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Pharm test 3

chap 27

Ch.27 Drugs for Respiratory Tract Disorders include • Anti-infammatory drugs • Bronchodilators • Antitussives • Expectorants • Antihistamines
Anti-infammatory drugs subclasses are - Antileukotriene drugs - Inhaled Steroids - Mast Cell Stabilizers - Oral Steroids
Bronchodilators subclasses are • Selective Beta-2 agonists • Other Bronchodilators
Oral Steroids include Prednisone• prednisolone •methylprednisolone• dexamethasone
Inhaled Steroids include Fluticasone (Flovent) (Flonase) •Budesonide (Pulmicort) (Rhinocort) •Mometasone (Asmanex) (Nasonex) • Triamcinolone (Azmacort-off mkt) (Nasacort) •Ciclesonide (---) (Omnaris)
Mast Cell Stabilizers include Cromolyn Sodium (NasalCrom) & and other formulations some no longer on mkt
Antileukotriene drugs include Montelukast (Singulair) •Zafirlukast (Accolate)
Selective Beta-2 agonists include Albuterol (Ventolin, Proventil, ProAir) ,Levalbuterol (Xopenex) ,Salmeterol (Serevent) ,Formoterol (Forodil) ,Aformoterol (Brovana) ,Terbultaline (Brethine)
Other Bronchodilators include Ipratropium (Atrovent) •Tiotropium (Spiriva) •Theophylline (Theodur)
Antitussives Codeine (usually in combination with Promethazine) •Hydrocodone (in combination with other drugs) chlorpheniramine (Tussionex •Dextromethorphan usually in combination with other OTC ingredients (Robitussin DM)
Expectorants Guaifenesin (plain Robitussin, Mucinex)
Antihistamines chap 26
Asthma characteristics Inflammation & hyperresponsiveness
Rhinitis Seasonal or non-seasonal
COPD Chronic bronchitis , Emphysema
Cromolyn sodium: Mast cell stabilizers indications Allergic rhinitis, (vernal) seasonal conjunctivitis , Long-term control asthma , Prevent exercise-induced bronchospasm, systemic mastocytosis, ulcerative colitis, food allergy
Localized pain & irritation Mast cell stabilizers adverse effects
Indications: prophylaxis and treatment of various forms of asthma (allergic asthma, aspirin-sensitive asthma) Antileukotriene drugs
liver enzymes (liver failure, liver injury), hypersensitivity reactions, allergic granulomatous vasculitis Antileukotriene drugs adverse effects
Indication:Treat or prevent acute bronchospasm β2 Agonists - rapid acting
Adverse eff: tachycardia, palpitations, tremors β2 Agonists - Rapid-acting
“Rescue inhalers” albuterol (Proventil)
Indications: Treat asthmas & emphysema, not for acute bronchitis β2 Agonists - Long-acting
Indications: COPD, rhinitis Muscarinic blockers:  Ipratropium (Atrovent), Tiotropium (Spiriva)
First-line treatment for COPD tiotroprium (Spiriva)
Indications: COPD, asthma, premie apnea theophylline (Theodur)
Adverse effects: GI, CNS, CV theophylline (Theodur)
What to remember when administer theophylline (Theodur)? Monitor serum levels
What is the first-line treatment for a cough? controlling the infection, allergy, and other condition responsible for a cough
Opioids characteristics have higher retio of antitussive effect to analgesic and euphoric effects
centrally acting antitussives opioids: dextromethorphan, codeine, hydrocodone
antitussive drugs to suppress coughing
Expectorants moa Reduce viscosity of tenacious secretions by increasing respiratory tract fluid. Mobilization & expectoration of mucous
Indications: Thick tenacious respiratory secretions; Dry, non-productive cough; Sinusitis guaifenesin (Mucinex)
Indications: prevent asthma attacks Glucocorticoids: Inhalation preferred route of administration
Thrush (oral candidiasis); Suppress growth in children Glucocorticoids (fluticasone, budesonide, triamcinolone): metered-dose inhalers (ise of spacer device)
Mast cell stabilizers are nonsteroid compounds that stabilize the plasma membrane of mast cells and eosinophils and thereby prevents degranulation and release of histamine ... substances that cause airway inflammation
the most widely used opioid antitussive drug Dextromethorphan
Indications: "nonprescription" products for cough and other respiratory tract conditions Dextromethorphan
Codeine and hydrocodone can cause little CNS depression or euphoria at doses that produce excellent antitussive (liquid cough preparations)
antileukotriene benefits children more than adults, younger children more than older children
Rapid acting B2 agonists albuterol, levalbuterol, terbultaline
Indication: prevent and treat acute bronchospasm rapid acting B2 agonist
tachycardia, palpitaions, tremors levalbuterol < albuterol
Long-acting B2 agonists Salmeterol and formoterol
Indications: long term treatment of asthma and emphysema, particularly "prevent nocturnal asthmatic attacks, inhibit late phase of allergen-induced bronchoconstriction" salmeterol and formoterol
dry mouth ipratropium and tiotropium
Indications: primarily to treat COPD, reduces rhinorrhea in pt with allergic or viral rhinitis, infants with acute bronchitis ipratropium
Expectorant moa facilitating the coughing up of mucus and other material from the lungs,
Indications: pts with thick, tenacious respiratory tract secretions; pt with dry, nonproductive coughing; pt with sinusitis to increase airway hydration Guaifenesin: oral nonprescriptive drug
Indicactions:primarily to treat chronic obstructive lung disorders and asthma, apnea, COPD, recurrent apnea in premature infants, obstructive sleep apnea, and periodic breathing Theophylline (bronchidilators)
Reduce sleep quality via CNS stimulation Theophylline (bronchidilators)
abdominal pain, nausea, vomiting; headache, anxiety, restlessness, insomnia, dizziness and seizures Theophylline (bronchidilators)
hypotension,bradycardia, extra systoles, premature ventricular contractions, and tachycardia; seizure and serious arrhythmias occur at concentration over 25 mg/L Theophylline (bronchidilators)
thoephyline is a methylxanthine drug
the most efficacious anti-inflammatory drugs for allergic rhinitis glucocortitoids
the only type of bronchodilator used to counteract acute asthmatic attacks B2 agonists
primarily to treat pt with COPD muscarinic antagonists
long-term basis to prevent bronchoconstriction in pt with asthma or emphysema theophylline
bronchodilators moa relax bronchial smooth muscle and prevent or relieve bronchospasm
Inhaled steroid vs oral steroids adverse effects are reduced when ginve by inhalation. excessive deposition of drgus in the mouth cause oral candidiasis (thrush)
arformoterol (active isomer of formoteron chronic bronchitis or emphysema
black-box warning long-acting B2 agonists: risk of asthma-related death
Created by: prinluu