Term
| pharmacotherapy for respiratory disease is classified as having what effect? |
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Definition
| symptomatic (aka not curative) |
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Term
| where are inhaled particles > or = 10 microns deposited? |
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Definition
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Term
| where are inhaled particles 1-5 microns deposited? |
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Definition
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Term
| where are inhaled particles < .5 microns deposited? |
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Definition
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Term
| What properties of an inhaled substance would you want to minimize systemic (non-lung) effects? |
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Definition
poor GI absorption
rapid metabolism |
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Term
Name the class, MOA, use, and any SEs for the drug named:
theophylline |
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Definition
methylxanthine bronchodilator
inhibits adenosine receptors (adenosine normally causes bronchoconstriction)
also inhibits PDE, which incr. levels of cAMP, which causes bronchodilation
SEs include GI distress, CNS stimulation, and cardiac stimulation/vasodilation |
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Term
Name the class, MOA, use, and any SEs for the drug named:
epinephrine |
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Definition
sympatheticomimetic bronchodilator
non-selective beta receptor-agonist
not used much for bronchodilation (beta-2) due to their disadvantageous effects of causing dangerous arrhythmias (beta-1) or falls in arterial O2 tension |
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Term
Name the class, MOA, use, and any SEs for the drug named:
albuterol, salmeterol |
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Definition
sympatheticomimetic bronchodilator
beta-2 selective receptor agonist
no major SEs except for tremors
(salmeterol is a slower onset, long-acting version of albuterol) |
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Term
| With increased time using a bronchodilator, does bronchial smooth muscle become desensitized? |
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Definition
| no (there is no down-regulation of receptors) |
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Term
| With increased time using a bronchodilator, does bronchial hyperresponsiveness or airway inflammation become desensitized? |
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Definition
| yes, called tachyphylaxis (there is a down-regulation of receptors) |
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Term
Name the class, MOA, use, and any SEs for the drug named:
ipratropium, tiotropium |
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Definition
anticholinergic bronchodilators
muscarinic receptor blockers which block parasympathetic activation associated with bronchoconstriction
tiotropium is a slower onset, long-acting version of ipratropium
use with a beta-2 agonist for synergy |
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Term
Name the class, MOA, use, and any SEs for the drug named:
cromolyn, nedocromil |
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Definition
inhaled/nebulized mast cell stabilizer
inhibit the release of mediators of inflammation and bronchoconstriction; prophylaxis for asthma management
*use nedocromil in children 12 y.o. or older |
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Term
Name the class, MOA, use, and any SEs for the drug named:
fluticasone, budesonide, triamcinolone |
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Definition
inhaled/intranasal corticosteroids
anti-inflammatory agents that inhibit arachadonic acid-derived mediator synthesis/release via incr. in lipocortin 1 which inhibits phospholipase A2 (PLA2 normally needed for biosynthesis of inflammatory mediators)
prevent late-phase asthmatic reaction and reduce bronchoalveolar hyperresponsiveness
inhaled/intranasal primarily for prophylaxis
SEs: mood disturbances, increased appetite, loss of glucose control in diabetics, candidiasis |
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Term
| When would one use systemic (oral/IV) corticosteroids like prednisone? |
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Definition
| sometimes necessary in the management of more severe asthmatic states that do not respond adequately to inhaled steroids |
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Term
Name the class, MOA, use, and any SEs for the drug named:
zileuton |
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Definition
inhibitor of leukotriene effects
inhibits 5-lipoxygenase and thus blocks the synthesis of leukotrienes
used for allergy or exercise-induced asthma prophylaxis (not for acute treatment) |
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Term
| what are some of the effects of leukotrienes? |
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Definition
| bronchoconstriction, incr. vascular permeability, incr. chemotaxis of WBCs, incr. mucous secretion |
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Term
Name the class, MOA, use, and any SEs for the drug named:
zafirlukast, montelukast |
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Definition
inhibitors of leukotriene effects
block leukotriene receptors
montelukast eliminated via bile and can also decr. peripheral eosinophils by 15% |
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Term
Name the class, MOA, use, and any SEs for the drug named:
omalizumab |
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Definition
monoclonal Ab directed against IgE
decreases IgE levels and IgE receptor abundance on basophils and dendritic cells
it decreases asthma exacerbations and use of inhaled steroids in pts who have moderate to severe allergy-induced asthma
also for pts who have issues with steroids (non-compliant, complications, inadequately controlled) |
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Term
Name the class, MOA, use, and any SEs for the drug named:
n-acetylcysteine, iodinated glycerol |
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Definition
mucolytic agents
reduce the viscosity of pulmonary secretions and facilitate their removal |
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Term
Name the class, MOA, use, and any SEs for the drug named:
codeine, hydrocodone, dextromethorphan, benzonatate |
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Definition
cough suppressant antitussive
used when a normally protective cough has become nonproductive or productive of sputum. Suppression can be restful.
these drugs raise the threshold of the central coordinating area to tussal impulses and dull the perception of cough stimuli |
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Term
Name the class, MOA, use, and any SEs for the drug named:
guaifenesin |
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Definition
expectorant antitussive
stimulate outflow of respiratory tract fluid and decr. the viscosity of secretions to facilitate expectoration, also allowing protection of irritated mucosa below the epiglottis where the cough impulse arises |
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Term
Name the class, MOA, use, and any SEs for the drug named:
phenylpropanolamine, pseudoephedrine |
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Definition
oral decongestant
sympathomimetic amine that stimulates alpha-adrenergic receptors to constrict dilated vessels, promoting drainage, resorption of exudate, and decr. hyperemia. Nasal airway patency also improved and breathing is easier.
SEs: irritability and insomnia
use caution in pts w/ HT, cardiac disease, hyperthyroidism, and diabetes |
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Term
Name the class, MOA, use, and any SEs for the drug named:
phenylephrine, oxymetazoline |
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Definition
topical decongestant
sympathomimetic amine that stimulates alpha-adrenergic receptors to constrict dilated vessels, promoting drainage, resorption of exudate, and decr. hyperemia. Nasal airway patency also improved and breathing is easier.
SEs: topical use can result in rebound congestion |
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Term
Name the class, MOA, use, and any SEs for the drug named:
fexofenadine, loratadine |
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Definition
antihistamines
block the H1 receptors, which provides symptomatic relief of allergic rhinitis
SEs: sedation and anticholinergic effects |
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Term
Name the class, MOA, use, and any SEs for the drug named:
colfosceril, beractant |
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Definition
synthetic pulmonary surfactant preparation
used for management of respiratory distress syndrome in premature infants |
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Term
Name the class, MOA, use, and any SEs for the drug named:
dornase alpha |
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Definition
agent to treat cystic fibrosis
genetically engineering DNase enzyme, inhaled by pts w/ CF to breakdown mucous, improve lung fxn, and reduce infxn.
SEs: throat inflammation, voice alteration, chest pain |
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Term
| What is the desmoplastic reaction? |
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Definition
| a secondary reaction to a neoplasm that causes fibrosis around the primary lesion |
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Term
| What does the term "glottic" refer to? |
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Definition
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