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Flashcards in Pharmacology Deck (47)
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1

What are the 4 administration techniques for asthma medications?

MDI (meter dose inhaler)
Nebulizer (liquid med in machine)
Inhaled powder (rotacaps, disc-inhaler)
Systemic admin (ora or parenteral routes IV, IM, SQ)

2

Albuterol, Proventil, Ventolin
Class
MOA
Onset/duration
Route

Class: SABA
MOA: bronchodilator
Onset: 15 min before activity or for acute attacks
Duration: 4-6 hours
Route: inhalation (can do IV but no advantages)

3

How do the sympathomimetics bronchodilators (beta-2 agonists) work?

-produce airway dilation
-vasodilation of smooth muscle in lungs!!!
-improve mucocilliary transport
-stimulate beta-andrenergic receptors

4

What are the SABA used for?

-prevention of exercise induced bronchospasm (asthma)
-help with ACUTE attacks
-inhibit smooth muscle contraction

5

What are the LABA used for?

Maintenance medication
inhibit smooth muscle contraction
NOT for acute attacks
Do NOT use alone, need to use with ICS

6

Levalbuterol (Xopenex)
Class
MOA
Onset/duration
Route

class: SABA
MOA: bronchodilator --inhibit smooth muscle contraction
Onset: less than 5 min
Duration 6-8 hours
Route: nebulizer

7

Salmeterol (Serevent)
Class
MOA
Onset/duration
Route
Uses

Class: LABA
MOA: bronchodilator --inhibit smooth muscle contraction
Onset: 20 min
Duration: 12 hours
Route: diskus
Uses: asthma/bronchospasm

8

Formoterol (Foradil)
Class
MOA
Onset/duration
Route
Uses

Class: LABA
MOA: bronchodilator--inhibit smooth muscle contraction
Onset: 20-30 min
Duration: 12 hours
Route: inhaler
Uses: asthma

9

Ipratropium (Atrovent)
Class
MOA
Onset/duration
Route
Uses

Class: anticholinergic
MOA: anticholinergic, reverses acetylcholine-induced bronchospasm (inhibiting parasympathetic nervous system) --inhibit smooth muscle contraction
Onset: ?
Duration: Q6
Route: inhaler
Uses:bronchospasm for COPD

10

Parasympathetic vs. sympathetic in asthma. What does what and what are you inhibiting/stimulating?

Parasymphathetic = constricts the airway, so want to inhibit acetylcholine
Sympathetic = opens the airways, so you want to stimulate the beta-2 receptors
So: either can stimulate sympathetic and or inhibit the parasympathetic

11

Tiotropium (Spiriva)
Class
MOA
Onset/duration
Route
Uses

Class: anticholinergic
MOA: reverses acetylcholine induced bronchospasm (parasymp)--inhibit smooth muscle contraction
Onset: ?
Duration: 24 hours
Route: diskus
Uses: bronchospasm w/ COPD

12

Theophylline (Theo-Dur)
Class
MOA
Route
Uses
Monitoring

Class: methylxanthine
MOA: prevents and/or reverse inflammation
Route: liquids, tablets, capsules
Uses: maintenance therapy -moderate--severe asthma, COPD
Monitoring: small TI, blood draws, can be toxic

13

Fluticasone (Flovent)
Class
MOA
Onset/duration
Route

Class: ICS
MOA: prevent, reverse inflammation
Onset/duration: 2-4 weeks
Route: inhaler

14

Budesonide (Pulmicort)
Class
MOA
Onset/duration
Route

Class: ICS
MOA: prevent, reverse inflammation
Onset/duration: 2-4 weeks
Route: Flexhaler, (nebulizer for kids)

15

Beclamethasone (Vanceril, Beclovent, QVAR)
Class
MOA
Onset/duration
Route

Class: ICS
MOA: reverse, prevent inflammation
Onset/duration: 2-4 weeks
Route: inhaler

16

Thiamcinolone (Azmacort)
Class
MOA
Onset/duration
Route

Class: ICS
MOA: reverse, prevent inflammation
Onset/duration: 2-4 weeks
Route: inhaler

17

Flunisolide (Aerobid)
Class
MOA
Onset/duration
Route

Class: ICS
MOA: reverse, prevent inflammation
Onset/duration: 2-4 weeks
Route: inhaler

18

Advair (salmeterol + fluticasone)
Class
MOA
Onset/duration
Route

Class: LABA + ICS
MOA: reverse, prevent inflammation and smooth muscle relaxation
Onset/Duration: maintence med
Route: diskus

19

Dulera (mometasone + formoterol)
Class
Onset/duration/uses
Route

Class: ICS + LABA
Used: maintenance med
Route: inhaler

20

Symbicort (budesonide + formoterol)
Class
Use
Route

Class: ICS + LABA
Used: maintenance med
Route: inhaler

21

Combivent (Ipratropium + albuterol)
Class
use
route

Class: ATC + SABA
Use: maintenance med
Route: inhaler or nebulizer

22

Cromolyn (Intal)
Class
MOA
Onset/duration
Route
used

Class: mast cell stabilizer (MCS)
MOA: prevent, reverse inflammation
Onset/duration: 4-6 weeks
Route: nasal or nebulizer
used: prophylaxis

23

Nedocromil (Tilade)
Class
MOA
Onset/duration
Route
used

Class: MCS
MOA: prevent, reverse inflammation
Onset/duration 4-6 weeks
Route: inhalation and neb
used: prophylaxis

24

What do MCS prevent?

release of inflammatory mediators (histamine) from mast cells, macrophages, neutrophils, and eosinophils

25

Montelukast (Singulair)
Class
MOA
Onset/duration
Route
CI

Class: Leukotriene inhibitor
MOS: competitive agonist of leukotriene receptors = prevent, reverse inflammation
Onset/duration: 1-3 hours
Route: po
CI: p-450 inhibitor!!!!

26

Asfrilukast (Accolate)
Class
MOA
Onset/duration
Route

Class: leukotriene inhibitor
MOA: competitive agonist of leukotriene receptors = prevent, reverse inflammation
Onset/duration: 1-3 hours
Route: po

27

Zileuton (Zyflo)
Class
MOA
Onset/duration
Route

Class: BLOCKS leukotriene production
MOA: blocks leukotriene production
onset/duration: 1-3 hours
route: pa
REMEMBER that this med, still is a leukotriene inhibitor, but it BLOCKS the production of leukotrienes, while the other two are competitive antagonists

28

Diphenhydramine (Benadryl), Atarax
Class
Indications
AE

Class: 1st gen antihistamine (more cross BBB and produce more sedation and other CNS effects)
Indications: Type I allergies = urticaria, pruritus, conjunctivitis, angioedema, sneezing, rhinorrhea
AE: drowsiness, anticholinergic effects

29

What are anticholinergic effects?

no shit, spit, pee, see
dry mouth, blurred vision, urinary hesitancy, constipation, confusion, mental cloudiness

30

Loratadine (Claritin)
Class
Indications
AE

Class: 2nd generation antihistamine
Indications: itching, sneezing, rhinorrhea, long-lasting, non-drowsy (seasonal AR)
AE: anticholinergic effects (less than 1st generation)