Pharm Ii Exam 1 - Drugs For Respiratory Tract

Front 1

1. 5 things responsible for bronchial tone regulation

Back 1

a. Acetylcholine
b. Epinephrine
c. Histamine
d. Leukotrienes
e. Prostaglandins

Front 2

1. Effect of Acetylcholine on bronchial tone

Back 2

a. Stimulates Muscarinic Receptors (M2 & M3 )
b. = Broncho CONSTRICTION

Front 3

1. Effect of Epinephrine on bronchial tone

Back 3

a. Stimulates B2 receptors
b. = broncho DILATION

Front 4

1. Effect of Histamine on bronchial tone

Back 4

a. Stimulation of H1 receptor
b. = broncho CONSTRICTION

Front 5

1. Effects of LT’s on bronchial tone

Back 5

a. Stimulation of LTD4 and LTE4
b. = broncho CONSTRICTION

Front 6

1. Effects of prostooglandins on bronchial tone

Back 6

a. PGE2 = broncho DILATION
b. PGF2a = broncho CONSTRICTION

Front 7

1. Extrensic factors that may lead to an asthma an attack

Back 7

a. stress,
b. exercise,
c. pollutants,
d. pollens, and
e. drugs

Front 8

1. in a susceptible astthmatic, the exposure to the stimulus triggers the release of _____________

Back 8

a. HISTAMINE
b. BRADYKININ
c. LEUKOTRIENES

Front 9

1. The release of the mediators in an asthmatic leads to_______________

Back 9

a. Bronchoconstriction
b. Decreased mucus clearance
c. Inflamation and edema

Front 10

1. 3 broad categories of medicine used to tx asthma

Back 10

a. Bronchodilators
b. Anti-inflammatory agents
c. Antitussives Mucolytics and Expectorants

Front 11

1. Classes of bronchodilators used to tx asthma

Back 11

a. BETA-AGONISTS
b. PHOSPHODIESTERASE INHIBITOR
c. MUSCARINIC ANTAGONISTS
d. ANTIHISTAMINES

Front 12

1. Classes of Anti-inflammatory agents used to tx asthma

Back 12

a. Mast Cell Stabilizers
b. Leukotriene Antagonists
c. Glucocorticoids

Front 13

1. BETA-AGONISTS used to tx asthma

Back 13

a. ALBUTEROL,
b. PIRBUTEROL,
c. SALMETEROL

Front 14

1. PHOSPHODIESTERASE INHIBITOR used to tx asthma

Back 14

a. THEOPHYLLINE

Front 15

1. MUSCARINIC ANTAGONISTS used to tx asthma

Back 15

a. IPRATROPIUM

Front 16

1. ANTIHISTAMINES used to tx asthma

Back 16

a. DIPHENHYDRAMINE

Front 17

1. Mast Cell Stabilizers used to tx asthma

Back 17

a. CROMOLYN,
b. NEDOCROMIL,
c. LODOXAMIDE

Front 18

1. Leukotriene Antagonists used to tx asthma

Back 18

a. MONTELUKAST,
b. ZAFIRULASK &
c. ZILEUTON

Front 19

1. Glucocorticoids used to tx asthma

Back 19

a. BECLOMETHASONE
b. FLUTICASONE
c. TRIAMCINOLONE

Front 20

1. Antitussives Mucolytics and Expectorants used to tx asthma

Back 20

a. CODEINE,
b. DEXTROMETHORPHAN,
c. HYDROCODONE????
d. GUAIFENESIN
e. Acetylcystine

Front 21

1. Stimulation of Beta-2 receptors leads to

Back 21

a. smooth muscle relaxation = bronchodilation
b. Increase intracellular cAMP

Front 22

1. Non-selective (alpha’s and beta’s) used to tx asthma

Back 22

a. epinephrine
b. B2 pathway is predominant

Front 23

1. If you use epinephrine in a asthmatic emergency…what side effects will you expect

Back 23

a. Will potentiate cardiovascular stimulation
b. Via: b1 in heart and a1 on blood vessels to increase heart rate and blood pressure

Front 24

1. Clinical use for epinephrine

Back 24

a. Emergencies only

Front 25

1. Fast-acting selective Beta-2 agonists

Back 25

a. Albuterol
b. Pirbuterol

Front 26

1. Slow-acting selective beta-2 agonist

Back 26

a. Salmeterol
b. Slower and longer-acting beta-2 agonist

Front 27

1. Clinical use of Salmeterol

Back 27

a. Useful for nocturnal asthma,
-----Inhibits late-phase allergen-induced bronchoconstriction after short acting beta-2 agonists wear off.
b. exercise-induced asthma

Front 28

1. Clinical use for ALBUTEROL

Back 28

a. Used for an acute asthma attach

Front 29

1. Clinical use of PIRBUTEROL

Back 29

a. Used for an acute asthma attach

Front 30

1. MOA of Ipratropium

Back 30

a. Muscarinic receptor antagonist

Front 31

1. Clinical use of Ipratropium

Back 31

a. Best for COPD
-----Not quite as effective with asthma when used alone
i. Often has synergistic effect when used with other asthma drugs

Front 32

1. Adverse effects of Ipratropium

Back 32

a. Minimal systemic effects(doesn’t cross into systemic circulation)
b. Nasal dryness
c. Dry mouth

Front 33

1. Moa OF THEOPHYLLINE

Back 33

a. Inhibits Phosphodiesterase -> Increased Camp -> dilation

Front 34

1. Primary and secondary actions of THEOPHYLLINE

Back 34

a. Primary = bronchodilation
b. Secondary = Inhibits mucus secretion, Decreases histamine release

Front 35

1. Adverse effects of THEOPHYLLINE

Back 35

a. CNS & Cardiac stimulation
b. GI irritation
c. NO ANTIDOTE FOR OVERDOSE!!!!
-----Treat symptoms of overdose

Front 36

1. MOA of Cromolyn

Back 36

a. Binds to & stabilizes mast cell membrane
b. Inhibiting release of inflamatory products

Front 37

1. Clinical use of Cromolyn

Back 37

a. Prophylactcc tx for asthma only
b. May also be taken 1 hour in advance to avoid exercise induced asthma
c. Can take 3-6 weeks to see effects
d. Younger pts respond better
e. ROA – oral and inhalation, also topical drops for opthalmic use

Front 38

1. Adverse effects of Cromolyn

Back 38

a. Relatively save with minimal effecks like:
-----Lung irritation
-----Bad taste
-----Headache

Front 39

1. Name the mast cell stabilizing drugs

Back 39

a. CROMOLYN
b. NEDOCROMIL
c. LODOXAMIDE
d. *****all three of these have the same MOA, ROA, and Adverse effects

Front 40

1. Name the Leukotriene Antagonists
--what receptor does it work at?
--it blocks the actions of which LT's?
--by blocking the LT's what is it preventing?
--which phase of asthma is this used to prevent?

Back 40

a. Zafirlukast
b. Montelukast
-----Antagonists at CysLT1 receptor
-----Blocks actions of LTC4, LTD4, and LTE4
-----Prevents inflammation, edema, bronchoconstriction and formation of thick/viscous mucus
-----Inhibits both early and late phases of constriction

Front 41

1. Name the LT synthesis inhibitor

Back 41

a. Zileuton

Front 42

1. Half life of Zafirlukast

Back 42

a. Zafirlukast = 2x daily

Front 43

1. Half life of Montelukast

Back 43

1x / day

Front 44

1. Clinical use of Montelukast

Back 44

a. Alternative for long term management of mild moderate asthma
b. Enhances the effect of beta-2 agonists
c. NOT FOR: severe asthma, acute constricction, exercise induced asthma, or monotherapy
a. May take several weeks to months for it to start working

Front 45

1. Adverse effects of Montelukast

Back 45

a. Does not have the adverse effects shown with – ZAFIRULASK

Front 46

1. Clinical use of Zafirlukast

Back 46

a. Alternative for long term management of mild moderate asthma
b. Enhances the effect of beta-2 agonists
c. NOT FOR: severe asthma, acute constricction, exercise induced asthma, or monotherapy
a. May take several weeks to months for it to start working

Front 47

1. Adverse effects of Zafirlukast

Back 47

a. ZAFIRULASK has the most pronounced adverse effect of the LT antagonists
b. Causes inhibition of CYP 2C9 and 3A4
-----Metabolism pathways for other drugs

Front 48

1. MOA of ZILEUTON

Back 48

a. Leukotriene synthesis inhibitor
b. Inhibits 5-lipoxygenase
-----Which is responsible for the conversion of arachadonic acid to LT’s
-----Decreases LT’s in asthma

Front 49

1. Hald life of ZILEUTON

Back 49

a. half life of 2 hours
b. Administer 4x daily

Front 50

1. Clinical use of ZILEUTON

Back 50

a. mild to moderate asthma
b. most effective in children
c. may be benificial in RA and Ulcerative collitis
-----not approved for these uses

Front 51

1. Adverse effects of ZILEUTON

Back 51

a. Inhibition of CYP1A2 and 3A4
b. Flu like symptoms
-----Headache
-----Drowsiness
-----Dyspepsia

Front 52

1. Mucolytic Drugs (give an example and whit it is used for)

Back 52

a. acetylcysteine (MUCOMYST)
b. reduces viscosity (treatment for acetaminophen OD)

Front 53

1. Expectorants (give an example and whit it is used for)

Back 53

a. Guaifenesin
b. Decrease viscosity of mucus & increase cough productivity

Front 54

1. Antitussives (give 2 examples and whit it is used for)

Back 54

i. Codeine and Dextromethorphan
-----Minimal analgesia or euphoria for dextromethorphan
ii. Used to suppress NONPRODUCTIVE cough

Front 55

what are 2 histamine releasing drugs contraindicated for asthmatics

Back 55

tubocurarine,
morphine

Front 56

1. Name the Glucocorticoids

Back 56

a. BECLOMETHASONE
b. FLUTICASONE
c. TRIAMCINOLONE

Front 57

1. effects caused by the 3 glucocorticoids

Back 57

a. Decrease inflammation
b. Decrease edema
c. Decrease histamine release

Front 58

1. Clinical use of the 3 glucocorticoids

Back 58

a. Prophylactic tx of asthma
b. Use as an adjunct to other bronchodilators
c. May take several weeks to improve
d. Comes in both Systemic and inhaled forms
e. DO NOT STOP TREATMENT ABRUPTLY

Front 59

1. ROA for BECLOMETHASONE

Back 59

a. Oral and inhaled forms

Front 60

1. ROA for FLUTICASONE

Back 60

a. Inhaled form only

Front 61

1. ROA for TRIAMCINOLONE

Back 61

a. Oral and nasal

Front 62

1. Adverse effects of inhaled glucocorticosteroids

Back 62

a. Hoarseness
-----Sore throat
b. fungal growth (Candida albicans)
c. Possible suppression of the adrenal-pituitary axis (but children with severe asthma can use)