Pharmacology

Front 1

Short Acting Beta 2 Agonists;
Meds;
MOA;
ADR;
CI;
Dose;
Monitoring;

Back 1

*Drug of choice for mld/mod asthma, COPD*
Albuterol, Maxair (pirbuterol), Xopenex, Alupent (metaproterenol)
MOA; relaxes bronchial smooth muscle by action on beta 2 receptors.
ADR; angina, HTN, palpitation, nausea, diarrhea, dizziness, irritability, CNS stimulation, asthma exacerbation, hyperglycemia, hypokalemia, allergy.
*ADR more pronounced w/po med, use spacer*
Precautions; CV dz, glaucoma, hyperthyroidism, DM, preg cat C (po terbutaline used to prevent labor)
CI; Hypersensitivity
Dose; Acute 4-8 puffs or neb 2.5mg q 20mins.
Chronic; 1-2 puffs q 4-6hrs/max 12 puffs qd. PO; 2-4mg 3-4X day/max 32mg qd.
Prophylaxis; 2 puffs 30mins prior to exercise.
Monitoring; PFT's, BP, HR, Gulcose, K.

Front 2

Long Acting Beta 2 Agonists;
Meds;
ADR;
CI;
Dose;
Monitoring;
Warnings;

Back 2

Serevent (salmeterol, Foradil (formoterol), Brovana (arformoterol.
*Not for acute attacks, maintence med only*
ADR; HA, HTN, tachycardia, CNS stimulation, dizziness, insomnia, asthma, bronchoconstriction, allergy.
CI; hypersensitivity, acute tx.
Monitoring; PFT's, BP, HR, CNS stim, glucose, k, asthma sx.
Warning; long acting may ↑ asthma related deaths, CV, DM, glaucoma, hyperthyroidism, hypokalemia, seizures, animal studies show dose dep.

Front 3

Cortidosteroids;
Meds & strength;
MOA;
ADR;
Warning;
CI;
Dose;
Conversion Oral to inhaled;

Back 3

Inhaled or systemic *1st choice for moderate/severe asthma or COPD
Aerobid (flunisolide)250mcg/puff, Asmacort (triamcinolone) 100mcg/puff, Asmanex (mometasone) 220mcg/puff, Beconase, QVar (beclomethasone) 40,80mcg/puff, Flovent HFA (fluticasone) 110mcg/puff, Pulmicort (budesonide) 90, 180 mcg/puff, Combo; Advair (fluticasone/salmeterol 100/50, 250/50, 500/50mcg/dose, Symbicort (budesonide/formoterol),
Prednisone, methylprednisone, given during acute attacks IV or PO
MOA; decrease immune response to allergens, irritants, cold & exercise (macrophages, T lymph, eosinophils)
ADR;(minimized w/spacer)HA, resp tract infection, throat irritation, sinus infection, cough, thrush, dizziness, insomnia, mood swings, bronchospasm, ↓ growth w/peds.
Warning; HPA suppression in children, viral infections, preg cat C.
CI; hypersensitivity, acute broncho-spasm.
Dose; use lowest strength to start, 1-2inh bid
Conversion; oral to inhaled, must taper off oral 10days p starting inhaled.

Front 4

Mast Cell Stablizers;
Meds;
MOA;
Use;
ADR;
Precautions;
CI;
Dose;

Back 4

Intal (cromolyn), Tilade (nedocromil)
MOA; prevent mast cell release of histamine & leukotrienes.
Use; preventitive, must be used @ regular intervals for 2-4wks, prophylaxis;10-15mins prior.
ADR; bad taste, HA, dizziness, drowsiness, n/v, cough.
Precautions; not for <6yrs, Preg cat B.
CI; hypersensitivity, acute bronchospasm.
Dose; 2puffs 3-4 X qd

Front 5

Cholinergic Antagonist
Meds;
MOA;
Use;
ADR;
Precaution;
CI;
Dose;

Back 5

Meds; Atrovent (ipratropium)
MOA; blocks vagally mediated contraction of smooth muscle.
Use; bronchospasm, COPD
ADR; bronchitis, palpitation, dizziness, nausea, sinusitis, glaucoma, urinary retention, dry eyes, dry mouth.
Precaution; not for acute attack, glaucoma, BPH/bladder obstruction.
CI; hypersensitivity to ipratropium or atropine.
Dose; 2puffs qid

Front 6

Methylxanthines, Theophylline;
Meds;
MOA;
Use;
ADR;
Precaution;
CI;
Dose;

Back 6

Theo24, Uniphyl, Elixophyllin
MOA; ↑ epinephrine release & then bronchodilation.
Use; Asthma, bronchitis, COPD
ADR;dose dependent,
Serum 15-25mcg/ml: n/v, diarrhea, insomnia, nervousness, dizziness, HA, muscle cramps.
Serum 25-35mcg/ml:tachycardia
Serum <35mcg/ml: Vtach, PVC, seizure.
*Narrow therapeutic index, drug interactions, replaced by albuterol & corticosteroids*
Precautions; vomiting, draw level & hold dose, hyperthroidism, seizures, hypertension & arrhythmias, smoking, avoid dietary stimulants, preg cat C
CI; hypersensitivity
Dose; wt based not to exceed 900mg qd (tablets, liquid, IV)

Front 7

Anti-leukotrienes Drugs;
What are Leukotrienes?
Meds;
MOA;
Use;
ADR;
Precaution;
CI;
Dose;

Back 7

Leukotrienes cause eoxinophil migration, neutrophil/monocyte aggregation, ↑ cap permeability, S/M contraction, edema, muccous secretion & bronchoconstriction.
Meds; Singulair qd(montelukast), Accolate bid(zafirlukast)
MOA; blocks leukotriene receptors responsible for secretions & edema in asthma.
Use; prophylaxis & chronic tx of asthma.
ADR; HA, dizziness, n/v/d, pain, weakness, hepatitis, infection.
Precaution; acute bronchospasm, liver dysfunction, preg cat B
CI; hypersensitivity
Dose; Singulair 10mg po qd >6mos, Accolate 20mg po bid >5yrs

Front 8

Leukotriene Inhibitors;
Meds;
MOA;
Use;
ADR;
Precaution;
CI;
Dose;

Back 8

Med; Zyflo (zileuton)
MOA; inhibits leukoriene formation.
Use; asthma
ADR; HA, pain, nausea, ↑ liver enzymes.
Precaution; liver dysfunction, peds <12, preg cat C, interacts w/theophylline & warfarin
CI; hypersensitivity, active liver dz
Dose; 600 mg qid

Front 9

Monoclonal Antibody;
Meds;
MOA;
Use;
ADR;
Precaution;
CI;
Dose;

Back 9

Meds; Xolair (omalizumab)
MOA; IgG monoclonal antibody, decreases IgE mediated response to allergies.
Use;Mod/Severe allergic asthma not respondent to corticosteroids.
ADR;HA, injection pain, URT infxn, viral infxn, sinusitis, dermatitis, anaphylaxis.
Precaution; monitor IgE levels, delayed allergic reaction
CI; hypersensitivity, acute bronchospasm, status asthmaticus.
Dose; based on wt & IgE levels, 150-400 units sugQ q 2-4wks, stays in body for 1yr.

Front 10

Myambutol (ethambutol);
Use;
MOA;
ADR;
Precaution;
CI;
Dose;
Monitoring;

Back 10

Use; TB
MOA;inhibits RNA synthesis
ADR;optic neuritis, hepatotoxicity, myocarditis, n/v, gout, blood dyscrasias, renal failure.
Precaution; liver, kidney dysfunction (↓ dose), preg C.
CI; hypersensitivity
Dose; daily, twice or three X a wk based on wt.
Monitoring; baseline & monthly visual tests, renal hepatic & blood test.

Front 11

Isoniazid (INH)
Use;
MOA;
ADR;
Precaution;
CI;
Dose;
Monitoring;

Back 11

Use;TB
MOA; Disruption of cell wall synthesis
ADR; liver failure, vision loss, HTN, palp, tachy, dizziness, rash, hyperglycemia, n/v, blood dyscrasias, hepatitis, peripheral neuropathy.
Precaution; boxed warning fatal hepatitis, liver dysfunction, eye problems, preg C
CI; hypersensitivity, acute liver dz.
Dose; 300mg qd for 6-9mos
Monitoring; 650mg/qd pridoxine to ↓ risk of peripheral neuropathy, LFT's, S/Sx of hepatitis.

Front 12

Pyrazinamide;
Use;
MOA;
ADR;
Precaution;
CI;
Dose;
Monitoring;

Back 12

Use; TB
MOA; converted to pyrazinoic acid, ↓ pH.
ADR; malaise, n/v, myalgia, hepatotoxicity, kidney toxicity, gout.
Precaution; renal or liver failure, gout, DM, preg C
CI; hypersensitivity, acute gout, severe liver dx.
Dose; 1000-3000 qd based on wt, ↓ w/renal impairment.
Monitoring; LFT, uric acid, kidney fxn tests.

Front 13

Rifampin;
Use;
MOA;
ADR;
Precaution;
CI;
Dose;
Monitoring;

Back 13

Use; TB
MOA; inhibist RNA synthesis, ABX.
ADR; dedema, flushing, ataxia, mental ▲s, dizziness, blood dyscrasias, acute renal failure, rash, n/v/d, pancreatitis, ↑LFT, flu sx.
Precaution; liver impairment, caution w/pyrazinamide/alcholism, discolors urine, saliva, sweat & tears, drug interactions, preg C
CI; hypersensitivity, pretease inhibitors
Dose; 10mg/kg/day
Monitoring; LFT, CBC, mental status

Front 14

Streptomycin;
Use;
MOA;
ADR;
Precaution;
CI;
Dose;
Monitoring;

Back 14

Use; TB
MOA; inhibits bacterial protein synthesis, aminoglycoside ABX.
ADR; hypotension, neurotoxicity, n/v, ototoxicity, nephrotoxicity.
Precaution; Black box warning for above ADR, renal impairment, nerve disorders, hearing loss, bacterial super infection.
CI; hypersensitivity, PREGNANCY.
Dose; 15mg/kg/day
Monitoring; hearing/tinnitus, Bun Cr, drug level

Front 15

Aminosalicylic Acid;
Use;
MOA;
ADR;
Precaution;
CI;
Dose;
Monitoring;

Back 15

Use; adjunctive tx in TB
MOA; competitive antagonist w/PABA
ADR; n/v, blood dyscrasias, hepatitis, optic neuritis
Precaution; hepatic/renal dysfunction, ulcer, nasal polyps, asthma, preg C.
CI; hypersensitivity
Dose; 150mg/kg/day in 2-3 doses.
Monitoring; adverse rxns

Front 16

Capastat (capreomycin);
Use;
MOA;
ADR;
Precaution;
CI;
Dose;
Monitoring;

Back 16

Use; TB
MOA; ABX, exact MOA unknown
ADR; ototoxicity, nephrotoxicity, eosinophillia, hypokalemia
Precaution; Box warning of above ADR, preg C, treatogenic
CI; hypersensitivity
Dose; 1gm/day for 60-120days, then 1gm 2-3 X q week
Monitoring; hearing tests, renal fxn, LFT, K.

Front 17

Seromycin (cycloserine);
Use;
MOA;
ADR;
Precaution;
CI;
Dose;
Monitoring;

Back 17

Use; adjunctive tx for TB
MOA; inhibits bacterial cell wall formation, ABX.
ADR; arrhythmia, drowsiness, HA, dizziness, vertigo, seizure, psychosis, vit b12 folate defiency.
Precaution; epilepsy, depression, anxiety, psychosis, renal impairment, alcoholism, preg C.
CI; hypersensitivity
Dose; 250 mg q 12hrs for 2wks, then 500mg-1gm for 18-24mos
Monitoring; renal, hepatic, blood tests, cycloserine level.

Front 18

Trecator (ethionamide);
Use;
MOA;
ADR;
Precaution;
CI;
Dose;
Monitoring;

Back 18

Use; TB tx when 1st line tx have failed.
MOA; inhibits peptide synthesis.
ADR; hypotension, depression, dizziness, rash, hypoglycemia, hypothyroidism, n/v, impotence, hepatitiis, peripheral neuritis, optic neuritis
Precaution; DM, cycloserine/isoniazid
Dose; 15-20mg/kg/day
Monitoring; LFT, thyroid fxn test, eye exam