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Respiratory Drugs
PHM232 Ch 9
| Question | Answer |
|---|---|
| Chronic obstructive pulmonary disease (COPD) | 2 major diseases: emphysema and chronic bronchitis; irreversible; |
| asthma | inflammatory disorder of the airways and causes coughing, wheezing, breathlessness, and chest tightness; reversible sm airway obstruction, progressive airway inflammation; occurs in intermittent attacks |
| dyspnea | labored or difficult breathing |
| acute | short, severe course |
| chronic | persisting for a long time |
| bronchospasm | spasmodic contraction of the smooth muscles of the bronchioles, or small airways |
| gastroesophageal reflux disease (GERD) | |
| asthma triggers | smoke, dust, exercise, pet dander, cold weather, GERD, colds or flu; medications, anxiety, laughing, and certain foods |
| MDI | metered dose inhaler, delivers specific amount of medication with each actuation, delivery mechanism suspends medication in particles or droplets that are fine enough to penetrate to the deepest parts of lungs; used with a spacer |
| spacer | decreases amount of spray deposited on the back of the throat and swallowed; holds the drug mist until patient is ready to breathe, patient breathes in mist at slower, more effective rate; side effects lowered |
| MDI propellant banned in 80s | Chlorofluorocarbons (CFCs), banned to depleting earth's ozone layer |
| new MDI propellant, required by FDA in 2008 for all MDIs | hydrofluoroalkane (HFA), produce finer mist than CFCs, has better pulmonary deposition of particles and does not produce serum or tissue accumulation when given at 12 hr intervals |
| dry powder inhaler | DPI |
| main difference in DPI and HFA | HFA: patient breathes in slowly DPI: patient breathes in quickly |
| nebulizer | device in which a stream of air flows past a liquid and produces a fine mist, which patient inhales breathing normally through a mouth piece or mask; drug more likely to be deposited deeper in the lungs |
| SABA (short acting beta agonists) | rescue medicines; bronchodilators; MOA: relax smooth-muscle cells of the bronchioles; stimulate beta 2 reeceptors in the lungs by producing smooth muscle relaxation in the bronchioles |
| SABAs | albuterol (ProAir, Proventil, Ventolin, VoSpire ER), levalbuterol (Xopenex), metaproterenol (Alupent) |
| albuterol | ProAir, Proventil, Ventolin, VoSpire ER; MDI for aerosol; nebulizer solution, syrup, tablet, RX only |
| albuterol | no contraindications; patients under 5 yr: use with spacer; patients under 4 yrs: use with face mask and spacer; drug interactions: interact with beta blockers (frequently used by people with heart disease, dosage monitored by prescriber carefully) |
| levalbuterol | Xopenex; MDI for aerosol, nebulizer solution, RX only |
| metaproterenol | Alupent; syrup, tablet, RX only |
| levabuterol | contraindicated in patients with hypersensitivity to albuterol; drug interactions: interact with beta blockers; |
| metaproterenol | no contraindications; contain benzyl alcohol (watch for toxicity in neonates); drug interactions: interact with beta blockers, rapid onset of action, little or no effect on heart rate |
| albuterol and levalbuterol side effects | tremors and nervousness, little effect on heart rate |
| people with asthma | should not use antihistamines during acute attacks, should avoid beta blockers, avoid aspirin, NSAIDS, penicillins, cephalosporins, and sulfa drugs |
| short acting inhaled bronchodilators | albuterol, levalbuterol, metaproterenol |
| inhaled corticosteroids used for | asthma treatment, should not be used for treatment of acute attacks |
| common inhaled corticosteroids | beclomethasone, budesonide, flunisolide, fluticasone, mometasone |
| combo drugs that include inhaled corticosteroids | budesonide-formoterol and fluticasone-salmeterol |
| zafirlukast (Accolate) | leukotriene receptor antagonist that has shown to be effective for asthma in adults and children |
| zileuton (Zyflo) | leukotriene inhibitor that carries strong warnings about liver toxicity and can increase theophylline levels |
| interacts with many drugs and should only be used when a patient's lung disease is unresponsive to other drugs | theophylline |
| cystic fibrosis | hereditary disease that involves the GI and respiratory systems. can be a fatal disease with some patients dying in early adulthood |
| COPD (chronic obstructive pulmonary disease) | emphysema and chronic bronchitis, irreversible |
| characterized by destruction of the tiny alveoli, or air sacs, of the lungs | emphysema |
| can be caused by cigarette smoke, exposure to occupational dusts, fumes, and environmental pollution; and bacterial infection | chronic bronchitis |
| dry mouth, nervousness, dizziness, headache, cough, and bitter taste | side effects of anticholinergics |
| common anticholinergics | aclidinium, ipratropium, tiotropium, umeclidinium |
| common drugs for treatment of bronchitis and emphysema | anticholinergics and LABAs |
| LABAs | arformoterol, formoterol, indacaterol, olodaterol, salmeterol |
| RDS (respiratory distress syndrome) | occurs in neonates during the first few hours of life. characterized by inadequate production of pulmonary surfactant |
| surfactant | fluid that lowers the surface tension between the air and alveolar surfaces, lack of surfactant leads to collapse of the alveoli along with acute asphyxia with hypoxia and acidosis. |
| 2 known causes of RDS | prematurity and maternal diabetes |
| surfactants used for RDS | beractant (Survanta), calfactant (Infasurf), lucinactant (Surfaxin), poractant alfa (Curosurf) |
| beractant | Survanta |
| calfactant | Infasurf |
| lucinactant | Surfaxin |
| poractant alfa | Curosurf |
| natural bovine lung extract, replaces deficient or ineffective endogenous lung surfactant in neonates, rescue therapy within 8 hrs of birth and as prophylactic therapy in high risk infants | beractant (Survanta) |
| replaces deficient endogenous lung surfactant, indicated for neonates under 72 hours of age, stored in refrigerator, swirled but not shaken | calfactant (Infasurf) |
| Surfactants dosage form | intratracheal suspension |
| first synthetic surfactant FDA approved for neonates with RDS. suspension must be warmed prior to use, shaken vigorously and visually inspected to ensure suspension is uniform, free flowing, and opaque white to off white. vials are single use | lucinactant (Surfaxin) |
| preferred for very tiny babies, requires less fluid than other surfactants, can be administered in one dose | poractant alfa (Curosurf) |
Created by:
ChemeketaPHM2021
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