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112 Cards in this Set
- Front
- Back
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Where is histamine stored?
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mast cells and basophils
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H1 receptors effect on vascular smooth muscle?
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increases blood vessel dilation
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H1 receptors effect on respiratory smooth muscle?
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increases contraction of bronchi and intestines
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H1 receptors effect on dermatologic and neurologic tissues?
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decreases autonomic muscarinic and vestibular activity
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H2 receptors effect on parietal cells?
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increases secretion of gastric HCl and pepsin
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Triple Histamine response?
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Redness, flare, and wheal
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Strategy for therapeutic use of histamine antagonists?
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targeting H1, H2, H3, and IgE receptors on mast cells and basophils
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#1 adverse effect of 1st generation antihistamines?
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sedation (because they cross the BBB)
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MOA of H1 receptor agonists?
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block released histamine and prevent histamine binding
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Benadryl, Dimetane, Chlor-Trimeton, Tavist
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First generation antihistamine. Benadryl is most sedating and Chlor-Trimeton is the least sedating
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Zyrtec, Xyzal, Clarinex, Claritin, Allegra
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2nd generation antihistamine; Zyrtec is the most/only sedating
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Astelin
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antihistamine nasal spray
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Optivar, Emadine
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ophthalmic antihistamine
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Vasocon-A, Naphcon-A
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Anti-histamine/decongestant combo
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1st and 2nd generation antihistamines are used in what type of hypersensitivity reactions?
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Type 1 hypersensitivity
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Which generation of antihistamines cause anticholinergic side effects?
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first generation only, seen in elderly patients who use them as sleeping aids
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How long does it take for mast cell stabilizers' benefit to occur?
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1-2 weeks
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Zaditor, Patanol
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antihistamine/mast cell stabilizer
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Crolom, Alomide, Alocril, Alamast
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Mast cell stabilizer
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Nasalcrom
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Mast cell stabilizer (nasal spray)
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Beconase AQ, Fluticasone, Flonase, Rhincort Aqua, Nasonex
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Nasal steroid
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Nasal steroid MOA?
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stabilize the allergic response, not improve the reaction to the response. They increase the patient's threshold to allergen exposure
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Alrex
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Ophtalmic corticosteroid
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Singulair
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Leukotriene antagonist
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Singulair is most effective if started when?
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before allergy season
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What drug has an adverse effect of increased risk of suicide?
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Singulair
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LTRA
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leukotriene receptor agonist
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ICS
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inhaled corticosteroid
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SABA
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short-acting beta2 agonist
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LABA
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long-acting beta2 agonist
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What do the yellow and green zones mean in the Peak Flow Zone System?
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green= 80-100% personal best
yellow = 50-80% personal best |
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What propellants are used in inhalers and which is more environmentally friendly?
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CFC= choloflourocarbons
HFA = hydroflouroalkane (green) |
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Corticosteroids: MOA and classification
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long-term control medications; they suppress disease and reverse inflammation
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Pulmicort, Flovent, Asmanex
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corticosteroid
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Contraindications of corticosteroids?
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status asthmaticus and fungal infections
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Adverse effect of corticosteroids?
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oral candidiasis
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MOA and classification of immunodilators?
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long-term control medications; they bind to circulating IgE and decrease mast ccell mediator response from allergen exposure
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Xolair
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immunodilator
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How are immunodilators administered?
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subcutaneous injection of anti-IgE drug
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Adverse effects of immunodilators?
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anaphylaxis i 0.2% of px
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LABAs are what types of drugs? (PL, PM, SL, SM)
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sympathomimetic (SM)
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Salmeterol xinofoate, Formoterol
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FDA approved LABA
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MOA of LABAs?
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bronchodilation
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Brovana, Perforomist
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LABA not FDA approved
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Containdications of LABAs?
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arrhythmia, tachycardia, narrow angle glaucoma
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Adverse effects of LABAs?
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tachycardia, tremor, dizziness
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Drug interactions of LABAs?
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Beta blockers: LABAs decrease the effect of BB's
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Advair, Symbicort
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corticosteroid + LABA combination
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What type of drug is Methylxanthines?
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Long-term control medications
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Theophylline
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Methylxanthines
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MOA of Methylxanthines?
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bronchodilation
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Administration of Methylxanthines?
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oral and IV
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Contraindications of Methylxanthines?
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seizure disorder
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Adverse effects of Methylxanthines?
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dose-related acute toxicities
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Therapeutic issues of Methylxanthines?
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diaphragmatic fatigue
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Leukotriene modifiers are what type of drugs?
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Long-term control medications
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Accolate, Zyflo
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Leukotriene modifiers
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SABAs are what type of drug? What conditions are they used for?
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rescue medications; asthma and COPD
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Albuterol
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SABA
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Levalbuterol
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SABA inhaler or nebulizer
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MOA of SABAs?
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binds to beta2-adrenergic receptors and causes smooth muscle relaxation
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Administration of SABAs?
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meter-dose inhaler, oral, aerosol
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Adverse reactions of SABA?
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tachycardia, tremor, dizziness
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Drug interactions of SABAs?
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MAO inhibitors
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Therapeutic issues of SABAs?
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Must use >2 days/week
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Anticholinergics are what type of drugs? What are they used for?
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rescue medications; bronchospasm associated with COPD and as an alternative bronchodilator for asthma patients who can't tolerate inhaled beta2 agonists
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Ipratropium
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anticholinergic FDA approved
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Tiotropium
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anticholinergic not FDA approved
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MOA of anticholinergics?
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bronchodilation via paralytics
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Purpose of a spacer?
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decreases the amount of drug that sticks to the back of the throat; used in children under 4
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What is the first line of treatment for COPD?
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anticholinergics
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Difference between heme-iron and nonheme-iron?
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heme-iron is efficiently absorbed, and nonheme-iron isn't. nonheme-iron must be reduced to ferrous iron to be absorbed
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Administration of iron suppliments?
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oral or with parenteral iron preps (IV, IM)
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How much elemental iron is absorbed in a 300mg tablet of ferrous sulfate?
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20% absorbed: 60mg
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How much elemental iron is absorbed in a 200mg tablet of ferrous sulfate, exsiccated?
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30% absorbed: 65mg
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Adverse effects of iron?
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dark feces and constipation
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Administration of iron dextran?
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buttocks injection and commonly IV
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Adverse effects of iron dextrans?
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anaphylaxis caused by the DEXTRAN (more common in patients who have been previously exposed to it)
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How do we monitor the efficacy of iron?
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therapeutic doses should increase Hb 1-2g each week, doses given for 3-6 months
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What is required for the absorption of B12? How long does this treatment last?
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intransic factor is required for B12 to be absorbed; lifelong treatment
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What must be determined before B12 treatment?
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the megaloblastic anemia's source since B12 will correct the anemia regardless, but it will not correct a folic acid deficiency
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Folic acid deficiency is commonly seen in who?
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pregnant women
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Methotrexate
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anticancer medicine used for folic acid deficiency
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Phenytoin
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antiseizure medicine used for folic acid deficiency
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Administration of folic acid?
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orally
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EPO
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used to treat anemia of chronic disease
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Epoetin alfa
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EPO agent
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What is the effect of using a DTTAOCD?
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improves overall quality of life
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What is the duration of DTTAOCD when they're administered by IV or intrafat injection?
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IV- 6 hours
SQ - 22 hours |
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Adverse effects of DTTAOCD?
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HTN
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Aranesp
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used to treat anemia of chronic disease; has a long half-life
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What is the clinical controversy associated with EPO agents?
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increase in death and cardiovascular events (thrombosis)
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What was the first effective oral diuretic?
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chlorothiazide
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H2O permeatbility in the collecting duct is controlled by what hormone?
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ADH
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Calcium transport in and out of the DCT is controlled by what hormone?
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PTH
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Chlorothiazide /hydrochlorothiazide, Bendroflumethiazide, polythiazide
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Thiazide diuretic
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Adverse effects of thiazide diuretics?
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hypokalemia, hyponatremia, hyperglycemia, hyperuricemia, olig/an urea
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Metolazone, Chlorthalidone
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sulfonamide derivatives (thiazide-related)
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Indapamide
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benzene-sulfonamide derivative (thiazide-related)
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MOA of thiazide-related drugs?
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management of edema
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Furosemide, Ethacrynic acid, and Bumetamide
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Loop diuretics; Bumetamide is most potent
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MOA of loop diuretics?
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inhibit Na, K, an Cl co-transport
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Adverse effects of loop diuretics?
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ototoxicity and other effects of diuretics
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How are thiazide diureticts used for diabetes insipidus?
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reduce urine output
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Which loop diuretic is excreted in a half metabolized state?
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Bumetamide
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Spirolactone, Amiloride, and Triamterine
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K-sparing diuretics
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MOA of K-sparing diuretics?
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competitive antagonist of aldosterone, which interferes with sodium absorption in the collecting duct
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Adverse effects of K-sparing diuretics?
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hyperkalemia and blue urine (triamterine)
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What are the contraindications of osmotic diuretics?
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CHF, HTN, and pulmonary edema
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What are the adverse effects of osmotic diuretics?
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N&V, polydipsia, chills, dizziness, lethargy, confusion
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5 uses of Carbonic Anhydrase inhibitors?
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Mountain sickness, glaucoma, absence seizures, PMS tension, edema
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What type of CAI administration isn't safe for ocular use?
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oral
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