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Duke PA Asthma/COPD/RTI Pharmacology

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

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