Respiratory Drugs

Question 1

What is COPD most commonly d/t?

Answer 1

Cigarette smoke

Question 2

What are two different types of COPD?

Answer 2

Bronchitis

Emphysema

Question 3

How is chronic bronchitis caused?

Answer 3

Mucociliary escalator system becomes paralyzed

Question 4

How is emphysema caused? D/t what?

Answer 4

Alveoli become hyper-inflated

D/t macrophage releasing protease that destroys elastin

Question 5

What are three things that cause SOB in asthma?

Answer 5

Bronchoconstriction
Edema
Mucus production

Question 6

What are environmental factor that cause asthma?

Answer 6

Exercise
Cold air
Allergens

Question 7

What inflammatory chemicals cause asthma?

Answer 7

Histamine
Prostaglandins
Leukotrienes
ECF-A

Question 8

What does ICS inhibit?

Answer 8

PLA2

Question 9

What does LTRA stand for?

Answer 9

Luekotriene receptor antagonist

Question 10

What are the 3 classes of bronchodilators?

Answer 10

Beta-2 agonist
Anticholinergics
Methylxanthines

Question 11

What are two types of beta-2 agonist?

Answer 11

LABA

SABA

Question 12

What is the MOA of beta agonists?

Answer 12

Activate adenylate cyclase to increase cAMP which causes SM dilation

Question 13

What does phosphodiesterase (PDE) do to cAMP?

Answer 13

Breaks down cAMP

Question 14

What is the MOA of methylxanthines?

Answer 14

Inhibits PDE and adenosine

Question 15

What does adenosine do?

Answer 15

Increases release of histamine which increases bronchoconstriction

Question 16

What is the MOA of muscarinic antagonists?

Answer 16

Decrease the release ACh which causes bronchoconstriction

Question 17

What does adenylate cyclase do to lungs?

Answer 17

AC increases the production of cAMP which causes SM dilation

Question 18

What are the 3 Long Acting Beta Agonist?

Answer 18

Arformoterol(Brovana)
Formoterol(Foradil,Perforomist)
Salmeterol(Serevent)

Question 19

Why does DPI stand for?

Answer 19

Dry powder inhaler

Question 20

What is the name of the 2 drugs that are methylxanthines?

Answer 20

Theophylline(Theo-Dur)

Aminophylline

Question 21

What is the Theophylline therapeutic range?

Answer 21

10-20mcg/mL

Question 22

What are the 3 anticholinergic drugs?

Answer 22

ipratropium(Atrovent)
tiotropium(Spiriva)
aclidinium(Tudorza)

Question 23

What condition are anticholinergics useful for? Why?

Answer 23

COPD

Because it reduces secretions in bronchioles

Question 24

What prevents anticholinergic bronchodilators from going systemic?

Answer 24

They are quaternary compounds that prevent it from crossing the membrane

Question 25

What are 2 vital signs that bronchodilators can greatly effect?

Answer 25

Increase HR and BP

Question 26

What helps loosen secretions when taking a bronchodilator?

Answer 26

Hydration

Question 27

Why can having anxiety with asthma be dangerous?

Answer 27

Can increase the risk for an asthmatic attack

Question 28

What is the goal w/ lungs when taking a bronchodilator?

Answer 28

Pt free of wheezing and clear lungs in 2-5 days

Question 29

When does toxicity for theophylline levels start?

Answer 29

>20mcg/mL

Question 30

What must be done to prevent thrush development when taking a ICS?

Answer 30

Rinse out mouth after using ICS

Question 31

What two types of drugs are leukotriene inhibitors?

Answer 31

LTRA | lipoxygenase inhibitor

Question 32

What levels must be monitored when taking a leuoktriene inhibitor?

Answer 32

AST and ALT levels

Question 33

What is PDE4 inhibitors indicated for?

Answer 33

COPD

Question 34

What is the MOA of omalizumab(Xolair) and mepolizumab(Nucala)?

Answer 34

Targets IgE and binds to it to prevent IgE from attaching to mast cells to release histamine

Question 35

What is considered mild/intermittent asthma? What is the drugs to be used for this?

Answer 35

<2 episodes/wk SABA PRN

Question 36

What is considered mild/persistent asthma? What is the drugs to be used for this?

Answer 36

>2 episodes/wk but <1/day ICS SABA PRN

Question 37

What is considered moderate/persistent asthma? What is the drugs to be used for this?

Answer 37

Daily episodes ICS LABA

Question 38

What is fluticisone w/ salmeterol called?

Answer 38

Advair

Question 39

What is budesonide w/ formoterol called?

Answer 39

Symbicort

Question 40

What is fluticasone w/ vilanterol?

Answer 40

Breo Ellipta

Question 41

What is considered severe/persistent asthma? What is the drugs to be used for this? What medication should be considered if a pt has allergies?

Answer 41

Multiple daily episodes High dose corticosteroid LABA Consider omalizumab(Xolair)