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DCPA Pulm Pharm
| Question | Answer |
|---|---|
| Mild Intermittent Asthma Medication | Bronchodialators |
| Increase bronchodialator use | Decreases effectivness |
| Beta 2 agonist - MOA | Relaxes smooth muscle by action on the beta-2 receptors (mostly lung cells...but some CV cells)- very quick onset (within minutes) |
| Beta 2 agonst - Contraindication | Beta blockers |
| Beta 2 agonst - Uses | Prophalactically for exercise induced asthma |
| Beta 2 agonst - SE | Tachycardia, Tremors, & HA |
| Beta 2 agonst - DI | MAO Inhibitors & TCAs |
| Beta 2 agonst - Examples | Albuterol (Proventil, Ventolin), Metaproteranol (Alupent), Pirbuterol (Maxair), Levabuterol (Xopenex), Salmeterol (Serevent), Formoterol (Forail) |
| Albuterol | Proventil, Ventolin |
| Albuterol (Proventil, Ventolin) - Administration | Drops, syrup, nebules, tabs, MDI |
| Metaproteranol | Alupent |
| Metaproteranol (Alupent) - Problems | Not very B2 selective therefore many CV SE (Tachycardia) |
| Pirbuterol | Maxair |
| Pirbuterol (Maxair) - Benefits | More beta selective than albuterol |
| Levabuterol | Xopenex |
| Levabuterol (Xopenex) - administration | Nebulizer & MDI |
| Levabuterol (Xopenex) - Efficiancy | R-isomer of albuterol (less side effects & increased efficiancy) but EXPENSIVE |
| Salmeterol | Serevent |
| Salmeterol (Serevent) - Type | Long (not a rescue inhaler - maintance: peak = 2-4 hours) |
| Salmeterol (Serevent) - DI | Increased toxicity with MAO inhibitors & TCAs |
| Formoterol | Foradil |
| Formoterol (Foradil) - Type | Long acting |
| Formoterol (Foradil) - administration | Bad tasting crushed tablets inside inhaler |
| Primatene Mist | Epinephrine |
| Primatene Mist (Epinephrine) - administration | Inhaled (OTC) or IM |
| Theophylline | Theo-Dur |
| Theophylline (Theo-Dur) - MOA | cAMP - relaxes smooth muscle |
| Theophylline (Theo-Dur) - maintanence | Must maintain 10-20 mcg/ml in blood (blood work) |
| Theophylline (Theo-Dur) - SE | Tachycardia, restlessness, nausea, irritability, HA, insomnia |
| Theophylline (Theo-Dur) - CI | Uncontrolled arrhythmias, hyperthyroidism, PUD, uncontrolled seizure disorders |
| Theophylline (Theo-Dur) - DI | Macrolid antibiotics, calcium channel blockers, beta blockers, seizure meds, St. John's Wort |
| Theophylline (Theo-Dur) - pregnancy | Category C- crosses placenta/breast milk, therefore cant use during pregnancy (tachycardia, irritiability & vomiting) |
| Ipratropium | Atrovent |
| Ipratropium (Atrovent) - MOA | Blocks ACH (bronchodilation)- fast acting (1-3 minutes & lasts 4-6 hours) |
| Ipratropium (Atrovent) - SE | Rare - poorly absorbed systemically |
| Ipratropium (Atrovent) - administration | MDI or nebulizer |
| Combivent | Ipratropium/albuterol |
| Combivent (Ipratropium/albuterol) - administration | MDI |
| Tiotropium Bromide | Spiriva |
| Tiotropium Bromide (Spiriva) - SE | Anticholinergic (dry mouth, constipation, glaucoma, blurred vision) |
| Tiotropium Bromide (Spiriva) - MOA | Relaxes smooth muscles |
| Tiotropium Bromide (Spiriva) - Use | For COPD patients with bronchospasm |
| Tiotropium Bromide (Spiriva) - Form | Inhaled powder (once/day) |
| Tiotropium Bromide (Spiriva) - Drug combinations | Can be used with both long & short acting B2 agonist |
| Mast Cell Stabilizers - use | Can be used prophalactically to inhibit antigen/exercise induced bronchospasm |
| Mast Cell Stabilizers - MOA | anti-inflammatory (stabilizes mast cells = decreases in leukotrienes) |
| Mast Cell Stabilizers - Examples | Cromolyn sodium (intal) & Nedocromyl (Tilade) |
| Cromolyn Sodium | Intal |
| Cromolyn Sodium (intal) - administration | Nebulizer or powder inhaler |
| Cromolyn Sodium (intal) - SE | Rare - poor systemic absorption |
| Nedocromyl (Tilade) - Potency | More potent than cromolyn |
| Nedocromyl (Tilade) - administration | Inhaler only |
| Inhaled Corticosteroids - MOA | Anti-inflammatory (blocks leukotrienes) |
| Inhaled Corticosteroids - SE | Less because metabolized by enzyme in lung - immunosuppression, osteoporosis, growth suppression in children, cataract/glaucome development. |
| Inhaled Corticosteroids - Special Steps | Must rinse after administration (decreases oral candidas) |
| Inhaled Corticosteroids - Examples | Beclomethasone Dipropionate (Beclovent, Vanceril), Budesonide (Pulmicort), Flunisolide (Aerobid), Triamcinolone (Azmacort), Fluticasone (Flovent) |
| Beclomethasone Dipropionate | Beclovent, Vanceril |
| Beclomethasone Dipropionate (Beclovent, Vanceril) - Administration | MDI - very slow acting |
| Budesonide (Pulmicort) - Administration | MDI - small amount to systemic circulation |
| Flunisolide (Aerobid) - Administration | MDI - large amount to systemic circulation (not very potent) |
| Triamcinolone (Azmacort) - Administration | MDI - large amount to systemic circulation (not very potent) |
| Fluticasone (Flovent) - administration | MDI or Rotadisk - hydrolyzed by the liver (low systemic risk - extremely potent) |
| Advair | Fluticasone/Salmeterol |
| Advair (Fluticasone/Salmeterol) - administration | Diskus - long acting maintanence |
| Advair (Fluticasone/Salmeterol) - SE | Low SE |
| Symbicort | Budesonide/Formoterol |
| Symbicort (Budesonide/Formoterol) - Administration | HFA inhaler - long lasting/maintanence |
| Symbicort (Budesonide/Formoterol) - SE | LOW |
| Symbicort (Budesonide/Formoterol) - Claim to fame | Faster than advair |
| Tiotropium | Spiriva Handihaler |
| Tiotropium (Spiriva Handihaler) - Type of medication | Long acting anticholinergic - maintanence |
| Tiotropium (Spiriva Handihaler) - Use | Bronchospasm (Chronic bronchitis or emphysema) |
| Tiotropium (Spiriva Handihaler) - SE | Anticholinergic (dry mouth, blurred vision etc.) |
| Systemic Corticosteroids - Use | Best short term "Burst" - exacerbations |
| Systemic corcticosteroids - Short term effects | Weight gain, insomnia, altered mood, glucose intolerance, hypokalemia |
| Systemic corcticosteroids - Long term effects | Adrenal axis suppression, cataracts, osteoporosis, cushings, gastritis, glaucoma, immunosuppression. |
| Systemic corcticosteroids - Special steps | Tappering - unless under 1 week & must take with food (decreases GI upset) |
| Systemic corcticosteroids - Examples | Prednisone (Deltasone), Methylprednisolone (Medrol-oral, Solumedrol - IV/IM), Dexamethasone (Decadron) |
| Prednisone | Deltasone |
| Prednisone (Deltasone) - common | Flexible & cheap |
| Methylprednisone | oral - Medrol, IM/IV - Solumedrol |
| Dexamethasone | Decadron |
| Dexamethasone (Decadron) - Use | IV - anti-emetic prior to chemo therapy |
| Leukotriene Receptor Antagonist - Use | Must be used in conjunction with other meds to reduce the use of rescue inhalers |
| Leukotriene Receptor Antagonist - Examples | Zafirlukast (Accolate), Montelukast (Singular) |
| Zafirlukast | Accolate |
| Zafirlukast (Accolate) - SE | Rare - Increases LFTs |
| Zafirlukast (Accolate) - DI | Increases warfarin (increases PT/INR by 45%) |
| Montelukast | Singular |
| Montelukast (Singular) - Safety | Safe & Efficiant for individuals as young as 2 years old |
| Nasal Preparatioons - Aqueous Forms | Less nasal tenderness, nose bleeds & little to no taste |
| Ocean Spray - use | Sterile saline spray to keep sinuses clear & moist |
| Ocean Spray - DI | DO NOT use within an hour of another nasal spray because it decreases the effectivness of other nasal sprays |
| Nasalcrom | Cromolyn Sodium |
| Nasalcrom (Cromolyn Sodium) - MOA | Stabilizes mast cells |
| Decongestant Nasal Spray - Examples | Afrin, Neo-synephrine |
| Decongestant Nasal Spray - SE | Rebound congestion |
| Steroid Nasal Spray - Examples | Beclomethaone (Vancenase). Budsonide (Rhinocort AQ), Trimacinolone (Nasocort), Fluisolide (Nasalide, Nasarel), Fluticasone (Flonase), Mometasone (Nasonex) |
| Vancenase | Beclomethaone |
| Rhinocort AQ | Budsonide |
| Nasocort | Trimacinolone |
| Nasalide or Nasarel | Fluisolide |
| Flonase | Fluticasone |
| Nasonex | Mometasone |
| Antihistamines & asthmatics | Dry up the airways & cause hyperactivity leading to acute asthma attack |
| Robitussin | Guafenesin: expectorant |
| Guafenesin | Expectorant |
| Robitussin DM | Guafenesin (Expectorant) & Dextromethorphan (Cough suppressant) |
| Dextromethorphan | Cough Suppressant |
| Robitussin CF | Guafenesin (Expectorant), Dextromethorphan (Cough suppressant), Pseudoephedrine (decongestant) |
| Pseudoephedrine | Decongestant |
| Delsym | Dextromethorphan (Cough suppressant): 3x the strength of Robitussin |
| Benzonatate | Tessalon |
| Benzonatate (Tessalon) - Use | Rx - antitussive capsules |
| Benzonatate (Tessalon) - SE | Drowsiness, HA & GI upset |
| Guaifenesin plus codeine (Hydrocodon) - SE | CNS Depression, potentiates alcohol, Nausea |
| Guaifenesin plus codeine (Hydrocodon) - DI | CNS depressants, MAO Inhibitors, TCAs |
| Guaifenesin plus codeine (Hydrocodon) - Use | Calms down cough & helps sleep |
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147401391
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