardia
- nervousness
- hyperglycemia
- hypokalemia

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15
Q

Mechanism of action of methylxanthines

A

adenosine receptor blockade = relaxation of bronchial smooth m

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16
Q

How are methylxanthines metabolized?

A

CYP450

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17
Q

Why do methylxanthines require laboratory monitoring?

A

variable PK (variable metabolism)

low therapeutic index w/ serious adverse effects

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18
Q

route of administration of methylxanthines

A

PO or IV (not inhaled)

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19
Q

Adverse effects of methylxanthines

A

CNS excitation (even seizure)
cardiac stim (dysrhythmias)
vasodilation/hypotension
diuresis
N/V, diarrhea

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20
Q

How do anticholinergics work in asthma/COPD?

A

block M receptors in bronchi = decreased bronchoconstriction

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21
Q

What is a SAMA

A

short acting inhaled muscarinic antagonist

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22
Q

What is a LAMA

A

long acting inhaled muscarinic antagonist

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23
Q

Which inhaled anticholinergics are quaternary ammoniums?

A

ipratropium
tiotropium

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24
Q

What is the implication of an inhaled drug being a quaternary ammonium?

A

Drug cannot cross membranes - it stays in the lungs and has no systemic adverse effects

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25
In asthma and COPD, treatment consists of two goals. What are these goals?
Anti-inflammation Bronchodilation
26
Which anti-inflammatory is the most effective for long term control of airway inflammation?
glucocorticoids
27
Route of administration of glucocorticoids for asthma/COPD?
usually inhaled acute exacerbations = PO/IV
28
Adverse effects of inhaled glucocorticoids
thrush hoarseness (long term high dose can have systemic adverse effects)
29
adverse effects of systemic glucocorticoids
adrenal suppression osteoporosis hyperglycemia immunosuppression fluid retention hypokalemia peptic ulcer disease growth suppression (peds)
30
List some inhaled glucocorticoids
beclomethasone budesonide fluticasone
31
How do leukotriene receptor antagonists work?
Suppress effects of leukotrienes decreased: - smooth m constriction - blood vessel permeability -inflammation
32
Route of administration of leukotriene receptor antagonists
PO
33
adverse effects of leukotriene receptor antagonists
depression/SI various depending on the specific drug (esp liver injury, CYP450 inhibition)
34
List some leukotriene receptor antagonists
zileuton zafirlukast montelukast
35
Which is the safest leukotriene receptor antagonist?
montelukast
36
Name the mast cell stabilizer
cromolyn
37
How do mast cell stabilizers work?
stabilize mast cell membrane = decreased histamine & inflammatory mediator release --> decreased inflammation
38
Which is the safest of ALL the anti-inflammatories used for asthma?
cromolyn
39
How do monoclonal antibodies work?
Ab bind target substance, rendering it inert
40
Adverse effect of all monoclonal antibodies used for any purpose
injection site reactions hypersensitivity reactions (can be as serious as anaphylaxis)
41
How do phosphodiesterase 4 inhibitors work for COPD?
inhibit PDE4 (enzyme that breaks down cAMP) --> increased cAMP results in: - suppression of cytokines - decreased WBC infiltration
42
List one PDE4 inhibitor
roflumilast
43
Adverse effects of PDE4 inhibtors
diarrhea anorexia HA back pain insomnia
44
List two glucocorticoid+LABA combinations
Symbicort Advair
45
List one SABA+anticholinergic combination
Combivent
46
Most effective treatment of allergic rhinitis
intranasal glucocorticoids
47
Do we use B2 agonists in allergic rhinitis
no - not a airway constriction issue use anti-inflammatories primarily since it's an inflammation issue
48
Which type of sympathomimetics (which receptor) are used in allergic rhinitis & why?
a1 receptor agonists = vasoconstriction decreases swelling & vessel permeability in the nose.
49
Which type of antihistamines are associated with sedation? List a coulple
1st generation chlorpheniramine diphenhydramine
50
List a couple sympathomimetics used for allergic rhinitis
phenylephrine pseudoephedrine
51
Why is the use of sympathomimetics for allergic rhinitis limited to a couple days?
Rebound congestion can occur
52
What type of cough is useful to be treated with a cough suppressant?
nonproductive sleep-depriving
53
What is another name for cough suppressants?
antitussives
54
What is an expectorant? (definition)
promotes secretion of sputum
55
What is a mucolytic (definition)?
breaks down thick mucus (so secretions can be expelled more easily)
56
List an expectorant
guaifenesin
57
List a couple mucolytics
hypertonic saline acetylcysteine
58
How do opioid antitussives suppress cough?
elevate the cough threshold in CNS
59
Which is the most effective cough suppressant?
codeine
60
What schedule drug is codeine when used for a cough suppressant
V
61
List a couple nonopioid antitussives
dextromethorphan diphenhydramine benzonatate

Pharm (27 decks)

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