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Pulmonary Pharmacology

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This refers to several lung diseases characterized by chronic obstruction of air flow and bronchoconstriction.
Chronic Obstructive Pulmonary Disease (COPD)
What are the three types of COPD?
Chronic bronchitis
Emphysema
Chronic asthma
What type of COPD causes an inflammation of the bronchial tree?
Chronic bronchitis
What disease is characterized as a destruction of alveolar walls and enlargement of terminal airspace?
Emphysema
What is the greatest risk factor for COPD?
Smoking
This disease affects about 30 million people in the US
COPD
This is a chronic condition affecting 4-5% or 10 million people of the US.
Asthma
What is asthma?
It is a characterized by bronchoconstriction, airway inflammation and mucus plugging of airways.
What are some conditions that may cause asthma?
Allergens, exercise, cold, psychological stress, and some unknown causes.
This condition involves inflammatory reaction, bronchoconstriction, airway inflammation and mucus plugging of airways?
Asthma.
What are some drugs used in the treatment of asthma?
Bronchodilators, anti-inflammatory agents, cromons, anti-leukotriene, antihistamines.
The following are examples of Bronchodilators used to treat asthma?
Beta 2 agonists: Albuterol
Xanthine derivatives: Theophylline
Anticholinergic agents: Ipatropium
What is an anti-inflammatory agent used to treat asthma?
Glucocortidcoids (hydrocortisone).
How do Beta-adrenergic agonists (bronchodilators)work?
They activate beta-2-adrenergic receptors to cause relaxation of airway smooth muscles.
What are some examples of Beta-adrenergic agonists (bronchodilators) used in the treatment of asthma?
Albuterol (PROVENTIL, VENTOLIN)
Epinephrine
salmeterol (SEREVENT)
Salmeterol (SEREVENT), a beta-adrenergic agonist (bronchodilator), works on what type of receptors?
Beta 1 and 2
What are the pharmacokinetics for Beta 2 Adrenergic agonists?
Oral, subcutaneous and inhalation adminisration.
What is the best way to administer a beta-2 adrenergic agonist?
Inhalation due to rapid onset.
Other than oral, subcutaneous, and inhalation what is another way beta-2 adrenergic agonists can be administered?
Through a nebulizer
The following are adverse affects of what type of drug used to treat asthma?

Non-selective beta agonists may cause cardiac effects.
CNS effects of nervousness, restlessness, and tremors.
Beta 2 Adrenergic agonists
What are the two types of beta-2 adrenergic agonists used for mild asthma?
Short acting and long acting beta-2 adrenergic agonists.
What is an example of a short acting beta 2 adrenergic agonist used in the treatment of mild asthma and what symptomatic treat ment is it used for?
Albuterol (PROVENTIL, VENTOLIN)
used to treat bronchospasm (acute attack)
What class of drugs used in the treatment of asthma is Xanthine derivatives?
Brochodilators.
What type are the following drugs used to treat asthma are:
Theophylline (THEO-DUR)
Aminophylline (PHYLLOCONTIN)
Caffeine
Xanthine derivatives (bronchodilators)
How do Zantinine derivatives (bronchodilator) work?
They probably cause bronchodilation by inhibiting phosphodiesterase enzyme and exhibits anti-inflammatory effects.
How are xanthine derivatives, such as theophylline (THEO-DUR)administered?
Oral, rectally or by injection
Used once or two times daily.
This type of bronchodilator has a narrow therapeutic index (toxicity may occur in therapeutic range in some pt.), may cause nausea, confusion, and irritability, at a high concentration may cause cardiac arrhythmias and seizures?
Xanthine derivative such as theophylline
What are some of the effects that Xanthine derivatives have on the CNS?
Nervousness, restlessness, and tremors.
Hydrocortisone (CORTEF), Methylprednisolone (MEDROL), Prednisone (DELTASONE), and Triamcinolone (AZMACORT)are what type of agents?
Anti-inflammatory
How do anti-inflammatory agents work?
They inhibit production of pro-inflammatory factors such as PGs, TXs, and leukotrienes.
How are anti-inflammatory agents administered?
IV administration for severe asthma and inhalation or orally for chronic use.
The following are adverse affects for which type of agent used to treat asthma?
Catabolic effects: thinning of bones, osteoporosis, muscle wasthing, skin breakdown.
Others: retardation in children, cataracts, glaucoma, hyperglycemia, negative f
Anti-inflammatory agents
Proper use of inhaler reduces the risk of adverse effects for what type of agent?
Anti-inflammatory
What is the first choice for treatment of moderate to severe asthma?
Anti-inflammatory agents
This type of agent can be used as a nasal spray in allergic rhinitis?
Anti-inflammatory
This agent may be used for COPD but not recommended for routine use?
Anti-inflammatory
Ipratropium is an example of what antagonist used in the management of COPD?
Cholinergic antagonists
How does Ipratropium, a cholinergic antagonist, work?
It blocks vagally-mediated contraction of airway
Zileuton, Zafirlukast, and Montelukast (SINGULAIR) are what type of of drug used to treat COPD?
Anti-leukotrienes.
How does Zileuton, an anti-leukotriene, work?
It inhibits lipoxygenase.
What anti-leukotriene inhibits the leukotriene receptor?
Zafirlukast.
What type of anti-leukotriene inhibits LT receptor
Montelukast (SINGULAIR)
This group of drugs is used to treat prophylaxis of asthma.
Anti-leukotrines.
What are two types of drugs that are cromons?
Cromolyn and Nedocromolyn
How do Cromons work?
they prevent degranulation and release of mediators.
What is the therapeutic use of cromons?
Prophylaxis of asthma to prevent allergen and exercise-induced bronchoconstriction.
What are some bronchodilators used in the treatment of COPD?
Beta-adrenergics, Anticholinergics, and Thyeophylline.
Glucocorticoids are under what group that treats COPD?
anit-inflammatory agents
During this condition the bronchial tubes become clogged with mucous and narrows the airways making it difficult to get air into and out of the lungs.
Chronic Bronchitis.
This condition is characterized by deformed or destroyed alveoli interfering with the exchange of oxygen and carbon dioxide. The amount of oxygen in the blood decreases while the amount of carbon dioxide increases. The airways tend to collapse restrictin
Emphysema
This type of asthma pt. has daily bronchocontrictive episodes and inhales and takes oral glucocorticoids?
Severe asthma pt.
Epinephrine, a beta adrenerigic agonist (bronchodilator) works on what type of receptors?
Beta 2 and alpha receptors.
Albuterol (PROVENTIL, VENTOLIN) a beta adrenergic agonsit (bronchodilator) is what type of beta agonist?
Beta-2-agonist
What is the treatment for a pt. who has mild asthma and has less than 2 bronchoconstrictive episodes per week?
Inhaled betat-2 agonist given as needed and possibly inhaled glucocorticoids.
What is an example of a long acting beta 2 adrenergic agonist used to treat asthma?
Salmeterol (SEREVENT) used for chronic condition.
This type of drug is used replaced by beta agonists and is used for conditions not responding to other forms of treatment?
Xanthine Derivatives such as theophylline
What anti-inflammatory agent is useful in some pt. but routine use offers no benefits?
Glucocorticoids.
What type of pt. use Ipratropium, a cholinergic antagonist?
pt. unable to tolerate adrenergic agonists (asthma)
The following are symptoms of what condition?
Shortness of breath, Wheezing, and rapid respiration.
Asthma
What classifies a pt. as having moderate asthma and how are they treated?
To be considered moderate you will have more than 2 bronchoconstrive episodes per week. You would inhale cromolyn and glucocorticoids.
What is important to remember when seeing a pt. who is taking an Xanthine derivative?
That there is a narrow therapeutic window so one needs to look for early signs of toxicity.

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