Respiratory Pharm I Flashcards Preview

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Flashcards in Respiratory Pharm I Deck (31):
1

Three components influencing bronchoconstriction

Activation of Mast Cells
Local Inflammation
Vagal Stimulation

2

Agents tat reduce bronchoconstriction and increase relaxation all increase levels of intracellular _____

cAMP

3

How do sympathomimetics act to treat asthma

Increase cAMP via Gs receptor subunit
Relaxes smooth muscle/Decreases Mast cell release

4

Examples of selective short acting beta adrenergic agents

Albuterol, terbutaline
metaproterenol, pirbuterol

5

Which beta adrenergic agent is a Pure R mixture

Levabuterol

6

Two main examples of long acting beta-agonists

Salmeterol and Formoterol

7

When to use a long acting beta agonist

Used w/ inhaled steroids for mainenence therapy
NOT for acute exacerbations

8

Antimuscarinic agonists are especially helpful in what conditions

Non-allergic (COPD)

9

Antimuscarinic agents used to help out COPD paients

Ipatropium
Tiotropium

10

How do methylxanthines work?

They block phosphodiesterase activity, preventing breakdown of cAMP. This causes bronchodilation and inhibition of inflammatory cells. This leads to a non-specific, inexpensive treatment.

11

Examples of methylxanthines that can be used to treat asthma?

Theophylline, Caffeine, Theobromine

12

Aside from asthma/COPD treatment, methylxanthines may also cause...

Increased Alertness, Nervousness, Tremor
Tachycardia, Rare arrythmias
Increased gastric acid, digestive enzyme secretion
Increased diaphragmatic fxn

13

Main issues with using the methylxanthine THEOPHYLLINE

Wide variation in blood levels
Narrow window to therapeutic range

14

Example of an Anti-IgE antibody

Omalizumab

15

How do anti-IgE antibodies work

They target the Fc portion of IgE, preventing its attachment to mast cells and basophils. This reduces the frequency/severity of exacerbations for llergen induced.

16

Downside of treating with omalizumab

Given parenterally
VERY expensive

17

How does Cromolyn work?

Inhaled powder that inhibits mast cell degranulation by a poorly understood mechanism (membrane stabolization)

18

When to use Cromolyn

Prophylactically, NOT during attack

19

Two approaches of leukotriene modifiers

Inhibition of 5-lipoxygenase (zileuton)
LTD4 receptor antagonist (montelukast)

20

Aerosol steroid treatments to know...

Beclomethasone, Fluticasone

21

Oral/parenteral steroids used in emergencies

Prednisone, Dexamethasone

22

Talk through the stepwise increase in asthma treatment

SABA PRN
Add in Low Dose ICS
Plus LABA
Increase Steroid Dose
If really bad, add omalizumab

23

Why do nebulizers work better than inhalers

Continuous use over minutes
Larger particles generated, so higher doses given
Problem -- Bacterial contamination

24

How do spacers help improve inhaler activity?

Aids in aerosolization
More makes it to lungs

25

Typical approach to therapy with COPD

Long acting beta agonists and anticholinergic agents
Can add theophylline -- but dangerous side effects
Inhaled steroids can be added in

26

Drugs that are not helpful for COPD exacerbations

NSAIDs
anti-leukotrienes

27

What to keep in mind when treating a COPD exacerbation

Keep patient out of hospital -- infection
Steroids may help, but less than asthma
Antibiotics for infections -- Doxy
Avoid O2, Dehydration

28

General strategies for treatment of nasal allergies

Avoidance of Triggers
Antihistamines
Nasal Steroids
Saline
Possibly antileukotrienes to decrease secretions

29

Commonly used antihistamines

Diphenhydramine, Chlorpheniamine, hydroxyzine
Fexofenadine, Loratadine, Certirizine

30

Name nasal steroids

Mometasone
Fluticasone

31

Commonly used decongestants

Pseudophedrine or phenylephrine