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Pharmacology > Week 6 ~ Respiratory System > Flashcards

Week 6 ~ Respiratory System Flashcards

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1
Q

What type of treatment is used for Upper Respiratory Diseases?

A

Empirical therapy —> because it’s difficult to identify between viral and bacterial causes of the common cold

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2
Q

What are the 4 upper respiratory disease (URI) drugs used for?

A

The common cold

Mostly caused by a virus

The virus invades tissues of the URT and an inflammatory response occurs, resulting in mucus production

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3
Q

How do Antihistamines work?

A

Drugs that directly compete with histamine for specific receptor sites

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4
Q

2 Histamine Receptors?

A
  1. H1 (Histamine 1) –> Commonly referred to as Antihistamines
  2. H2 (Histamine 2) –> Reduce gastric acid in peptic ulcer disease
    - -> Include Cimetidine, Ranitidine
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5
Q

What are the 3 properties of Antihistamines?

A
  1. Antihistamine
  2. Anticholinergic
  3. Sedative
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6
Q

Antihistamines Mechanism of Action

A

Block action of histamine at the H1 Receptor sites by competing with histamine

Should be given early before histamine binds to receptors

Drying effect reduces nasal, salivary and lacrimal gland production

Sedative effect may cause drowsiness

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7
Q

What symptoms does antihistamines prevent that are caused by histamine?

A
  1. Vasodilation
  2. Increased GI and respiratory secretions
  3. Increased capillary permeability and itching
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8
Q

Antihistamines Indications

A

Nasal allergies/Allergic Reactions

Motion Sickness

Sleep Disorders

Parkinson’s Disease

Seasonal Allergies, ie hay fever

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9
Q

Antihistamines Contraindications

A

Known drug allergy

Children

Acute asthma

Heart Disease

Narrow angle glaucoma

Hypertension

Kidney Disease

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10
Q

Antihistamines Adverse Effects

A

Anticholinergic effects such as dry mouth, difficulty urinating, constipation, drowsiness, changes in vision

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11
Q

Antihistamines Drug Interactions

A

Alcohol

MOI’s

CNS Depressants…may increase CNS depressant effects

Apple/Grapefruit/Orange Juice

St Johns Wort

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12
Q

2 Types of Antihistamines

A
  1. Traditional: work peripherally and centrally
    —>have Anticholinergic effects, more effective
    Then no sedating drugs
  2. Nonsedating: work peripherally
    - –> eliminate unwanted adverse effects, longer duration
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13
Q

2 Kinds of Traditional Antihistamine Drugs?

A
  1. Diphenhydramine

2. Chlorpheniramine

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14
Q

3 Kinds of Non-Sedating Antihistamine Drugs

A
  1. Fexofenadine —> Allegra
  2. Loratadine –> Claritin
  3. Cetirizine —> Reactin
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15
Q

3 Types of Decongestants

A
  1. Adrenergics –> Sympathomimetics
  2. Anticholinergics –> Parasympatholytics
  3. Corticosteroids —> Intranasal Steroid
    (Topical)
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16
Q

What’s the largest group of Decongestant?

A

Adrenergics

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17
Q

2 methods of administering decongestants?

A
  1. Oral

2. Inhaled/topically applied to nasal membranes

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18
Q

Oral Decongestants

A

Delayed onset but prolonged effects

No rebound congestion

Effect is less potent than topical decongestants

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19
Q

Name of an Oral Decongestant?

A

Pseudo ephedrine

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20
Q

Topical Nasal Decongestants

A

Prompt onset and produces potent effect

Causes rebound congestion, making the condition worse if used for several days

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21
Q

3 Types of Topical Nasal Decongestants

A
  1. Topical Adrenergics
  2. Intranasal Adrenergic (Inhaled)
  3. Intranasal Steroids
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22
Q

3 Intranasal Adrenergic Drugs

A
  1. Oxymetazoline Hydrochloride —> Vicks, Claritin
  2. Phenylephrine Hydrochloride
  3. Xylometazoline Hydrochloride –> Otrivin
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23
Q

3 Intranasal Steroid Drugs

A
  1. Beclomethasone Dipropionate
  2. Fluticasone Proprionate
  3. Flunisolide
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24
Q

Nasal Decongestant ADRENERGICS Mechanism of Action

A

Act on blood vessels surrounding nasal sinuses

Constrict small blood vessels that supply upper respiratory tract

RESULTS: tissues shrink, nasal secretions in swollen mucous membranes are able to drain and nasal stuffiness is relieved

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25
Nasal Decongestion NASAL STEROIDS Mechanism of Action
Shrink engorged nasal mucous membranes Relieve nasal stuffiness by acting on blood vessels surround nasal sinuses, have an anti inflammatory effect, decrease immune cells that respond to the inflammatory response
26
Nasal Decongestant Contraindications
Drug Allergy Narrow angle glaucoma Diabetes Hypertension Prostatitis Hyperthyroidism Uncontrolled Cardiovascular disease
27
Nasal Decongestants should be used cautiously in patients with history of what?
1. Stroke/TIA's 2. Diabetes 3. Long Standing Asthma 4. Benign Prostatic Hyperplasia 5. Cerebral Arteriosclerosis
28
Decongestant Adverse Effects
1. ADRENERGICS: causes nervousness, insomnia, tremors, palpitations 2. STEROID: causes local mucosal dryness
29
4 Drugs for Upper Respiratory Disease
1. Antihistamines 2. Decongestants 3. Antitussives 4. Expectorants
30
2 Types of Cough
1. Productive: cough up phlegm etc | 2. Nonproductive: dry cough
31
What are Antitussives?
Drugs used to stop or reduce coughing May be opiod or nonopiod *Used only for Non-productive coughs*
32
Opiods Mechanism of Action as an Antitussives?
Suppress the cough reflex in the medulla
33
Types of Antitussive Opiods
Codeine --> Robitussin, Dimetane - C, Dimetapp - C Hydrocondone
34
Antitussive Nonopiod Mechanism of Action
Suppress the cough reflex by numbing the stretch receptors of the respiratory tract and preventing the cough reflex from being stimulated
35
Types of Nonopiod Antitussives?
Dextromethorphan --> Benylin DM-E, Buckleys, Robitussin | Vick's
36
Antitussive Contraindications
Drug allergy Opioid Dependancy High risk respiratory depression
37
Antitussive Opioid Adverse Effects
Sedation Nausea/Vomiting Lightheadedness Constipation
38
Antitussive Nonopioid Adverse Effects
Dizziness Drowsiness Nausea
39
What are Expectorants?
Drugs that aid in the expectoration of mucus
40
Expectorant Mechanism of Action
1. Reflex Stimulation --> Loosens/thins secretions in respiratory Tract creating mucus that's easier to remove *Gauifenesin (Robitussin) 2. Direct Stimulation --> Secretory glands are stimulated to produce More respiratory tract fluids ``` *Iodine containing products: Iodinated Glycerol Potassium Iodide (less used) ```
41
Expectorant Indications
Used for relief of productive coughs associated with common cold, bronchitis, pertussis, laryngitis, sinusitis, pharyngitis
42
Expectorant Contraindications
Drug allergy Hyperkalemia (for potassium containing expectorants)
43
Expectorant Adverse Effects
Nausea Vomiting Gastric Irritation
44
Diseases of Lower Respiratory Tract?
COPD Asthma Emphysema Chronic Bronchitis
45
2 Types of Respiratory Drugs
1. Bronchodilators | 2. Non-Bronchodilators
46
2 Bronchodilators
B-Adrenergic Agonists Xanethine Derivatives
47
2 Non Bronchodilators
Antileukotrines Corticosteroids
48
What do B-Agonists do?
Stimulate B2 Adrenergic Receptors which are located throughout the lungs
49
3 Types of B-Agonists
1. Non-Selective Adrenergics 2. Non - Selective B-Adrenergics 3. Selective B2 Drugs
50
What do Non-Selective Adrenergics do?
Stimulate A1, B1 (Cardiac), B2 (Respiratory) receptors *Include Epinephrine (Adrenaline)
51
What do Non-Selective B-Adrenergics do?
Stimulate both B1 and B2 Receptors *Isoproterenol
52
What do Selective B2 drugs do?
Stimulate only B2 receptors *Salbutamol
53
B-Agonists Mechanism of Action
Specific receptors are stimulated and cause dilation of the airways resulting in: Activation of B2 receptors --> Activates cAMP --> Relaxes smooth muscles of the airway --> bronchial dilation = Increased air flow
54
B Agonists Indications
~ Bronchopasm related to asthma, bronchitis ~ Treat and prevent acute attacks ~ Treatment of hypotension and shock ~ Cause uterine relaxation to prevent premature labour ~Treat Hyperkalemia --> stimulates K+ to shift into cells
55
B-Agonist Adverse Effects
``` Anorexia Insomnia Restlessness Tremors Cardiac Stimulation Hyperglycaemia ```
56
B-Agonist Contraindications
Drug Allergy Uncontrolled cardiac dysrhthmias High risk of stroke
57
B-Agonist Drug Interactions
Increase risk of hypertension Increase risk of cardiac toxicity Require an adjustment to Antihyperglycemic drugs
58
2 Synthetic types of Xanthines?
1. Aminophylline | 2. Oxtriphylline
59
What's the only Xanthines Derivative used as a Bronchodilator?
Theophylline
60
What are 3 Natural Plant Alkaloid Xanthines?
1. Caffeine 2. Theobromine 3. Theophylline
61
Xanthines Derivative Mechanism of Action
1. Increase levels of energy producing cAMP by competitively inhibiting Phosphodiesterase, the enzyme that breaks down cAMP ----> decreased cAMP levels ---> smooth muscle relaxation - -> Bronchodilation --> increased airflow 2. Stimulate CNS and Cardiovascular System (Increase heart rate) 3. Diuresis
62
What is the category of Xanthines Derivatives?
Bronchodilators
63
Xanthine Derivative Indications
Asthma COPD Emphysema Chronic Bronchitis
64
Xanthine Derivative Contraindications?
``` Drug allergy Peptic Ulcers Seizure disorders Hyperthyroid Uncontrolled cardiac Dysrhthmias ```
65
Xanthines Derivative Adverse Effects
``` Nausea/Vomiting Anorexia Increased urination Gastroesophogeal Reflux during sleep Sinus tachycardia Palpitations Extra systole Ventricular Dysrhythmias ```
66
Xanthine Derivative Drug Interactions
When used with Sympathomimetics (caffeine) increased heart and CNS stimulation result St Johns Wort (Hypericum Perforatum) and smoking enhance the rate of Xanthine drug metabolism
67
Anticholinergics Mechanism of Action
Bind to ACh receptors, preventing ACh from binding ---> prevents bronchi constriction = dilation of airways
68
Types of Anticholinergic Drugs
1. Ipratropium Bromide (Atrovent) 2. Tiotropium * Slow and prolonged action*
69
Anticholinergic Adverse Effects
``` Dry mouth or throat Anxiety Headache Cough Nasal Congestion Palpitations GI distress ```
70
What are Antileukotriene Drugs?
*New class of asthma medication Prevent Leukotrienes from attaching to receptors on circulating immune cells and immune cells within the lungs = inflammation in the lungs is blocked
71
2 Types of Antileukotriene Drugs?
1. Montelukast - Singulair 2. Zafirlukast - Accolate * Leukotriene receptor antagonists*
72
What do Leukotrienes do?
Are substances released when a trigger such as dust starts a series of chemical reactions in the body. They cause inflammation, mucus production, broncho constrictions, coughing, sneezing, SOB
73
Antileukotriene Drug Effects
By blocking Leukotrienes they: 1. Prevent smooth mm contraction of bronchial airways 2. Decrease mucus secretion 3. Prevent vascular permeability 4. Decrease neutrophil and leukocytes in the lungs, preventing Inflammation
74
Antileukotriene Indications
Used for the prophylaxis and long term treatment of asthma in adults or children above age 12
75
Antileukotriene Contraindications
Drug allergy Allergy to povidone, lactose, titanium dioxide, cellulose derivatives
76
Antileukotriene Adverse Effects
Headache Nausea Diarrhea Liver Dysfunction
77
Corticosteroids Mechanism of Action
*Used for Chronic Asthma* ~Available in oral and inhaled forms Anti-Inflammatory Effects Stabilize membranes of cells (WBC/Leukocytes) that release harmful broncho constricting substances Increase responsiveness of bronchial smooth muscle to B-Adrenergic stimulation
78
What symptoms does Corticosteroids not relieve?
Symptoms of Acute Asthma Attacks
79
4 Inhaled Corticosteroid Drugs?
1. Beclomethasone Dipropionate 2. Budesonide 3. Fluticasone Furoate 4. Fluticasone Propionate - Flonase, Flovent, Diskus
80
Inhaled Corticosteroid Indications
Bronchospastic Disorders that aren't under control by conventional bronchodilators **NOT for acute asthma!!**
81
Inhaled Corticosteroid Contraindications
Candida/Fungal Infections Hypersensitive to Glucocorticoids
82
Inhaled Corticosteroid Adverse Effects
Coughing Dry mouth Pharyngeal Irritation Oral Fungal Infections *Systemic effects are rare because it's an inhalation therapy*

Pharmacology (6 decks)

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