Duke PA Asthma/COPD/RTI Pharmacology
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| Used for quick relief of asthma symptoms no matter the classification | short acting beta2 agonist
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| used daily for long term control of asthma in all classifications except mild intermittent | inhaled corticosteroids
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| potent bronchodilators that are the drug of choice for mild intermittent asthma | short acting beta2 agonist
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| onset of action 5-30 minutes, with relief for 4-6 hours | short acting beta2 agonist
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| drug of choice for acute anaphylaxis | epinephrine
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| Beta 2 agonists have no anti-inflammatory effects and therefore | should not be use as the sole therapuetic agent for management of persistant asthma
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| albuterol | short acting beta2 agonist
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| terbutaline | short acting beta2 agonist
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| all patients with asthma should be prescribed a | quick-relief inhaler
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| salmeterol | long acting beta2 agonist (LABA)
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| xinafoate | long acting beta2 agonist (LABA)
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| formoterol | long acting beta2 agonist (LABA)
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| have slower onset of action and should not be used for quick relief of asthma symptoms | long acting beta2 agonist (LABA)
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| considered to be useful adjunctive therapy for attaining asthma control | long acting beta2 agonist (LABA)
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| drug of first choice for any degree of persistent asthma | inhaled corticosteroids
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| patients achieving ____ consecutive months of improved asthma control may be considered for a reduction in inhaled corticosteroid dosing | 3-6
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| targets underlying airway inflammation | inhaled corticosteroids
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| patients with severe exacerbation of asthma may require | intravenous injection of methylprednisolone or oral prednisone
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| severe exacerbation of asthma | status asthmaticus
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| ____ decrease the deposition of drug in the mouth caused by improper inhaler technique | spacers
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| selective, reversible inhibitor of the cysteinyl luekotriene-1 receptor | montelukast and zileuton
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| allows for modest reductions in doses of beta2 agonists and corticosteroids | leukotriene antagonists
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| zafirlukast and zileuton are both inhibitors of | cytochrome P450
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| elevations of serum hepatic enzymes have occured with | leukotriene antagonists
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| Pretreatment with ____ blocks allergen and exercise induced bronchoconstriction | cromolyn
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| cholinergic antagonist | ipratropium
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| useful in patients unable to tolerate adrenergic agonists | ipratropium
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| blocks vagally mediated contraction of airway smooth muscle and mucus secretion | ipratropium
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| not traditionally effective in the treatment of asthma unless COPD is also present | ipratropium
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| previously the mainstay of asthma therapy _____ has been replaced by beta2 agonists due to its narrow therapuetic window | theophylline
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| recombinant DNA derived monoclonal antibody that selectively binds to human immunoglobulin E | omalizumab
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| may be particularly useful in patients with moderate to severe asthma that are poorly controlled with conventional therapy | omalizumab
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| the foundation of therapy for COPD | inhaled bronchodilators such as anticholinergic agents
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| anti-inflammatory medications that reduce airway hyperresponsiveness, inhibit inflammatory cell migration and activation, and block late phase reaction to allergen | corticosteroids
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| stabilize mastcells and interfere with chloride channel function | Cromolyn sodium and nedocromil
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| liver function monitoring is essential for | leukotriene modifiers
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| inhaled bronchodilators that have a duration of bronchodilation of at least 12 hours after a single dose | long acting beta2 agonist (LABA)
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| is the preferred therapy to combine with ICS in youths ³12 years of age and adults. | long acting beta2 agonist (LABA)
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| Increasing use of SABA treatment or the use of SABA > __ days a week for symptom relief (not prevention of EIB) generally indicates inadequate asthma control | 2
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| are the most consistently effective anti-inflammatory therapy for all agegroups, at all steps of care for persistent asthma | Inhaled corticosteroids
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| ____ used shortly before exercise may be helpful for 2–3hours | short acting beta2 agonist
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| Frequent or chronic use of ____ as pretreatment for EIB is discouraged, as it may disguise poorly controlled persistent asthma | long acting beta2 agonist (LABA)
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| Clinicians who administer omalizumab are advised to be prepared and equipped for the identification and treatment of | anaphylaxis
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| the preferred ICS for pregnancy | budesonide
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| the preferred SABA for pregnancy | albuterol
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| consult with asthma specialist if step __ or higher is required in children 0-4 years of age | 3
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| consult with asthma specialist if step __ or higher is required in children 5-11 years of age | 4
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| Preferred Step 1 treatment for patients 12 and up | SABA PRN
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| Preferred Step 2 treatment for patients 12 and up | low dose ICS
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| Preferred step 3 treatment for patients 12 and up | low dose ICS plus LABA or medium dose ICS
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| Preferred step 4 treatment for patients 12 and up | medium dose ICS plus LABA
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| preferred step 5 treatment for patients 12 and up | high dose ICS plus LABA and consider omalizumab for patients with allergies
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| preferred step 6 treatment for patients 12 and up | high dose ICS plus LABA plus oral corticosteroids, and consider omalizumab for patients with allergies
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| regular treatment with _____ does not modify the long term decline in FEV1, but has been shown to reduce the frequency of exacerbations in COPD patients with an FEV1 of <50%, and repeated exacerbations | inhaled glucocorticosteroids
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| long term treatment with ______ is not recommended in patients with COPD | oral glucocorticosteroids
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| reduces serious illness and death in COPD patients by 50% | influenza vaccine
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| initiate oxygen therapy for very severe COPD if PaOx is at or below ___ kPa or SaO2 is at or below __% | 7.3, 88
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| antibiotics should be given to COPD patients | with increased dyspnea, increased sputum volume, increased sputum purulence
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| antibiotics should be given to COPD patients | who require mechanical ventilation
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| tell patients to rinse and spit when using ICS to reduce | systemic absorption
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| Only prescribe in combination with ICS in pts with moderate to severe persistent asthma | long acting beta2 agonist (LABA)
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| carry a black box warning for asthma (especially when used as monotherapy) | long acting beta2 agonist (LABA)
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| contains fluticasone and salmeterol | Advair
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| contains budesonide and formoterol | Symbicort
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| Leukotriene modifier | Singulair
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| Approved for allergic rhinitis | Singulair
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| effective for seasonal asthma and for prevention of exercise induced bronchospasm | mast cell stabilizers
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| effective for seasonal asthma and for prevention of exercise induced bronchospasm | Cromolyn sodium and nedocromil
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| treatment of choice for management of EIB | short acting beta2 agonist
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| > __ canister/month indicates need to intensify anti-inflammatory therapy | 1
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| Anticholinergic for COPD | tiotropium (spiriva)
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| Anticholinergic for asthma | Ipratropium (Atrovent®)
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| Turn liquid medication into a fine mist that is easily inhaled | nebulizers
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| used for patients who can't use metered dose inhalers | nebulizers
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| Should be done in the am and between noon and 2:00pm for 2-3 weeks to establish personal best, then QD | peak flows
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| ultimate goal of COPD therapy | prevention
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| oxygen, consider surgery | very severe COPD (stage 4)
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| inhaled corticosteroids in COPD | severe (stage 3), and very severe (stage 4)
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| Bronchodilator of choice for acute exacerbations of COPD | short acting beta2 agonist
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| dry powder anticholinergic inhaler used for COPD | tiotropium (spiriva)
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| Combination of albuterol and ipratropium-used in treatment for COPD | Combivent®
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| use in pts inadequately controlled on optimal bronchodilatory therapy in COPD | theophylline
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| 60% of pts experience adverse effects at serum concentrations of 20-30 mg/L-N,V,D, headache, nervousness, | theophylline
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| Withdrawal of ____ can precipitate exacerbationin COPD | steroids
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| not recommended in COPD | expectorants, mucolytics, antitussives, respiratory stimulants
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| only therapy to show mortality benefit in COPD | oxygen
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| goal of oxygen therapy | increase Pao2 to > 60 mmHg
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| H. influenzae is antibiotic resistant to ampicillin because it secretes | beta-lactamase
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| nearly all M. catarrhalis bacterium secrete | beta-lactamase
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| excellent bioavalability is an advantage of | fluoroquinolones
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| good activity against typical and atypical respiratory tract pathogens including PRSP, BLPHI | fluoroquinolones
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| can be used in penicillin allergic patients is an advantage of | fluoroquinolones
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| not approved in pediatrics (13-14) | fluoroquinolones
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| rare tendon rupture is a possible adverse reaction | fluoroquinolones
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| possible CNS toxicity is a possible adverse reaction | fluoroquinolones
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| not considered a respiratory floroquinolone | ciprofloxacin
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| good activity against typical pathogens and atypical pathogens | macrolides/azalides
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| a lot of safety data available for use in pediatrics | macrolides/azalides
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| the grandfather of macrolides, that has a lot of GI effects, doesn't have good activity against H. flu, and is seldom used anymore | erythromycin
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| can be used in penicillin allergic patients is an advantage of | macrolides/azalides
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| good activity against typical respiratory pathogens | penicillins with or without beta-lactamase inhibitor
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| inexpensive is an advantage of | penicillins with or without beta-lactamase inhibitor
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| a lot of safety data available for use in pediatrics | penicillins with or without beta-lactamase inhibitor
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| no activity against atypical respiratory pathogens | penicillins with or without beta-lactamase inhibitor
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| low potential for drug interactions is an advantage for | penicillins with or without beta-lactamase inhibitor
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| productive cough greater than or equal to 3 months in 2 consecutive years | chronic bronchitis
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| this patient should receive no antibiotics | acute bronchitis
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| Short-term cough, producing mucoid sputum,Persistent cough after 5 days of URI, usually viral in etiology | acute bronchitis
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| smokers get | chronic bronchitis
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| cephalosporins | cefpodoxime, cefuroxime
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| macrolides | azithromycin, clarithromycin
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| fluoroquinolones | levofloxacin, moxifloxacin
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| there is no evidence that shows that _____ has a role in therapy for chronic bronchitis | long term antibiotic prophylaxis
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| therapy for pertussis | macrolides, trimethoprim-sulfamethoxazole
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| if risk factors or there is a high incidence locally of MRSA | vancomycin or linezolid
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| treatement for legionella pneumophila | combination should include a macrolide (e.g., azithromycin) or a fluoroquinolone (e.g., ciprofloxacin or levofloxacin) rather than an aminoglycoside
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| Fever to 104º F, chills, myalgias, headache, ~3 days, Clear nasal discharge, not much congestion, Onset abrupt,Hoarseness, cough, sore throat become more symptomatic over 3 to 4 days after fever | influenza
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| Oseltamivir, zanamivir and peramivir belong to this class | neuraminidase inhibitor
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| never add a single drug to a failed regimen when trying to treat | TB
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| Fever, Chills, Night sweats, Appetite loss, Weight loss, Productive, prolonged cough > or equal to 3 weeks, Chest pain, Hemoptysis, Easy fatigability are all symptoms for | TB
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| clinically significant drug interactions with all | rifamycins
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| can cause color blindness | ethambutol
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