Pharmacology

Front 1

Stimulation of the sympathetic nervous system, mainly through the release of ______ from the adremal gland and the subsequent stimulation of beta-2 receptors, produces smooth muscle relaxation (bronchodilation).

Back 1

epinephrine

Front 2

Parasympathetic stimulation (_____) produces contraction (bronchoconstriction).

Back 2

acetylcholine

Front 3

The most common causes of respiratory difficulties are chronic obstructive pulmonary disease (COPD) and ______.

Back 3

asthma

Front 4

________ is a common respiratory condition that is caused by emphysema and chronic bronchitis. Both conditions cause irreversible changes to the respiratory system

Back 4

COPD- chronic obstructive pulmonary disease

Front 5

____ _____ is caused by chronic irritation of the respiratory tract. Cigaretty smoke and other environmental pollutants increase and thicken respiratory secretions of mucus. these secretions interfere with gas exchange, resulting in eventual fibrotic changes in the respiratory lining. Drug therapy can provide some relief, but it cannot reverse the fibrosis and other physical changes in the respiratory lining.

Back 5

chronic bronchitis

Front 6

____ is a disease process involving destruction of the alveolar walls. Consequently, there is an enlargement of the air spaces within the lungs. It is difficult to expel air from the lungs.

Back 6

Emphysema

Front 7

_____ and _____ agents are used to dilate the bronchi and to promote expectoration of bronchial secretions.

Back 7

bronchodilators and mucolytic

Front 8

____ is a repiratory condition characterized by shortness of breath and wheezing. These effects are caused by bronchiolar constriction. Factors that cause this include respiratory irritants (dust and noxious chemical), exercise (particularly in cold weather), respiratory tract infections, aspirin and related drugs, and allergy to foreign proteins (pollen and animal dander).

Back 8

asthma

Front 9

In allergic asthma, individuals develop____ to the foreign protein (antigen).

Back 9

antibodies

Front 10

Relief of asthmatic attacks involves use of drugs that relax respiratory smooth muscle (_____) and drugs that produce antiinflammatory effects on the respiratory passageways.

Back 10

bronchodilators

Front 11

What repiratory disease is mucosal edema and increased produciton of bronchial mucus. Ciliary activity of the repiratory tract is usally depressed. This decrease interferes with the clearing of mucus and other devris from the lower respiratory airways and it is an inflammatory condition of the respiratory passageways?

Back 11

asthma

Front 12

During an inflammatory reaction, chemial ____ are formed and released from injured tissue, mast cells, and leukocytes in the respiratory tract.

Back 12

mediators

Front 13

The chemical mediators involved include____, eosinophillic chemotactic factor of anaphylaxis (____), and various prostaglandin dirivatives (_____ and the slow reacting substance of anaphylaxis (____).

Back 13

histamine
ECF-A
leukotrienes
SRS-A

Front 14

Whenever there is injury or insult to body tissue, ____ is rapidly released from mast cells. This causes bronchoconstriciton, increased vascular permeability that contributes to mucosal edema, and infiltration of leukocytes, particularly eosinophils.

Back 14

histamine

Front 15

______ are usually of little benefit in the treatment of asthma, and for this reason, histamine is not considered to be the most important mediator in asthma.

Back 15

Antihistamines

Front 16

Eosinophillic chemotactic factor (ECF-A) is also released by mast cells and functions to attract ____ to the site of cell injury or irritation.

Back 16

eosinophils

Front 17

Eosinophils are part of the general inflammatory and allergic reaction that often occurs in the lining of the respiratory tract in asthma. The inflammatory and llergic reactioins worsena nd prolog the asthmatic process. when this occurs, antiinflammatory ____ drugs are used to suppress the inflammatory process.

Back 17

corticosteroid

Front 18

The ____ are a series of chemical mediators produced by almost all body cells. When cells are irritated or injured, various of these are rapidly formed and released by the cell membranes. These produce numerous biological effects, including effects on smooth muscle, secretion of mucus, and the inflammatory process.

Back 18

prostaglandins

Front 19

In asthma, on of the most important prostaglandin mediators in the ____.

Back 19

SRS-A slow reacting substance of anaphylaxis

Front 20

The ____ are on type of prostaglandic that is formed in asthma. During anaphylasix and asthma, the mast cells produce and release several of different one of these.

Back 20

leukotrienes

Front 21

Sympathetic stimulation by epinephrine (beta -2 receptors) produces _____.

Back 21

bronchodilation

Front 22

Parasympathetic activation, via the vagus nerve, produces _____ and increased secretion of mucus . Noxious irritants of the respiratory tract stimulate vagal reflexes that result in parasympathetic activation.

Back 22

bronchoconstriction

Front 23

_____ include beta-adrenergic drugs (sympathomimetics), theophylline, and anticholinergic drugs.

Back 23

Bronchodilators

Front 24

_____ stimulation of bronchial smooth muscle causes bronchodilation. This effect is mediated by the beta-2 adrenergic receptors. Consequently, drugs that stimulate beta-2 receptors produce bronchodilation.

Back 24

sympathetic

Front 25

Epinephrine(which is normally released from the adremal gland) and isoproterenol are two potent beta receptor stimulators. These drugs stimulate both beta-1(heart) and beta -2 (smooth muscle )receptors. As a consequence, increased heart rate and other sympathetic effects occur in addition to bronchodilation. Overuse of these drugs may cause tachycardia and cardiac _____. These two drugs are available as OTC aerosols.

Back 25

arrhythmias

Front 26

Adrenergic drugs that selectivly stimulate the ___ receptors at therapeutic doses are available. these drugs are preferred over the older drugs, which stimulate both beta 1 and beta 2 receptors. However, at higher than therapeutic doses or in susceptible individuals, the selective beta 2 drugs may cause some beta 1 receptor cardiac stimulation

Back 26

beta 2 receptors

Front 27

The newer drugs can be administered ___, whereas the older drugs are administered only by subcutaneous injection of aerosol

Back 27

orally

Front 28

The durationof action of the newer beta adrenergic drugs are much ___, and therefore provides longer protection with fewer drug administration

Back 28

longer

Front 29

_____ is the only xanthine used in the treatment of asthma. It inhibits an intracellur enzyme, phosphodiesterase, which normally inactivates cyclic AMP. By inhibiting phosphodiesterase, levels of cyclic AMP increase in bronchiolar smooth muscle and in mast cells. This action causes bronchodilation and inhibits the release of mediators from mast cells

Back 29

Theophylline

Front 30

Theophylline can be administered what three routes?

Back 30

orally, rectally and intravenously

Front 31

_____ is a water-soluble preparation of theophylline that is used for intravenous administration, usually during acute asthmatic attacks.

Back 31

Aminophylline

Front 32

The most frequent side effects from oral administration of this drug is nausea and vomitting. Som patients experience flushing, headache, and hypotension, restlessness, insomnia, tremors, & convulsions?

Back 32

theophylline

Front 33

______ drugs (atropine like) are not widely used in the treatment of asthma. Although they do produce some bronchodilatiion, they tend to dry mucous membranes.

Back 33

Anticholinergic

Front 34

By blocking the actions of acetylcholine (which increases intracellular levels of cyclic GMP), the anticholinergic drugs decrease intracellular levels of cyclic GMP, to prevent what?

Back 34

constriction

Front 35

_____ is a derivative of atropine and is the most widely used anticholinergic drug for asthma. It is an oral inhalatin with a slow onset but prolonged duration of action. It is poorly absorbed into the systemic circulation, and therefor causes few adverse effects. Excessive drying of the mout and upper respiratory passages may cause discomfort and is the most common side effects

Back 35

Ipratropium Bromide (Atrovent)

Front 36

Two drug classes, the ____ and the _____ inhibitors, are used to reduce and control the inflammatory reaction that occurs in asthma.

Back 36

corticosteroids
leukotriene

Front 37

This drug class's main use is for the treatment of inflammatory and allergic conditions such as asthma. The major effect is treatment of asthma is to inhibit the inflammatory response that occur in the respiratory airways. They are used to control bronchiolar inflammation, which is a major component of asthma. Parenterally and orally

Back 37

corticosteroids

Front 38

_____ (Deltasone) is widely used in bronchiolar inflammation

Back 38

Prednisone

Front 39

These drugs are more commonly administered by oral inhalation for the chronic control of asthma. Use of this route greatly reduces systemic absorption and the adverse effects associated with its use.

Back 39

corticosteroids

Front 40

Corticosteroid adverse effects:
fluid retention, muscle wasting, metabolic disturbances, and increased susceptiblity to infection, the incidence of oral infections (usually fungul) and they can cause hoarseness and other vocal chord disturbances. The incidence of these adverse effects can be reduced by doing what?

Back 40

rinsing the mouth with water after inhalation

Front 41

Prostaglandin derivatives known as _____. These substances cause bronchoconstriction, mucus production, and inflamation.

Back 41

leukotrienes

Front 42

____ (Accolate) and ____ (Singulair) are leukotriene receptor antagonists that block the receptor that leukotrienes bind to. The drugs are administered orally.

Back 42

Zafirlukast
montelukast

Front 43

These drugs cause headache, infection, nausea, and diarrhea.

Back 43

leukotriene inhibitors

Front 44

_____ sodium is a drug that interferes with the antigen-antibody reaction to release mast cell mediators. The drug is taken prophylactically (before allergic exposure) on a daily basis. This is useful in certain types of nonallergic asthma.

Back 44

Cromolyn

Front 45

(_____) for allergic rhinitis, as an oral inhaler (Cromolyn Sodium Inhalation, USP) or with a special device (Intal Inhaler) that delivers the drug as a fine, micronized powder for the treatment of asthma. Most frequent effects are nasal stinging, nasal irritation, headache, and bad taste. Rash, hives, cough, and angiodema.

Back 45

Nasalcrom

Front 46

_____(tilade) is a drug similar to cromolynn in mechanism and pharmacological effect. It is administered by oral inhalation, usually two inhalations four times per day.

Back 46

Nedocromil

Front 47

____ are chemical agents that liquefy broncial mucus. These are administered by aerosol to thin or liquefy the secretions.

Back 47

Mucolytics

Front 48

_____ (Mucosil, Mucomyst) contains a chemical group (sulfhydryl) that breaks apart the glycoproteins in bronchial secretion.

Back 48

Acetylchysteine

Front 49

Acetylcysteine is irritating and can cause _____. For this reason, a bronchodilator is added to the inhalation mixture. Administration is usually by nebulization, three or four times a day, followed by postural drainage and tracheal suction when necessary.

Back 49

broncospasm

Front 50

______ are agents that stimulate the production of respiratory secretions, which then decrease the irritation and cough caused by excessive dryness of the airways. Main use is to increase the output of respiratory tract secretions, which indirectly suppresses cough.

Back 50

expectorants

Front 51

The expectorants include salts (ammonium chloride and potassium citrate), ipecac syrup, and ____. Expectorants are addded to many cough syrups and cold medications.

Back 51

guaifenesin

Front 52

After oral administration, the expectorants produce their effect by first irritating the lining of the stomach. This gastric irritation stimulates gastric reflexes that increase both gastric and respiratory tract secretion. Because of the gastric irritation, expectorants may cause ____ and ____.

Back 52

nausea and vomitting