Pharmacology -- Respiratory System Drugs

Front 1

Q: Define Asthma

Back 1

Define Asthma
1. Airway obstruction that is reversible, either spontaneously or with treatment
2. Airway inflammation
3. Increased airway responsiveness to a variety of stimuli.

Front 2

Q: Define COPD

Back 2

Define COPD
Airway diseases that are irreversible; include:
1. Chronic bronchitis -- chronic or recurrent excess mucus secretion into the bronchial tree that occurs on most days during a period of at least 3 months of the year for at least 2 consecutive years
2. Emphysema -- a condition of the lung characterized by abnormal permanent enlargement of the air spaces distal to the terminal bronchiole

Front 3

Q: Bronchodilators

Back 3

Bronchodilators
Act by relaxing the smooth muscles of the bronchial tree, thereby relieving bronchiospasm and increasing the vital capacity of the lungs

Front 4

Q; Take a breath

Back 4

A: Breath is healing

Front 5

Q; Define Asthma

Back 5

Define Asthma
1. Airway obstruction that is reversible, either spontaneously or with treatment
2. Airway inflammation
3. Increased airway responsiveness to a variety of stimuli.

Front 6

Q: Define COPD

Back 6

Define COPD
Airway diseases that are irreversible; include:
1. Chronic bronchitis -- chronic or recurrent excess mucus secretion into the bronchial tree that occurs on most days during a period of at least 3 months of the year for at least 2 consecutive years
2. Emphysema -- a condition of the lung characterized by abnormal permanent enlargement of the air spaces distal to the terminal bronchiole

Front 7

Q: Bronchodilators

Back 7

Bronchodilators
Act by relaxing the smooth muscles of the bronchial tree, thereby relieving bronchiospasm and increasing the vital capacity of the lungs

Front 8

Q: Bronchodilator
Sympathomimetic Bronchodilators
albuterol (Ventolin, Proventil -- "rescue drug")
salmeterol (Serevent--long acting) (in combo with steroid fluticasone is Advair)
epinephrine (Primatine-OCD)

Back 8

Sympathomimetic Bronchodilators
Effects:B2 rec. act on lung
Side Effects: nervousness, anxiousness, tachycardia, arrythmia

Front 9

Q: Bronchodilator
Parasympatholytics (anti-cholenergic, better for COPD);
ipatropium --short acting 4-5 hrs (Atrovent)/combo w/albuterol (Combivent)
tiotropium -- long acting 1-2 x d (Spiriva)

Back 9

Parasympatholytic Bronchodilators

Effects: anticholenergic, better for COPD
Side effects: dry mouth, tachycardia

Front 10

Q: Bronchodilator
Xanthines
Theophylline (oral)
Aminophylline (IV)

Back 10

Bronchodilators, Xanthines
Effects: bronchiodilates
Side Effects: palpitations, elev. heart rate, anxiety, pee
Cautions, interactions: caffeine, chocolate, diuretic effect

Front 11

Q: Bronchodilator
Leukotriene Antagonists/Inhibitor
zafirlukast (Accolate)
montelukast (Singulair)
Zileuton (Zyflo)

Back 11

Leukotriene Antagonists/Inhibitor Bronchodilator

Effects: Stabilizes mast cells thus reduces inflammation in airway
Side Effects: very minimal

Front 12

Q; Corticosteroid
beclomethasone (Beclovent, Vanceril--inhalants) (Vancenase--up the nose)

Back 12

Corticosteroid
Effects: Anti-inflammatory agent; most important agent in reducing acute asthma attack
Acute: IV
Chronic: inhalant (best), systemic oral
Side Effects: immune suppresive, elevates blood glucone, Cushingoid Sign (buffalo back)
Cautions: rinse mouth or you'll get oral trush

Front 13

Q: Prophylactic Agents for Asthma
cromolyn (Intal, Nasalcrom) -OCD, 2-4 x d
nedocromil (Tilade)

Back 13

Prophylactic Agents for Asthma

Prevention of exacerbation of an attack
No value in the treatment of acure attacks

Front 14

Q: Mucolytics

Back 14

Mucolytics
Agents that liquify pulmanary secretions

Front 15

Q: Expectorants

Back 15

Expectorants
Agents that reduce viscosity and loosen secretions which would assist in the expelling of sputum

Front 16

Q: Expectorant
guaifensin (Robitussin)

Back 16

Expectorant guaifensin (Robitussin)

Water is the cheaper and better alternative. But make sure its warm, b/c cold causes bronchiospasm-- Prof NEVER recommends Robitussin

Front 17

Q: Antitussives

Back 17

Antitussives
Prevent coughing in patients NOT requiring a productive cough

Front 18

Q: Antitussives - Narcotics

Codeine
Hydrocodone

Back 18

Antitussives - Narcotics

note that people on hydrocodone for pain never have coughs
Side Effects: sedation, constipation
Cautions: too much narcotic, careful with the heavy machinery; addiction

Front 19

Q: Antitussives - Non-Narcotics
dextromethorphan (Robitussin-DM) --OTC
benzonatate (Tessalon) (script)

Back 19

Antitussives - Non-Narcotics

Only for dry cough
Side Effects: take too much, get a little rash
Cautions: too much, "mental status change" (i.e., robotripping)

Front 20

Q: Define Antihistamines

Back 20

Antihistamines
Medications that completely antogonize the histamine-1 receptor sites
Not curative, but relieving of allergy symptoms caused by histamine release

Front 21

Q: Antihistamines-Sedating
chloropheniramine (Chlor-Trimeton)
brompheniramine (Dimetapp)
diphenhydramine (Benadryl)

Back 21

Antihistamines-Sedating

Side Effects: Benadryl, dry mouth and other anti-cholenergic effects
Cautions for sedation, interactions: alcohol

Front 22

Q: Define Decongestants

Back 22

Decongestants

Constrict blood vessels in the respiratory tract, resulting in shrinkage of swollen mucus membranes and helping to open nasal airway passages
-Beware of rebound effect
-Many OTC preparations

Front 23

Q: Decongestants
phenylpropanolamine (Sudafed PE)
pseudoephedrine (Sudafed)
oxymetazoline (Afrin) -- big rebound after 2 days
phenylephrine (Neo-Synephrine) -- rebound, only use a day or two

Back 23

Decongestants

Notes: phenylpropanolamine (Sudafed PE) doesn't work & sucks

Side Effects: bc works on sympathetic NS causes vasoconstriction, elev glucose, and other stimulant effects: watch BP, not good for cornoary patients, only take to relieve symptoms, can develop tolerance

Front 24

Q: Define Expectorants

Back 24

Expectorants

Agents that reduces viscosity and loosen secretions which would assist in the expelling of sputum

Front 25

Q: Expectorant
guaifensin (Robitussin)

Back 25

Expectorant
guaifensin (Robitussin)

Water is the cheaper and better alternative. But make sure its warm, b/c cold causes bronchiospasm-- Prof NEVER recommends Robitussin

Front 26

Q:Define Antitussives

Back 26

Antitussives
Prevent coughing in patients NOT requiring a productive cough

Front 27

Q: Antitussives - Narcotics

Codeine
Hydrocodone

Back 27

Antitussives - Narcotics

only for dry cough
note that people on hydrocodone for pain never have coughs
Side Effects: sedation, constipation
Cautions: too much narcotic, careful with the heavy machinery; addiction

Front 28

Q: Antitussives - Non-Narcotics
dextromethorphan (Robitussin-DM) --OTC
benzonatate (Tessalon) (script)

Back 28

Antitussives - Non-Narcotics

Only for dry cough
Side Effects: take too much, get a little rash
Cautions: too much, "mental status change" (i.e., robotripping)

Front 29

Q: Define Antihistamines

Back 29

Antihistamines
Medications that completely antogonize the histamine-1 receptor sites
Not curative, but relieving of allergy symptoms caused by histamine release

Front 30

Q: Antihistamines-Sedating
chloropheniramine (Chlor-Trimeton)
brompheniramine (Dimetapp_
diphenhydramine (Benadryl)

Back 30

Antihistamines-Sedating

Side Effects: Benadryl, dry mouth and other anti-cholenergic effects
Cautions for sedation, interactions: alcohol

Front 31

Q: Antihistamines - Non-Sedating
certirizine (Zyrtec) (most effective)
desloratadine (Clarinex) -- only script one
loratadine (Claratin)
fexofenadine (Allegra)

Back 31

Antihistamines - Non-Sedating

Side Effects: none

Front 32

Q: Define Decongestants

Back 32

Decongestants
Constrict blood vessels in the respiratory tract, resulting in shrinkage of swollen mucus membranes and helping to open nasal airway passages
-Beware of rebound effect
-Many OTC preparations

Front 33

Q: Decongestants
phenylpropanolamine (Sudafed PE)
pseudoephedrine (Sudafed)
oxymetazoline (Afrin) -- big rebound after 2 days
phenylephrine (Neo-Synephrine) -- rebound, only use a day or two

Back 33

Decongestants

Notes: phenylpropanolamine (Sudafed PE) doesn't work & sucks

Side Effects: bc works on sympathetic NS causes vasoconstriction, elev glucose, and other stimulant effects: watch BP, nor good for cornoary patients, only take to relieve symptoms, can develop tolerance