Pharmacology 4

Front 1

Review of respiratory tract

Back 1

oral cavity, pharynx (glottis and epiglottis), larynx (vocal cords), trachea, lungs, bronchi (primary, secondary, and tertiary), bronchioles, alveoli, capillaries

Front 2

Functions of upper resp. tract

Back 2

humidifies and moisturizes, filters, and warms external air as it enters the lungs

Front 3

Drugs that maintain proper airflow thorugh resp. passages (not for treating specific lung disease)

Back 3

Antitussive, decongestant, antihistamines, mucolytics and expectorants

Front 4

Antitussives:
1. purpose
2. other uses
3. main adverse effect
4. side effects

Back 4

1. to suppress coughs and other minor throat irritations.
2. combined with aspirin and acetaminophen for relief of minor pain and fever; can inhibit CNS cough reflex; anesthetic pain relief
3. sedation
4. GI upset and dizziness

Front 5

What is histamine?

Back 5

a substance that is produced by the body any time cells are damaged; they cause vaso- and bronchoconstriction

Front 6

Decongestant
1. purpose
2. how it works
3. adverse effect
4. side effects
5. types

Back 6

1. to treat allergies, the common cold, and other infections that produce a runny nose and stuffy head
2. contain alpha adrenergic agonists which bind with receptors to create vasoconstriction, which drys up secretions and decreases congestion
3. nausea and cardiovascular irregularities in BP and HR
4. headache, dizziness, nervousness
5. ephedrine and its derivatives

Front 7

Antihistamines:
1. purpose
2. how it works
3. primary adverse effects
4. side effects
5. types

Back 7

1. sedation and treatment of Parkinsons's and seasonal allergies
2. an endogenous chemical reaction that involves two different receptors, H1 and H2:
H1 are on respiratory tissues and H2 are involved in gastric acid secretions
- these drugs block H1 causing decrease nasal congestion, mucosal secretions, conjunctivitis, and allergies (sneezing and coughing)
3. sedation, blurred vision, and poor coordination, fatigue, and dizziness
4. GI upset
5. Benadryl (crosses blood brain barrier & causes drowsiness), Claritin (does not cross nor produce drowsiness)

Front 8

Mucolytics and Expectorants
1. purpose
2. uses
3. adverse effects

Back 8

1. mucolytics lessen viscosity of respiratory secretions while expectorants facilitate the production and removal of mucous (i.e. prevent accumulation of thick mucous that block airways)
2. for acute and chronic resp. problems (colds, bronchitis, pneumonia and emphysema)
3. nausea, vomiting and inflammation of the oral and nasal mucosa

Front 9

Adverse effects of Ephedrine

Back 9

sudden death and tachycardia

Front 10

Briefly explain 1. COPD, 2. emphysema, 3. chronic bronchitis

Back 10

1. a comon respiratory condition caused by emphysema and chronic bronchitis (smoking, pollution, second hand smoke)
2. a disease process involving destruction of the alveolar walls; enlargement of air spaces in lungs; SOB and decrease resp. exchange
3. caused by chronic irritation of the respiratory tract due to smoke and pollutants that increase and thicken resp secretions of mucous, which interfere with gas exchange (cough, infection possible)

Front 11

Asthma:
1.definition
2.causes
3.why can you not exhale
4. symptoms

Back 11

1. narrowing of bronchial airways due to smooth muscle constriction (bronchospasm); not a COPD because it is not a consistaent problem
2. triggered by environmental and emotional factors including exs and allergens
3. bronchial tissues swell, airways narrow and passages are blocked. Stale air is trapped deep in lungs forcing to use only upper lung area to gasp for air.
4. excess mucous, wheezing, SOB, CO2 levels increase-causes you to faint or go into resp. distress/arrest

Front 12

Two Types of Asthma

Back 12

1. Extrinsic: most common in children; family history of asthma; triggered by allergens (tree pollens, grass, and droppings of house dust mites). These are inhaled or ingested and adhere to mast cells that line resp. mucosa. Releases mediators (histamine, leukotrienes, and other prostoglandin derivatives); leukotriene play a larger role as a bronchodilator and antiinflammatory

2. Intrinsic: usually adult onset in 40s and 50s; no family history and they dont respond to allergy tests; no rise in antibodies that usually trigger antigen-antibody rx

Front 13

How to Prevent Asthma

Back 13

avoidance of allergens or other triggers: animal dander, perfumes/colognes, tobacco smoke, pollen, mold, fumes, dust; attacks will then occur less

Front 14

First form of treatment for acute asthma attacks...

Back 14

cromolyn sodium: prevents release of mediators (mast cell stabilizers)- this is more for children; prevents bronchospasm (does not cause dilation) so does not relieve symptoms of attacks; use is continuous and it is inhaled so may cause cough; is ineffective in 90% and will eventually require long-term corticosteroid therapy orally or inhaled

Front 15

4 types of drugs used for COPDs and asthma

Back 15

1. bronchodilators
2. corticosteroids
3. cromolyn sodium
4. xanthine derivatives

Front 16

Bronchodilators
1. purpose
2. how it works
3. types
3. side effects

Back 16

1. relax smooth muscle and expand airways
2. a) beta agonists stimulates production of cAMP which releases protein kinase and inhibits smooth muscle contraction
b) anticholinergic rxs block muscarinic receptors which prevents effects of ACH in bronchoconstriction and airflow improves
3. for ppl who cannot tolerate other bronchodilators; Atrovent is an aerosol inhaler (more for COPD)
4. dry mouth and tachycardia

Front 17

Corticosteroids
1. purpose
2. how it works
3. admin routes
4. adverses/side effects

Back 17

1. for inflammatory mediated bronchospasm; most effective for controlling this type of ashtma
2. inhibits the production of prostaglandins and leukotrienes and the migration of specialized cells during any inflammation process
3. oral tablets and inhalation
4. edema of the face; lung cancer over time, osteoporosis, muscle wasting, hypertension, and type II diabetes

Front 18

Cromolyn Sodium
1. purpose
2. use
3. admin routes
4. adverse effects

Back 18

1. prevents bronchospasm (but not a bronchodilator); inhibits the release of histamines and leukotrienes from pulmonary mast cells
2. a preventative and decreases hypersensitivity
3. use continuously; by inhalation/ nasal spray
4. irritation of nasal and respiratory tracts (itchy)

Front 19

Xanthine derivatives
1. purpose
2. type
3. side effects/adverse effects

Back 19

1. inhibits the production of enzymes that prevent smooth muscle relazation; added when inhaled beta agonists alone cannot control symptoms; usually discontinued once asthma attacks are under control by inhaled corticosteroids and beta agonists
2. theophylline - once considered foundation of drug therapy for asthma but now is taking a secondary role
3. nausea and vomiting , flushing, headache, and hypotension/ restlessness, insomnia, tremors, and convolusions (caution with CVD patients

Front 20

Non-narcotic Analgesics (pain) and anti-inflammatories include:

Back 20

Salicylates
Acetaminophen
NSAIDs

Front 21

Salicylates
1. most common
2. duration of action/ use
3. uses
4. adverses
5. exs effects

Back 21

1. aspirin (generic)
2. action: 4 hours max/ for pain (10 days), for fever (3 days max)
3. OTC anti-platlet (blood thinner), pain relief, fever (anti-pyrotic), anti-inflammatory
4. rining, dizziness, tachycardia, vomiting, abdominal pain, birth defects (for anti-inflammatory-skin rash, irritation), should be avoided for young children b/c linked to reye syndrome
5. decrease O2 uptake

Front 22

Acetaminophen
1. most common
2. duration of action / of use
3. uses
4. examples as pain reliever

Back 22

1. tylenol
2. action- 6 hours, use short term
3. pain relief (esp for soft tissues and bone injuries b/c does not inhibit healing process) and fever reducer
4. relieves headache by decrease of prostaglandin synthesis in CNS only

Front 23

NSAIDs
1. most common
2. uses
3. max amount
4. adverses

Back 23

1. ibuprofen
2. anti-inflammatory, fever reducer and pain relief
3. 3200 mg/day
4. photosensitivity, GI bleeding, ulcers, kidney damage

Front 24

Reye Syndrome
1. early symptoms
2. effects

Back 24

1. somtimes follows viral infection, vomiting, agitation, lethargy
2. can cause intracranial hypertension, edema in brain, possible cerebral hemorrhage=death

Front 25

Safety guidelines for use of acetaminophen

Back 25

1. as a therapeutic does, its always safe
2. OD is the primary risk
3. following large doses, liver is unable to detoxify the metabolites
4. these toxins bind to the liver cells=destruction and failure
5. 2 times max is the recommended dose; 5-6 times can cause liver failure
6. there is an antidote if given within 8 hours of OD, can survive and recover; deaths are usually intentional

Front 26

Precautions of Aspirin use

Back 26

1. increased risk with therapeutic long-term use
2. mimics NSAIDs, even low doses given to elderly for CV benefits can cause adverses
3. OD can cause metabolic abnormalities, coma, seizures, hyperthermia
4. combined with alcohol-increased risk of GI bleeding; could have black tarry stool if not vomiting blood

Front 27

Advice for distance runners

Back 27

1. aspirin not advised because they are already prone to GI bleeding
2. decreased effects of corticosteroids
3. avoid peptobismol b/c it has salicylates
4. 30 min prior to exercise and after exercise take next dose

Front 28

Name some NSAIDs COX-2 inhibitors
1. the 2 marketed
2. the two inhibitors no longer used and why
3. name 3 other NSAIDs in the order of the most to least potent

Back 28

1. celecoxib (celebrex) and meloxicam (mobic)
2. vioxx and bextra because they were causing CV problems
3. Orudis Actron and Orudis-KT, naproxen (aleve), ibuprofen (advil, motrin, nuprin)-also most common

Front 29

an injection into the joint capsule is called....

Back 29

intraarticular

Front 30

what is the quickest way to administer an analgesic?

Back 30

IV

Front 31

which antiinflammatory drug is most common to be inhaled?

Back 31

corticosteroids

Front 32

another name for acetaminophen

Back 32

tylenol

Front 33

most common adverses of salicylates

Back 33

GI bleeding, tachycardia

Front 34

what are the main uses of narcotics?

Back 34

pain, cough suppressant and diarrhea

Front 35

at therapeutic doses is it easier to OD on Thothelene or Albuterol

Back 35

theothelene

Front 36

when tisses is damaged, this substance is produced

Back 36

prostaglandins

Front 37

define dysphonia

Back 37

hoarseness (from inhaler usually)

Front 38

in a 24 hour frame, how many mg would you have to take to reach toxic levels of NSAIDs

Back 38

3200 mg

Front 39

in the respiratory tract, beta 2 agonists do what?

Back 39

cause smooth muscle relaxation

Front 40

would a cortizone injection delay or speed up the healing process

Back 40

delay healing

Front 41

which type of asthma develops in childhood?

Back 41

extrinsic asthma