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Pharmacology > Unit 5 Textbook: Pulmonary > Flashcards

Unit 5 Textbook: Pulmonary Flashcards

1
Q

Examples of upper respiratory infections

A

Common cold and rhiosinusitis

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2
Q

Most common pathogen for common cold

A

Human rhinovirus

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3
Q

First line treatment for common cold

A

Nonpharmalogical–rest, increased water, saline gargles, menthol rubs on chest, vaseline

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4
Q

Nasal spray Decongestants

A

Oxymetazoline hydrochloride and phenylephrine hydrochloride
Work within minutes
Sympathomimetic agents that stimulate alpha and beta receptors causing vasoconstriction in respiratory mucosa to improve ventilation

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5
Q

Oral decongestants

A

Pseudoephedrine + phenylephrine
Work within 30 minutes
Sympathomimetic agents that stimulate alpha and beta receptors causing vasoconstriction in respiratory mucosa to improve ventilation

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6
Q

Decongestants contraindicated in

A

Glaucoma, uncontrolled htn, CAD, MAO inhibitor use within 14 days

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7
Q

Expectorants

A

Gualfenesin
Should not be used >1 week
Usually same effectiveness as water
Decreases adhesiveness and surface tension of respiratory tract and facilitates removal of viscous mucus

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8
Q

Antitussives

A

Dextromethorphan + Benzonatate
Typically ineffective in common cold
Direct inhibition of cough center in medulla

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9
Q

Anti inflammatory drugs for common cold

A

COX inhibitors inhibit prostaglandin secretions which can decrease headache, malaise, myalgias, cough, sneezing
Naproxen is DOC
Tylenol and NSAIDs may increase viral shedding

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10
Q

Anticholinergics for common cold

A

Ipratropium bromide as nasal spray to alleviate nasal congestion

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11
Q

Antihistamines for common cold

A

Not recommended as mono therapy
Diphenhydramine + Chlorpheniramine
Nonsedating antihistamines are not effective

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12
Q

Antihistamines are CI in

A

Breastfeeding and neonates and enlarged prostate

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13
Q

Rhinosinusitis

A

Inflammation of mucous membranes that line sinuses and nasal cavity causing nasal blockage, discharge, facial pain and pressure

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14
Q

Acute rhinosinusitis

A

<4 weeks
Usually infectious
d/t rhinovirus, influenza, parainfluenza
Hallmark symptoms: nasal congestion, nasal discharge, facial pain, headache, anosmia

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15
Q

Chronic rhinosinusitis

A

> 12 weeks

More inflammatory mediated

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16
Q

Symptomatic relief for acute rhinosinusitis

A

Analgesics, topical intranasal steroids, nasal saline

Only recommended to get cultures if supportive measures are not working

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17
Q

Antibiotics recommended for acute bacterial rhinosinusitis

A

Amoxicillin, Doxycycline, Levofloxacin, Moxiflocacin, Clindamycin
Amoxicillin-clavulonate: first line

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18
Q

Asthma

A

Characterized by airway narrowing and airway hyperresponsiveness due to interactions between activated EMTU and inflammatory mediators which activate cholinergic nerves causing bronchoconstriction and mucous secretion

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19
Q

Diagnostic criteria for asthma

A

Wheeze, SOB, cough, chest tightness, presence of variable airflow limitation

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20
Q

Testing for asthma

A

Methacholine and histamine

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21
Q

All people with asthma should receive

A

B2 agonist bronchodilator

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22
Q

How often should patient with asthma be re-assessed

A

every 3-12 months

Treatment can be lowered if symptoms are well controlled for 3 months

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23
Q

Stepwise approach for asthma in children over 12 years

A
  1. Short acting beta 2 agonist PRN
  2. Low dose Inhaled corticosteroid
  3. Low dose inhaled corticosteroid + long acting beta agonist OR medium dose ICS
  4. Medium dose inhaled corticosteroid + long acting beta agonist
  5. High dose inhaled corticosteroid + long acting beta agonist
  6. High dose inhaled corticosteroid + long acting beta agonist + oral corticosteroid
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24
Q

Short acting beta 2 agonist

A

albuterol

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25
Long acting beta 2 agonist
Arformoterol, formoterol, salmeterol
26
Corticosteroids for asthma
Decrease airway inflammation by inhibiting or inducing production of end effector proteins Short course of oral steroids recommended for acute asthma exacerbation
27
Examples of inhaled corticosteroids
Beclomethasone, budesonide, ciclesonide, fluticasone, mometasone
28
Zileuton
Leukotriene modifier drug | Inhibits 5-LOX preventing conversion of arachidonic acid to bronchoconstrictor and proinflammatory leukotrienes
29
Montelukast and zafirlukast
Leukotriene modifier drug | Bind to cysteinyl leukotriene receptors
30
Leukotriene modifier drugs are indicated for
Alternative medications for long term control of mild persistent asthma and long term control of moderate persistent asthma when combined with ICS
31
Mast cell stabilizers
Cromolyn | Prevent release and synthesis of proinflamamtory mediators by inhibiting influx of calcium into activated mast cells
32
Methylxanthines
Theophylline + Aminophylline | Relax bronchial smooth muscle, enhance diaphragmatic contractility and have slight anti inflammatory effects
33
Amalizumab
Anti-IgG antibody that prevents IgE from binding to IgE receptors on mast cells High risk of anaphylaxis
34
COPD
chronic progressive airflow limitation Usually due to smoking--results in lung inflammation, airflow obstruction, hyperinflation, mucous hypersecretion, ciliary dysfunction, gas exchange abnormalities
35
Symptoms of COPD
Chronic cough with or without chronic sputum production and persistent progressive dyspnea
36
nondrug therapy for COPD
Tobacco cessation, avoidance of irritants, energy conservation
37
Drugs used to treat COPD
B2 agonists, anticholinergics, corticosteroids, methylxanthines, phosphodiesterase 4 inhibitors
38
Anticholinergics for COPD
Ipratropium bromide--short acting | Tiatropium bromide--long acting
39
Oral corticosteroids used for COPD
prednisone | Indicated for acute COPD exacerbation
40
Phosphodiesterase 4 inhibitors for COPD
Roflumilast | Increases cAMP which relaxes bronchial smooth muscle
41
When are antibiotics indicated for COPD
5-10 day course of antibiotics if all 3 cardinal symptoms are present: increased dyspnea, increased sputum production, purulent sputum Most common pathogens: H. influenzae, strep pneumoniae, moraxella catarrhalis
42
Group A COPD dx
mMRC 0-1 CAT <10 Give a SABA or SAMA for acute No long term tx
43
Group B COPD
mMRC >2 CAT > 10 SABA or SAMA for acute LABA or LAMA for long term maintenance
44
Group C + D COPD
mMRC 0-1 CAT <10 SABA or SAMA for acute ICS + LAMA or ICS + LABA
45
Acute bronchitis
Reversible inflammatory condition of the tracheobronchial tree; usually self limiting
46
Usual causes of acute bronchitis
Rhinovirus, coronavirus, influenza, parainfluenza, adenovirus, RSV Very few bacterial causes: Bodetella pertusis, chlamydophila pneumoniae, mycoplasma pneumoniae
47
Diagnostic criteria for acute bronchitis
Cough that is initially dry and nonproductive but as secretions increase, cough becomes more mucoid, usually lasting 7-10 days Coarse, moist bilateral crackles, ronchi, wheezing
48
First line drug therapy for acute bronchitis
Supportive: fluids, best rest, mild analgesic and antipyretics (acetaminophen best), dextromethorphan
49
When are antibiotics indicated for acute bronchitis
If patient has COPD, high fevers, purulent sputum, respiratory symptoms >4-6 days, >65 years old, chronic diseases present
50
Which antibiotic for H. Influenzae
Amoxicillin
51
Which antibiotic for Moraxella Catarrhalis
Amoxicillin + Clavulanate (Augmentin)
52
Which antibiotic for M. Pneumoniae or C. Pneumoniae
Macrolide or doxycycline
53
Which antibiotic for B. Pertussis
Macrolide
54
Which drug for Influenza
Oseltamivir or Zanamivir
55
Chronic bronchitis
Productive cough and sputum production for 3 months of the year for at least 2 years Predominant factor is cigarette smoke
56
Uncomplicated chronic bronchitis
Little to no lung impairment Usually due to H. Influenzae, S. Pneumoniae, M. Catarrhalis First line: Amoxicillin, doxycycline, macrolide or sulfamethoxazole/trimethoprim (Bactrim)
57
Complicated chronic bronchitis
FEV1 <50%, lung impairment, elderly, comorbid illnesses, frequent exacerbations Usually due to H. Influenzae, S. Pneumoniae, M. Catarrhalis First line: amoxicillin-clavulanate, 2nd or 3rd gen cephalosporins, doxycycline
58
Severe complicated chronic bronchitis
FEV1 < 35%, severe airflow obstruction and constant purulent sputum production Usually due to H. Influenzae, S. Pneumoniae, M. Catarrhalis OR enterobacteriacea or Pseudomonas First line: levofloxacin or ciprofloxacin (due to G- pathogens)
59
Community acquired pneumonia
Infection of the lungs that leads to consolidation of the usually air filled alveoli
60
Most common pathogen of community acquired pneumonia
S. pneumoniae
61
Most common virus that causes community acquired pneumonia
Influenza
62
Meds for pneumonia with no recent antibiotic use or other issues
Macrolide or doxycycline
63
Meds for pneumonia with recent antibiotic use, presence of comorbiditis
Amoxicillin, augmentin, or fluoroquinolone
64
Meds for pneumonia in children
Amoxicillin

Pharmacology (56 decks)

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