Respiratory, Gastrointestinal, Endocrine & Bone Mineral Density

Question 1

Drugs that DECREASE VISCOSITY of secretions and help prevent thick mucus from blocking respiratory pathways. Commonly used to treat COPD & pneumonia

Answer 1

Mucolytics

Question 2

Facilitate PRODUCTION & EJECTION of mucus and helps prevent thick mucus from blocking respiratory pathways. Commonly used to treat COPD and pneumonia.

Answer 2

Expectorants (Guaifensesin)

Question 3

Two classifications of medications used to treat obstructive pulmonary disease

Answer 3

Bronchodilators & Anti-inflammatory agents

Question 4

Types of Bronchodilators

Answer 4

Beta-adrenergic agonists, Xanthine derivatives, & anticholinergics

Question 5

Anti-inflammatory agent used for obstructive pulmonary diseases

Answer 5

Glucocorticoids

Question 6

Beta-Adrenergic Agents

Answer 6

Stimulation of beta-2 receptors on respiratory smooth muscle cells to cause RELAXATION via bronchodilation. Can be selective or nonselective
Ex: Albuterol, Levalbuterol, Salmeterol

Question 7

Route of administration for Beta-adrenergic agents

Answer 7

Inhalation (preferred - inhalers or nebulizers), orally, and subcutaneously

Question 8

Adverse effects of beta-adrenergic agents

Answer 8

Tolerance, cardiac irregularities (nonselective), stimulation of CNS receptors causing nervousness, restlessness, and tremor

Question 9

Xanthine Derivatives

Answer 9

Treat airway obstruction by producing bronchodilation - Mechanism is debated upon.
Ex: Theophylline, caffeine, aminophylline

Question 10

Adverse effects of xanthine derivatives

Answer 10

Toxicity (overlap of therapeutic & toxic ranges) - Nausea, confusion, irritability, and restlessness. Cardiac arrhythmias, fatal seizures

Question 11

Anticholinergic Drugs

Answer 11

Block the acetylcholine receptors on respiratory smooth muscle cells to prevent vasoconstriction caused by increased vagal tone and acetylcholine release – Result in bronchodilation
Choice drug in COPD treatment

Question 12

Choice drug in COPD treatment

Answer 12

Anticholinergic Drugs

Question 13

Glucocorticoids

Answer 13

Control inflammation induced bronchospasms by causing powerful anti-inflammatory effects

Question 14

Most effective drug at controlling asthma

Answer 14

Glucocorticoids

Question 15

What should be done after taking glucocorticoid medications by mouth?

Answer 15

Rinse mouth out after to reduce risk of oral irritation

Question 16

Adverse effects of glucocorticoids

Answer 16

Osteoporosis, skin breakdown, muscle wasting, retardation of growth, cataracts, glaucoma, hyperglycemia, & aggravation of DM/HTN

Question 17

Leukotriene Inhibitors

Answer 17

Inflammatory compounds used to control airway inflammation - Combined with glucocorticoids and beta agonists for better management of COPD & asthma

Question 18

First line of defense for LONG TERM asthma management - Main treatment for asthma

Answer 18

Glucocorticoids - Combined with beta-2 agonists for optimal results

Question 19

Why are glucocorticoids preferred for asthma over bronchodilators?

Answer 19

They reduce the inflammation that underlies asthma, not just treat the secondary manifestations

Question 20

Best choice for asthma attacks

Answer 20

Short acting beta-2 agonist. Leukotriene inhibitors can also be used to control inflammation

Question 21

First choice drug for treating COPD by maintaining airway patency and prevent airflow restriction

Answer 21

Anticholinergics
Long-acting beta-2 agonists are also used to promote bronchodilation

Question 22

Pharmacological management for maintaining airway patency in Cystic Fibrosis

Answer 22

Bronchodilators and mucolytics or expectorants limit formation of mucus plugs.
Systemic glucocorticoids are useful in limiting airway inflammation and improving pulmonary function (prednisone)

Question 23

When should PT be scheduled after administration of medication?

Answer 23

30-60 minutes after mucolytic and expectorants are given via nebulizer

Question 24

Bronchodilator Toxicity

Answer 24

Cardiac arrhythmias, nervousness, confusion, tremors (systemic effects)

Question 25

Rehab considerations for Glucocorticoid treatment

Answer 25

Skin breakdown Prevent overstressing of bones/musculotendinous structures

Question 26

Drugs that control & limit gastric acid

Answer 26

Antacids, H2 receptor blockers, & proton pump inhibitors

Question 27

Antacids

Answer 27

Neutralize stomach acids Types include aluminum, magnesium, sodium bicarbonate or combinations

Question 28

Adverse effects of antacids

Answer 28

Electrolyte imbalances, changes in other drug pharmacokinetics that rely on stomach acidity (should NOT be taken within 2 hours of other orally administered drugs)

Question 29

H2 Receptor Blockers

Answer 29

Prevent stimulation of gastric acid secretions by blocking histamine receptors Treat acute and long-term management of peptic ulcer & GERD

Question 30

Side Effects of H2 receptor blockers

Answer 30

Headache, dizziness, mild GI problems, arthralgia, myalgias, tolerance

Question 31

Proton Pump Inhibitors

Answer 31

Inhibit the enzyme responsible for secreting acid from gastric parietal cells by 80-95%

Question 32

Drug of choice for long-term management of gastric/duodenal ulcers & GERD

Answer 32

Proton Pump Inhibitors

Question 33

Adverse effects of PPI

Answer 33

Gastric acid rebound, gastric polyps, GI tumors, decreased bone mineralization and risk of fx

Question 34

Clinical Use of Endocrine Drugs

Answer 34

1. Replacement Therapy 2. Diagnosis of Endocrine Disorders 3. Exploitation of beneficial effects 4. Alter normal endocrine function

Question 35

Adrenocorticosteroids (2)

Answer 35

Glucocorticoids & Mineralcorticoids

Question 36

Primarily involved in control of glucose metabolism and body's ability to deal with stress - Decreases inflammation and suppresses immune system

Answer 36

Glucocortocoids

Question 37

Maintains fluid and electrolyte balances in the body

Answer 37

Mineralcorticoids - Ex: Aldosterone

Question 38

Glucocorticoids - Endocrine Indications

Answer 38

- Restore normal function after adrenal cortical hypofunction (Addison's) - After removal of adrenal glands or pituitary gland - Rheumatoid arthritis - Manage systemic inflammation - Treat severe acute inflammation (no more than 4) - Control inflammation or suppress immune system for short-periods of time

Question 39

Adverse effects of endocrine glucocorticoids

Answer 39

Adrenocortical suppression, drug induced Cushing's Syndrome (hypersecretion), breakdown of tissues (catabolic effect), loss of bone strength (osteoclast), peptic ulcers, slow growth, etc.

Question 40

Aldosterone (Mineralcorticoids)

Answer 40

Maintains fluid & electrolye balance within the body - Works on kidneys to increase sodium & water reabsorption and excretion of potassium Commonly used as replacement therapy - Addison's disease

Question 41

Negative Physiological Effect of Aldosterone

Answer 41

Increased production promotes renal sodium and water retention -- Leads to HTN and heart failure Can also cause inflammation, hypertrophy, and fibrosis of cardiac/vascular tissues

Question 42

Adverse effects of mineralcorticoids

Answer 42

HTN, edema, weight gain, hypokalemia

Question 43

Mineralcorticoid Antagonists

Answer 43

Potassium sparing diuretics used to treat HTN and heart failure

Question 44

Conditions treated with Glucocorticoids

Answer 44

Obstructive pulmonary disease (asthma, cystic fibrosis), endocrine issues More specific: RA, ankylosing spondylitis, lupus erythematosus, acute bursitis

Question 45

What kind of supplements are taken to prevent bone loss in OP, Rickets, Osteomalacia, & Hypoparathyroidism?

Answer 45

Calcium Supplements

Question 46

Maximum tolerated dose of Ca per day?

Answer 46

2,500 mg/day Any dose above 1,000mg/day increases risk of arterial calcification and cardiovascular disease

Question 47

Adverse Effects of Calcium Supplements

Answer 47

Hypercalcemia (constipation, drowsiness, fatigue, headache), confusion, irritability, cardiac arrhythmias, HTN, N/V

Question 48

Vitamin D

Answer 48

Increase intestinal absorption of calcium and phosphate Too much can cause vitamin D toxicity

Question 49

Bisphosphonates

Answer 49

Inhibit osteoclast activity, promote bone mineralization, inhibit abnormal bone formation, prevent bone pain/fractures, and prevent bone loss

Question 50

Primary treatment for Osteoporosis?

Answer 50

Bisphosphonates

Question 51

Adverse Effects of Bisphosphonates

Answer 51

Death of bone tissue in jaw (osteonecrosis), atypical subtrochanteric hip fx, GI disturbances

Question 52

Calcitonin

Answer 52

Mimics endogenous calcitonin Prevents bone loss in OA, postmenopausal OP, and glucocorticoid induced OP

Question 53

Rehab implications for Estrogen Therapy

Answer 53

Enhance bone mineralization by incorporating weight bearing & resistance exercises