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50 Cards in this Set
- Front
- Back
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short term asthma agents?
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- beta adrenergic agonist
- methylxanthines - anticholinergics |
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long term control asthma agents?
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- glucocorticoids
- leukotriene inhibitors and receptor antagonists - mast cell stabilizers |
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leukotriene modifier agents?
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- zafirlukast
- montelukast - zileuton |
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leukotriene modifier method of action?
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- leukotriene receptor antagonist
-> stops LKT cascade: zafirlukast and montelukast - inhibits leukotriene synthesis -> stops the cascade from occurring: zileuton |
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leukotriene modifier adverse effects?
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- headache
- abdominal pain - nausea - dyspepsia - increased liver enzymes (zileuton) |
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leukotriene modifier interactions?
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- warfarin
- theophylline - propranlol - terfenadine |
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mast cell stabilizer agents?
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- cromolyn (PO/inhaled)
- nedcomil (inhaled) |
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mast cell stabilizer method of action?
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inhibits the degradation of mast cells -> inhibits mediator release
- no bronchodilator activity |
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mast cell stabilizers adverse effects?
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- dry mouth
- pharyngitis - cough - nausea - headache |
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beta adrenergic agonist method of action?
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stimulates beta adrenergic receptors -> production of cyclic AMP -> smooth muscle relaxation -> bronchodilation
- beta 2 selective |
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short acting PO beta 2 agonist agents?
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- albuterol
- isoproterenol - metaproterenol - terbutaline |
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short acting MDI beta 2 agonist agents?
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- albuterol
- bitolterol - epinephrine - isoetharine - isoproterol - metaproterenol - pirbuterol - terbutaline |
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short acting nebulizer beta 2 agonist agents?
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- albuterol
- bitolterol - enpinephrine - isoetranine - isoproterenol |
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short acting injection beta 2 agonist agents?
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- epinephrine
- isoetranine - isoproterenol - metaproterenol - terbutaline |
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long acting beta 2 agonist agents?
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formoterol- seen in combo with salmeterol
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single isomer beta 2 agonist agents?
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levebuterol: neb/MDI
- most selective for beta 2 |
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short acting beta 2 dosing?
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- relief of acute symptoms
- 1-2 puffs MDI q4-6 h - 2 puffs prior to exercise |
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long acting beta 2 agonist dosing?
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- not for acute symptoms!
- MDI >12 yo- 2 puffs q12h - 30-60 minutes before exercise |
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beta 2 agonist adverse effects?
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- palpitations
- tachycardia - muscle tremor - nervousness - hypokalemia - hyperglycemia - dizziness - headache - nausea |
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corticosteroid method of action?
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- reverses down regulation of beta 2 receptors
- inhibits migration of inflammatory cells - inhibits cytokine and histamine production |
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inhaled corticosteroid agents?
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- beclomethasone
- budesonide - flunisolide - fluticasone - triamcinolone LT prevention of sxs- dose based on severity |
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inhaled corticosteroid adverse effects?
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- coughing
- dysphonia - throat irritation - thrush - if swallowed -> systemic effects |
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systemic corticosteroid agents?
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- methylprednisolone (can be IV)
- prednisolone - prednisone used in short burst for acute exacerbations, LT in severe |
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systemic corticosteroid adverse effects?
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short term:
- weight gain - fluid retention - mood changes - hypertension - abnormal glucose metabolism long term: - adrenal suppression - cataracts - diabetes - growth suppression - hypertension - osteoporosis |
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methylxanthines method of action?
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-increases cyclic AMP -> adenosine antagonism -> decreases vascular permeability
- increases mucociliary clearance - increases diaphragmatic contractility LT use, nocturnal |
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methylxanthine agents?
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- theophylline (PO)
- aminophylline (inj) |
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who has decreased clearance of methylxanthines?
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- neonates
- elderly - hepatic dysfunction - cardiac decompensation - cor pulmonale - febrile illness |
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methylxanthine adverse effects?
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- N/V/D
- cramps - headache - restlessness - irritability - tachycardia |
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methylxanthine interactions?
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decreased conc:
- <9 yo - anticonvulsants - rifampin - smoking increased conc: - allopurinol - cimetidine - macrolides - propranolol - quinolones - ticlodipine |
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anticholinergic method of action?
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inhibits acetylcholine (causes bronchospasm) -> decreased bronchospasm
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anticholinergic agents?
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- ipratropium
- bromide - tiotropium bromide |
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anticholinergic adverse effects?
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- dry mouth
- tachycardia - palpitations - dizziness - headache - constipation - urinary difficulty - blurry vision |
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mild intermittent asthma management?
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- quick relief med +
- systemic corticosteroid for severe exacerbations |
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mild persistent asthma management?
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- quick relief med +
- controller: low dose inhlaed CS OR - cromylin - LKT modifier |
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moderate persistent asthma management?
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- quick relief med +
- low- medium dose inhaled CS + - long acting beta 2 agonist alternatives: - med dose inhaled CS alone or - low-med dose inhaled CS + LKT receptor antagonist patients with severe recurring exacerbations: med dose inhaled CS + long acting beta 2 agonist |
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severe persistent asthma control?
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- quick relief med +
- controller: high dose inhaled CS and long acting beta 2 agonist - if needed: systemic long term CS |
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CF mucolytic therapy agents?
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- dornasealfa
- acetylcysteine |
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dornasealfa method of action and dosing?
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- degrades the concentrated DNA in CF sputum- targets DNA released from dead neutrophils
- decreases viscosity - dose daily, 2x per day, or every 2 days |
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pulmonary infections in CF patients: common pathogens and treatment?
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- regular abx courses: q2-3 wks
- treat with AGs + PCN or cephalosporin - H. flu (2-5 yrs) - staph aureus (6-17 yrs) - pseudomonas- colonized by late adolescence |
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PK issues in CF patients?
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- increased clearance = higher dose needed
- increased volume of distribution - altered absorption |
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CF pancreatic enzyme replacement?
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pancrealipase
- 100 units/mg amylase - 100 units/mg protease - 24 units/mg lipase dosed on lipase content |
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diuretic classes/ types?
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- osmotic
- carbonic anhydrase inhibitors - loop - thaizides - aldosterone blockers |
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osmotic diuretic method of action?
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- works at proximal tubule, thin descending limb, distal tubule and collecting ducts
- blocks convective movement of Na |
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carbonic anhydrase inhibitor diuretic method of action?
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- works at proximal tubule
- stops HCO3, H, Na reabsorption |
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loop diuretic method of action?
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- works at ascending LOH
- impedes Cl/Na/K reabsorption - most Na excretion of diuretics |
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thiazide diuretic method of action?
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- works at early distal tubule
- impedes Cl reabsorption -> impedes Na reabsorption - moderate Na excretion |
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aldosterone blocker diuretic method of action?
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- works at late distal tubule and early collecting ducts
- lease amount of Na excreted |
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diuretic method of action?
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increase in amount of Na excreted -> increase in volume excretion -> decrease in preload= rapid improvement in edema
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diuretic adverse effects?
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- electrolyte depletion: Na/Cl/K
- hypotension - dizziness - dehydration |
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angiotensin- converting enzyme inhibitors (ACEI) method of action?
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blocks production of angiotensin 2 ->decreases sympathetic stimulation/ decreases production of aldosterone and vassopressin -> decreases vasocontriction
- increase in bradykinins -> increase in vasodilatory prostaglandins |
