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245 Dental Pharmacology > Respiratory Pharmacology > Flashcards

Respiratory Pharmacology Flashcards

1
Q

What are the two main respiratory pathologies?

A

Asthma and COPD

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2
Q

Characteristics of asthma

A
  • Episodic and reversible
  • Inflammatory condition
  • Marked by a reduction in expiratory air flow (bronchioles obstructed by muscle spasm, edema of mucoa and thick secretions)
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3
Q

What medication would be used for immediate relief of asthma?

A

Albuterol

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4
Q

What medication would be used for long-term treatment of asthma?

A

Anti-inflammatory steroid

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5
Q

What is asthma precipitated by?

A

Precipitated by allergens, pollution, exercise, stress, upper respiratory infection, sulfites

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6
Q

What are the symptoms of asthma?

A
  • Symptoms include wheezing and shortness of breath
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7
Q

Characteristics of COPD

A
  • Chronic and irreversible airway obstruction
  • Air Trapping
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8
Q

What are the two types of COPD?

A
  • Emphysema
  • Chronic bronchitis
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9
Q

What is emphysema?

A
  • Alveolar destruction
  • Airspace enlargement
  • Airway collapse
  • Slow onset usually due to smoking, may resmble old age
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10
Q

What do we not give pts w/ COPD?

A

Nitrous

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11
Q

What is a possible surgical treatment for COPD

A

Lobectomy

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12
Q

What is the main treatment for respiratory pathologies?

A

Metered dose inhalers that deliver medication directly to the bronchioles

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13
Q

What are the advantages of metered dose inhalers?

A
  • Lower dose means less adverse effects
  • Greater bronchiodilating effect
  • Can be accurately measured
  • Rapid, predictable onset of action
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14
Q

Disadvantages of metered dose inhalers

A

Difficult to use properly
Easily overused which can lead to diminished response
Need for “spacer”

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15
Q

What type of autonomic agents are used in the treatment of respiratory pathologies?

A
  • Short-acting beta-2 agonists
  • Cholinergic Antagonists
  • Inhaled corticosteroids
  • Leukotriene receptor antagonists
  • Antihistamines
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16
Q

What are short-acting beta-2 agonists used for?

A

“Rescue Inhalers”
Albuterol
Used for acute episodes or management of mild symptoms

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17
Q

Why are long-acting beta-2 agonists use controversial?

A

Long acting beta agonists can cause death
-Not a tx for asthma
-Not anti-inflammatory

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18
Q

What are cholinergic antagonists used for?

A
  • Management of moderate to severe COPD
  • Management of chronic bronchoconstriction
  • NOT for acute episodes
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19
Q

What are some adverse effects of beta-2 agonists?

A
  • Increased HR and BP
  • Anxiety
  • Tremor
  • Xerostomia
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20
Q

What are some adverse effects of cholinergic antagonists?

A
  • Blurred vision and sensitivity to light
  • Headache
  • Nausea
  • Cough
  • Tachychardia
  • Xerostomia and altered taste
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21
Q

What is the mechinism of action of inhaled corticosteroids?

A
  • Reduce hypersensitivity of airway to allergens
  • Reduce inflammation
    -Decrease narrowing of airways
    -Decrease swelling at bronchioles
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22
Q

What are some types of inhaled corticosteroids?

A

Qvar (beclomethasone)
Flovent (fluticasone)
Pulmicort (budesonide)

23
Q

What are some adverse effects of inhaled corticosteroids?

A

Xerostomia
Hoarse voice
Cough
Increased fungal infections (oral candidiasis)

24
Q

What are the 4 I’s?

A

When you take a drug that reduces inflammation:
* Reduced immunity
* Increased risk of infection
* Impaired wound healing

25
Q

What condition may people have when they use inhaled corticosteroids that they may not realize they have until a clinician looks in their mouth? How can this be prevented?

A
  • Fungal pharyngitis
  • Pt. should be instructed to gargle and rinse w/ water after use
26
Q

When using a corticosteroid and beta-2 agonist together, which should be used first?

A

Beta-2 agonist

27
Q

What is the mechanism of action of leukotriene receptor antagonists?

A
  • Block the action fo leukotrienes (inflammatory mediators)
  • Inhibit the immune response to allergens
  • Decrease airway contriction, mucous secretion
  • Promote bronchodilation
28
Q

What form are leukotriene receptor antagonists made in?

A

Singulair (montelukast)- Pill (not inhaled)

29
Q

Who are leukotriene receptor antagonists given to?

A

Those who don’t want or cannot have steroids

30
Q

What are leukotriene receptor antagonists used to treat?

A
  • People with asthma
  • Used to treat allergies
  • NOT used to treat COPD
31
Q

What is an adverse effect of leukotriene receptor antagonists?

A

Causes increased risk of suicidal ideation

32
Q

What is the mechanism of action of antihistamines?

A

Selectively block histamine-1 receptors
Decrease allegic rxn

33
Q

How are antihistamines organized?

A
  • By generations
  • Based on potential for sedation
34
Q

Describe 1st generation antihistamines

A
  • High potential for sedation
  • diphenhydramine- Benadryl
35
Q

Describe 2nd generation antihistamines

A
  • Considered “non-sedating”
  • loratadine- Claritin
  • centirizine- Zyrtec
36
Q

What are antihistamines used to treat?

A
  • Seasonal allergies
  • Mild allergic rxns
  • Anaphylaxis
  • Nausea
  • Motion sickness
37
Q

Adverse effects of antihistamines

A

Sedation
Xerostomia
Constipation
Headache
Tachycardia

38
Q

What can occur if a LA is used when the patient is taking Benadryl?

A

Can cause arrhythmias

39
Q

What is the mechanism of action of antitussives?

A
  • Act directly on the medulary cough center of the brain to reduce cough reflex
  • Do not work on your lungs, they work in your brain
40
Q

Types of antitussives

A

dextromethorphan (DXM)
codeine
hydrocodone

41
Q

Adverse effects of antitussives

A

Dying effect on the mucous membranes
Drowsiness and sedation
GI upset

42
Q

When should antitussives be used?

A

At the end of a cold to control nonproductive cough

43
Q

Mechanism of action of nasal decongestants

A

Stimulate alpha receptors in nasal mucosa
- promote vasoconstriction
- shrink nasal mucous membranes
- improve airflow

44
Q

Types of nasal decongestants

A

Topical: Afrin (oxymetazoline)
Systemic: Sudafed (pseudophedrine)

45
Q

What are nasal decongestants used for?

A

Relieve discomfort of nasal congestion from common cold, sinusitis and allergic rhinitis

46
Q

Adverse ffects of nasal decongestants

A

Local stinging and burning
Rebound congestion
Tachycardia

47
Q

What is the mechanism of action of topical nasal steroid decongestants?

A

Reduce inflammation and allergic response in nasal passages

48
Q

Types of topical nasal steroid decongestant

A

Nasonex
Flonase
Rhinocort

49
Q

Uses for topical nasal steroid decongestant

A

Seasonal alelrgic rhinitis

50
Q

Adverse effects of topical nasal steroid decongestants

A

Local burning, irritation, stinging
Dryness of mucosa
Headache

51
Q

Mechanism of action of expectorants

A

Reduce adhesiveness and surfce tension
Allows easier movement of less viscous secretions

52
Q

Types of expetorants

A

Robitussin (guaifenesin)
Mucinex

53
Q

Uses for expectorants

A

Symptomatic relief of respiratory cnditions characterized by a dry, nonproductive cough

54
Q

Adverse effects of expectorants

A

GI symptoms
Headache, dizziness

245 Dental Pharmacology (20 decks)

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