Respiratory Pharm Flashcards Preview

Pharmacology > Respiratory Pharm > Flashcards

Flashcards in Respiratory Pharm Deck (49)
Loading flashcards...
1

describe asthma

  • Chronic inflammation of the airways
  • Bronchial hyperresponsiveness
  • Airflow obstruction
  • reversible

2

inflammation in airway secretion from asthma results in

  • Bronchiolar Smooth Muscle Spasm
  • Airway Hyperresponsiveness
  • Airway Edema
  • Increased Mucus Secretion

3

classify asthma based on severity 

4

overview of drugs for asthma management 

5

list the inhaled short-acting β2 adrenergic agonists (SABAs)

Albuterol
Terbutaline
Pirbuterol

6

list the Inhaled long-acting β2 adrenergic agonists (LABAs)

Salmeterol
Formoterol

7

describe the MOA of β2 Adrenergic Agonists

  • Binds/activates β2 adrenergic receptors on airway smooth muscle cells
  • Activation of β2 receptors stimulates adenylyl cyclase and increases formation of cAMP
  • cAMP activates protein kinase A which phosphorylates and inactivates myosin light chain kinase → relaxation of the airway smooth muscle cells and bronchodilation

8

___ are the DOC for relief of acute asthma symptoms and prevention of exercise-induced bronchospasm

SABAs are the DOC for relief of acute asthma symptoms and prevention of exercise-induced bronchospasm

9

LABAs are combined with ____ for long-term control in moderate and severe persistent asthma

LABAs shouldn’t be used as ___ for long-term control of asthma as they have no _____

Are LABAs used for treating acute asthma symptoms? 

LABAs are combined with inhaled corticosteroids (ICS) for long-term control in moderate and severe persistent asthma

LABAs shouldn’t be used as monotherapy for long-term control of asthma as they have no anti-inflammatory action

LABAs are NOT used for acute astham symptoms

10

list AEs of β2 Adrenergic Agonists

 

  • tachycardia, tremor, and hypokalemia
    • reduced via inhalation administration 
  • LABAs increase risk of serious asthma- related events (hospitalization, intubation, and death)

11

list the Inhaled Short-Acting Muscarinic Antagonists (SAMAs)

Ipratropium

 

12

list the Inhaled Long-Acting Muscarinic Antagonists (LAMAs)

Tiotropium

13

what is the MOA of ipratropium and tiotropium

block muscarinic receptors on the airways causing bronchodilation and reduction of respiratory secretions

14

Ipratropium is less effective than ____ 

but provides additive benefit to SABAs in the management of moderate to severe exacerbations of asthma

Ipratropium is less effective than SABAs

but provides additive benefit to SABAs in the management of moderate to severe exacerbations of asthma

15

____ is the DOC for β-blocker-induced bronchospasm

Ipratropium is the DOC for β-blocker-induced bronchospasm

 

16

____ may be added to ICS for long-term control of severe persistent asthma

Tiotropium may be added to ICS for long-term control of severe persistent asthma

17

list the Anticholinergic AEs

  • quaternary ammonium compounds
  • minor anticholinergic effects, e.g. xerostomia
  • may be safer than SABAs in patients with cardiovascular disease

18

Methylxanthines

Theophylline

19

Theophylline inhibits ____, increasing ____ evoking bronchodilation

Theophylline inhibits phosphodiesterase, increasing cAMP evoking bronchodilation

20

____ can be given orally or IV and is ___ therapy for patients with persistent asthma

Theophylline can be given orally or IV and is alternate therapy for patients with persistent asthma

21

list the AEs of Theophylline

  • Largely replaced by β2 agonists and corticosteroids due to narrow therapeutic window, adverse effects, and potential for drug interactions
  • most common: headache, nausea, vomiting, abdominal discomfort, and restlessness
  • At high concentrations: cardiac arrhythmias and seizures

22

list the inhaled corticosteroids (ICS)

Beclomethasone
Fluticasone
Flunisolide
Budesonide

23

list the systemic corticosteroids

 

Prednisolone
Dexamethasone

24

Glucocorticoids inhibit ____ and ____, resulting in reduced formation of leukotrienes and prostaglandins

Glucocorticoids inhibit phospholipase A2 and COX-2, resulting in reduced formation of leukotrienes and prostaglandins

25

Prolonged use of SABAs results in β2 receptors desensitization...

 ____ prevent or reverse this desensitization

Prolonged use of SABAs results in β2 receptors desensitization...

 corticosteroids prevent or reverse this desensitization

26

____ are the most effective long-term control medication in the management of persistent asthma.

corticosteroids are the most effective long-term control medication in the management of persistent asthma.

27

Oral ____may be added to ICS for long-term control of severe persistent asthma

 

Oral prednisolone may be added to ICS for long-term control of severe persistent asthma

 

28

A short course of _____ is used for moderate and severe acute exacerbations of asthma to speed recovery and to prevent recurrence of exacerbations

A short course of systemic corticosteroids is used for moderate and severe acute exacerbations of asthma to speed recovery and to prevent recurrence of exacerbations

29

list the AEs of inhaled ICS

  • Inhaled CS = lower bioavailability than systemic CS → less adverse effects
  • Local AEs: 
    • oropharyngeal candidiasis
    • dysphonia, reflex cough and bronchospasm
  • Long-term use:
    • osteoporosis and cataracts
    • may cause deceleration of vertical growth in children

30

Long term use of systemic glucocorticoids may result in ____ and _____ 

Long term use of systemic glucocorticoids may result in hypercortisolism and Cushing's syndrome