Pharm Test 2

Front 1

Other names for an adrenergic bronchodilator

Back 1

Sympathometic or B2 agonist

Front 2

What is the duration of action for the following subgroups of adrenergic bronchodilators

Back 2

Ultra short acting <3hrs

Short acting 4-6hrs

Long acting 12hrs or more

Front 3

Indications for ultra short and short relief agents

Back 3

Relief of an acute reversible airflow obstruction in asthma or other obstructive airway diseases/conditions

Front 4

Another term for Ultra short acting and short acting agents

Back 4

Rescue agents or medications

Front 5

Indications for long acting agents

Back 5

Maintenance bronchodilation and control of bronchospasm or control of nocturnal symptoms in asthma or other obstructive airway diseases

Front 6

Cause of cyclic 3’5’ AMP AND PURPOSE

Back 6

B2 stimulation—adenylate cyclase (+Mg and ATP)—cyclic 3’5’ AMP. Produces bronchial smooth muscle relaxation and bronchodilation.

Front 7

Cause of break down of cyclic amp and response to breakdown

Back 7

Enzyme phospodiesterase breaks it down and reverses effects of bronchodilation which causes any baseline broncoconstriction to return

Front 8

Side effects of adrenergic bronchodilators

Back 8

Tremors, nervousness and shakiness, ^BP, insomnia, tolerance to bronchodilator effect, bronchoconstriction reactions to the solution additives (SVN), and propellants, tachycardia, headache, nausea, dizziness

Front 9

Important facts of catecholamine category

Back 9

Rapid onset and degradation, ineffective orally, could cause pink rain out of tubing or sputum, cardiac adverse effects, inactivated by light, heat, or air

Front 10

Important facts of Noncatecholamine category

Back 10

More specific to B2 receptors, less adverse cardiac effects, suitable for oral administration, delayed degradation, prolonged bronchodilation

Front 11

Important facts about Ultra short acting adrenergic catecholamine bronchodilators

Back 11

Lack B2 specifically which causes strong B1 effects, metabolized rapidly, onset 1-3mins, duration 1-3hrs

Front 12

Epinephrine

Back 12

Ultra short acting sympathomimetic

Brand name- Adrenalin (S)

Cardiac stimulant, one of the strongest bronchodilators, tx for hypersensitivity reactions, management of acute asthma episodes (injection), MDI OTC is primatine mist

Front 13

Racemic Epinephrine

Back 13

Ultra short acting sympathomimetic

Brand name- Micronephrine or Vaponephrin

Strong alpha effects, vasoconstriction to help reduce airway swelling (stridor)

Front 14

Important facts ab SABAS

Back 14

More b2 than catecholamines, rescue agents to relieve acute bronchospasm, rapid onset 1-10mins, short duration 4-6hrs

Front 15

Albuterol

Back 15

SABA (S,M)

Brand names-Proventil, ventolin, proair (MDI)

Primarily B2, less B1 compared to others, can be given orally too

Front 16

Levalbuterol

Back 16

SABA (S,M)

Brand name-Xopenex

Only single R isomer available, less heart rate and tremor w this compared to others (HR>150)

Front 17

Important facts about LABAS

Back 17

Maintenance therapy only, not suited for relief of acute airway obstruction or bronchospasm, not recommended for rescue administration, slow peak effect, duration 12hrs or more

Front 18

Salmeterol

Back 18

LABA

Brand name-Serevent (D)

Stronger B2 effects than B1, pts usually require a fast acting beta agonist for periods of dyspnea between doses

Front 19

Formoterol

Back 19

LABA

Brand name- Foradil, Performist (D,S)

Selective B2 w long acting effects, indicated for maintenance of asthma (5 and older), or in conjunction w other meds in COPD

Front 20

Arformoterol

Back 20

LABA

Brovana (S)

Single R isomer or Foradil, selective B2 w long side effects, indicated for maintenance tx of bronchoconstriction in COPD

Front 21

Olodaterol

Back 21

LABA

Brand name-Striverdi Respimat (M)

ULTRA LABA

Tx in COPD, very rapid onset, not currently for asthma

Front 22

Vilanterol

Back 22

LABA

ULTRA LABA similar to olodaterol, ONLY AVAILABLE IN COMBO MEDS

Front 23

Why are LABAS not suited for relief of acute airflow obstructions

Back 23

Repeated administration can risk pt for accumulation and toxicity. Long onset of action doesn’t give quick relief.

Front 24

Other names for Anticholinergic bronchodilators

Back 24

Parasympatholytics, anti muscarinic agents, LAAC or LAMA

Front 25

Clinical uses for anticholinergic bronchodilators

Back 25

Maintenance tx of bronchoconstriction in COPD including chronic bronchitis, emphysema and severe asthma and for reducing COPD exacerbations

Front 26

Side effects of Ipratropium and other anticholinergics

Back 26

MDI & SVN- dry mouth and cough (VERY COMMON)

MDI- (occasional) nervousness, irritation, dizziness, headache, rash, and palpitations

SVN-pharyngitis, dyspnea, flulike, bronchitis, nausea, upper airway infection, eye pain, urinary retention, use caution in pts that are allergic to peanuts, soy

Front 27

Use caution w anticholinergics with what pts

Back 27

Glaucoma, prostatic hypertrophy, and urinary retention

Front 28

What needs to be protected when pt uses anticholinergic via MDI or aerosol mask

Back 28

Eyes due to ^intraocular pressure that may result

Front 29

Ipratropium

Back 29

Parasympatholytic

Brand name-Atrovent (S,M)

SVN generic, shortest duration of all meds in category

Front 30

Tiotropium

Back 30

Parasympatholytic

Brand name-Spiriva respimat & handihaler (M,D)

When a higher level of baseline bronchodilation is required, respimat only LAMA approved for routine use in asthma (6 and older)

Front 31

Aclidinium

Back 31

Parasympatholytic

Brand name- Turdoza Pressair (D)

Contraindicated in pt w lactose intolerance

Front 32

Umeclidinium

Back 32

Parasympatholytic

Brand name-Incruse Elipta (D)

Contraindicated w pts w lactose intolerance

Front 33

Revefenacin

Back 33

Parasympatholytic

Yuperli (S)

Only nebulized 24hr Parasympatholytic

Front 34

Clinical uses of Inhaled Drug combinations

Back 34

Bronchodilation, better control of obstruction, reduced drug dosages, avoidance of steroids

Front 35

Albuterol & Ipratropium

Back 35

SABA/Parasympatholytic combo

Brand names- DUONEB (S), combvient respimat(M)

Front 36

Vilanterol and Umeclindinuim Bromide

Back 36

LABA/Parasympatholytic combo

Brand name-Anoro Elipta (D)

Not indicated for asthma, contraindicated for pts w lactose intolerance

Front 37

Olodaterol and Tiotropium Bromide

Back 37

LABA/Parasympatholytic combo

Brand name- Stioloto Respimat (M)

Not indicated for Asthma