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Pharm 225A > Respiratory meds > Flashcards

Respiratory meds Flashcards

1
Q

Two main classes of drugs for asthma

A
  • Bronchodilators
  • anti inflammatory agents
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2
Q

Types of bronchodilators

A
  • B2 adrenergic agonist
  • Methylxanthines
  • anticholinergics
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3
Q

MoA B2 Adrenergic agonists

A
  • relaxes smooth muscle –> bronchodilation
  • increase ciliary motility –> mucus clearance
  • suppress histamine release
  • increase myocardial conductivity
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4
Q

Albuterol

A
  • short acting beta2 agonist ; inhaled
  • quick relief of acute bronchospasm; prevention of exercise induced bronchospasm
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5
Q

levalbuterol

A
  • short acting beta2 agonist; inhaled
  • quick relief of acute bronchospasm; prevention of exercise induced bronchospasm
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6
Q

Terbutaline

A
  • short acting beta2 agonist; inhaled
  • SQ/IV for fetal distress, suppress pre-term labor
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7
Q

Salmeterol

A
  • long acting beta2 agonist; inhaled
  • commonly used with fluticasone (ICS)
  • decreases s/s and risk of exacerbations, improves lung fxn
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8
Q

Formoterol

A
  • long acting beta2 agonist; inhaled
  • commonly used with budesonide (ICS)
  • decreases s/s and risk of exacerbations, improves lung fxn
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9
Q

AEs of B2 agonist (short acting)

A
  • well-tolerated
  • tachy, angina, tremors
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10
Q

AEs of B2 agonist (long acting)

A
  • must be combined with ICS in persistent asthma
  • discontinue LABA is possible once asthma control achieved
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11
Q

MoA of Methylxanthines

A
  • release of Epi in adrenal medulla –> smooth muscle relaxation of bronchi
  • improved resp muscle
  • increases cardiac output and mucus clearance
  • decreased airway inflammation
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12
Q

Theophylline

A
  • methylxanthine; inhaled
  • narrow therapeutic index
  • SE’s: insomnia, N/V, Toxicity = tachycardia and convulsions
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13
Q

Theophylline toxicity risk

A
  • increase risk of toxicity with CYP1A2 and 3A4 inhibitors
  • ex. propranolol, ciprofloxacin, LT modifiers, caffeine
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14
Q

MoA of anticholinergics

A
  • block muscarinic receptors –> bronchodilation
  • block bronchoconstriction
  • off label asthma, mostly for COPD
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15
Q

Ipratroprium bromide

A
  • short acting inhaled anti-cholinergic agent
  • used in combo with SABA albuterol
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16
Q

Tiotropium Bromide

A
  • long acting inhaled anti-cholinergic agent
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17
Q

AEs of anticholinergic agents

A
  • dry mouth
  • constipation
  • urinary retention
  • blurred vision
  • tachy
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18
Q

Types of anti-inflammatory drugs

A
  • steroidal/non-steroidal
  • leukotriene modifiers
  • biologics
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19
Q

MoA of Corticosteroid

A
  • decreased levels of inflammatory mediators
  • decreased airway edema, mucus production/hypersecretion
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20
Q

Fluticasone

A
  • inhaled corticosteroid/glucocorticoid
  • paired with LABA salmeterol
  • most effective anti-asthma
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21
Q

Budesonide

A
  • inhaled corticosteroid/glucocorticoid
  • paired with LABA formoterol
  • most effective anti-asthma
22
Q

methylprednisolone

A
  • oral glucocorticoid
  • also injectable
23
Q

prednisone

A
  • oral glucocorticoid
24
Q

AEs of glucocorticoid

A
  • oropharyngeal candidiasis if inhaled improperly
  • dysphonia
  • growth suppression in children

to minimize = spacer, rinse mouth after admin, antifungal use

25
Q

Long term SEs of systemic steroids

A
  • cushings syndrome
  • adrenal insufficiency
  • CNS effects (nervousness/depression)
  • immunosuppression
  • osteoporosis
  • peptic ulcers
  • growth retardation in children
  • catracts/glaucoma
26
Q

MoA of leukotriene D4 receptor antagonist

A
  • blocks D4 receptors
  • bronchodilates, decreases mucus, exercise induced asthma prevention
27
Q

MoA of 5-Lipooxygenase Inhibitors

A
  • prevent formation of leukotrienes
  • leads to anti-inflammation/bronchodilation
28
Q

Zafirlukast

A
  • PO
  • leukotriene D4 receptor blocker
29
Q

Montelukast

A
  • PO
  • leukotriene D4 receptor blocker
  • also for exercise induced asthma
30
Q

Zileuton

A
  • PO
  • 5-lipo-oxygenase inhibitor
  • need to monitor LFTs
31
Q

Leukotriene Modifiers AEs

A
  • headache
  • Nausea/diarrhea
  • BBW - neuropsychiatric events
  • upper RTI
32
Q

Cromolyn (MoA, Use, Route, AEs)

A
  • MoA: prevents release of inflamm. mediators (not bronchodilator)
  • Uses: prophylaxis of exercise induced bronchospasm
  • route: inhaled, nebulizer
  • AEs: occasional cough/bronchospasm
33
Q

Anti-IgE Antibody MoA

A
  • Prevents release of mediators of allergic response that cause bronchospasm
34
Q

AEs of Anti-IgE antibody

A
  • BBW: anaphylaxis after 1st dose/delayed onset (>1 year)
35
Q

Omalizumab

A
  • recombinant monoclonal antibody
  • route: SubQ every 2-4 wks for 3 doses
  • 2nd choice for allergy related asthma if all others fail
36
Q

Drugs used in the tx of COPD

A
  • short acting/long acting bronchodilators
  • Glucocorticosteroids
37
Q

Roflumilast (class/route/MoA/AE)

A
  • Phosphodiesterase 4 inhibitor
  • PO
  • MoA: smooth muscle relaxation –> bronchodilation and decreased inflammation for severe COPD
  • AE: weight loss, N/V, suicidal thoughts
38
Q

MoA of anithistamines

A
  • inhibit histamine release
  • histamine receptor antagonist
39
Q

Diphenhydramine (class/route/AEs)

A
  • aka benadryl, 1st gen antihistamine
  • oral, intranasal
  • AEs: sedation, stimulant effect in some patients
  • 2nd & 3rd gen have less SEs
40
Q

Mometasone

A
  • intranasal corticosteroid in treatment in allergic rhinitis
41
Q

MoA of decongestants

A
  • alpha 1 adrenergic agonist
  • vasoconstriction –> less mucosal edema and exudation
  • immediate effects
42
Q

Phenylephrine

A
  • PO or nasal decongestant
  • extensive 1st pass metabolism when PO
43
Q

Psuedoephedrine

A
  • PO decongestant
  • can be manipulated into methamphetamine
44
Q

Oxymetalozine

A
  • intranasal decongestant
45
Q

AEs of decongestants

A
  • rebound when used > 3-5 days
  • irritability, anxiety, insomnia
  • increased BP (caution for HTN/CAD patients)
46
Q

MoA of antitussives

A
  • Central: suppress cough center in medulla
  • peripheral: lessen irritation of respiratory tract
  • not recommended for children under 6 (seizures)
47
Q

Dextromethorphan (DM)

A
  • non-opioid antitussives, PO
  • blocks the cough reflex center in the CNS
  • abused if used in large quantities
48
Q

Diphenhydramine

A
  • non-opioid antitussive, PO
  • MoA: sedative/anticholinergic props, cough suppression
  • AEs: sedation, dizziness, dry mouth
49
Q

Benzonatate

A
  • non-opioid antitussive, PO
  • decreases sensitivity of respiratory tract receptors
50
Q

Opioid antitussives (MOA)

A
  • MoA: suppresses CNS cough center & inhibits sensory nerves in bronchi
  • contain codeine
51
Q

Guaifenesin

A
  • PO
  • Expectorant
  • decrease cough frequency, decrease phlegm thickness, removal of secretions
52
Q

Acetylcystine

A
  • PO
  • mucolytic
  • breaks up respiratory mucoprotein into smaller strands; mucus more watery
  • also for cystic fibrosis and overdose of acetaminophen

Pharm 225A (7 decks)

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