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DU PA As/COPD RTI PH
Duke PA Asthma/COPD/RTI Pharmacology
| Question | Answer |
|---|---|
| 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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