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Pharm29

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robbypowell's version from 2016-11-08 04:00

respiratory and asthma meds (a long one)

Question Answer
_____(long/short) term ______ (high/low) flow of oxygen is good for patients with COPDLong term; low flow
T/F: excessive oxygen (>40%) over a prolonged period can cause blindness in premature infantsTrue
T/F: oxygen should be given in as low a dose for as short a time possible due to its adverse effectsTrue
What are the adverse effects of oxygen treatment?Cytotoxicity due to free radicals and superoxides (sore throat, irritation, coughing, pain)
_____ ______ _____ stimulates respiratory and vasomotor centers in medulla as an arousal agentAromatic ammonia spirit
What is an emergency drug for syncopeAromatic Ammonia spirit (smelling salts)
________ is an analeptic that directly stimulates the CNS respiratory and vasomotor centers… used in ventilation depressionDoxapram
What is the most common respiratory disease? Bronchial Asthma (affects >10% of population and causes 5,000 deaths/yr)
which immunoglobulin is involved in bronchial asthma?IgE (mast cells)
allergen → antigen presenting cell binds to ____ (cell) → release of ______ (general) → these bind to ______ (cell) → Ig _________ synthesis → Ig___ binds to ______ (cells) → allergen binds to Ig___ → triggers inflamm release of mediatorsAPC binds to T CELL; Cytokines (released); these bind to B CELL; synthesized IgE; IgE binds to Mast Cells; Allergen binds to IgE on Mast Cells
T/F: Histamine, released by Mast Cells is responsible for asthmaFalse (according to notes it is only one small component, not solely responsible)
____ (ion) may play a role in exacerbating asthma, because it triggers release of histamine from vesicles in mast cellCalcium
parasympathetic stimulation (bronchoconstriction) and what 3 mediators play a role in asthmaHistamine, Adenosine, & Leukotriene (HALP) (Histamine, Adenosine, Leukotriene, Parasympathetic)
4 inducers of non-IgE dependent asthmacold air, exercise (i can vouch for this one), irritant, stress (this one too)
_______ hypersensitivity reaction has antigen-antibody interactions, IgE is key player (seconds to hours); ______ hypersensitivity reaction has T-cell involvement (9-96 hours)Immediate (seconds to hours); Late (9-96 hours)
what 5 cellular elements play a role in chronic inflammatory disorder of the airway?Neutrophils, Eosinophils, Lymphocytes, Macrophages, Mast cells; MLMEN (mad lung men)
acute, sub-acute, or chronic: recruitment of inflammatory cellsAcute (early/immediate) (IgE)
acute, sub-acute, or chronic: T cells activated, more persistent inflammatory patternsub-acute (late)
acute, sub-acute, or chronic: persistent levels of cell damage and repairchronic
ATP --> cAMP via what enzyme?adenyl cyclase
cAMP --> AMP via what enzyme?Phosphodiesterase
how does caffeine (a methylxanthine) act as an anti-asthmatic?inhibits Phosphodiesterase (which converts cAMP to AMP... so if Ph-di-est-ase is inhibited then cAMP levels are higher... cAMP acts as Bronchodilator)
T/F: Caffeine (methyl xanthine) has anti-asthmatic effectsTrue (inhibits Phosphodiesterase, which converts cAMP to AMP... so if Ph-di-est-ase is inhibited then cAMP levels are higher... cAMP acts as Bronchodilator)
T/F: cAMP has bronchodilator properties, and so increasing its levels is a main treatment strategy for asthma txTrue
T/F: cAMP has bronchoconstrictor properties, and so decreasing its levels is a main treatment strategy for asthma txFalse (Bronchodilator; increase its levels)
B agonists, as a means to treat asthma, increase ______ levels by increasing what enzyme?cAMP; Adenyl Cyclase (ATP--->cAMP)
#1 treatment for acute asthma attack → produce broncho_______ by stimulating ____ receptors in airway smooth muscle... which are _____ (cholinergic/adrenergic) receptorsBronchoDILATION; B2 receptors; ~Adrenergic
B2 activation causes increase in _____ levels; a decrease in intracellular ___ levels, and ____ muscle relaxationinc cAMP, dec intracellular Ca, Smooth m. relaxation
T/F: Increased BP due to epinephrine administration is beneficial to decrease the hypotension due to histamine releaseTrue
T/F: Decrease BP due to epinephrine administration is beneficial to increase the hypotension due to histamine releaseFalse (epi inc BP; which dec the hypotension)
Epinephrine is a ______ receptor ______ (selective/non-selective) ________ (agonist/antagonist)Adrenergic (alpha and beta) Nonselective (hits all receptor subtypes) Agonist (excitatory)
T/F: B2 selective agonists are "usually the first line of tx for intermittent/acute asthma" but not as sole therapeutic agent in chronic asthmaTrue
T/F: B2 selective agonists are useful as the sole therapeutic agent for chronic asthmaFalse (they're not)
T/F: Isoproterenol is a B2 selective Beta agonist, and so useful for asthma treatmentFalse (it is Beta NONSELECTIVE, and so not indicated bc of cardiac effects)
T/F: Albuterol is a B2 selective Beta agonist, and so useful for asthma treatmentTrue (esp for rapid onset, or temporary asthma)
T/F: Salmetrol is a B2 selective Beta agonist, and so useful for asthma treatmentTrue (esp for chronic... but w risk of tachycardia)
Primary example of a short-acting B2 agonistAlbuterol (inhaler, syrup, nebulizer are the three preparation methods)
2 examples of long acting B2 agonists, useful for chronic asthma txSalmetrol & Formeterol
T/F: Inhaled glucocorticoids are given for moderate to sever asthmaTrue
T/F: Inhaled glucocorticoids are given for mild asthmaFalse (moderate-severe)
T/F: Inhaled Corticosteroids are useful for immediate alleviation of an acute asthma attackFalse (affect longer term components of asthma: inhibit prostaglandin synthesis via inhibition of phospholipase A2 enzyme and suppress eosinophilic recruitment = fewer inflammatory mediators)
T/F: Inhaled B2 Agonists are useful for immediate alleviation of an acute asthma attackTrue (e.g. Albuterol)
corticosterioids inhibit what step of the Phospholipid pathway?Phospholipid + phospholipase A2 arachidonic acid (synthesis of Arachidonic acid)
T/F: excessive use of NSAID's can aggravate asthma or predispose a patient for asthmaTrue
T/F: use of corticosteroids can aggravate asthma or predispose patient to asthmaFalse (cortico/gluco corticoids used to treat... this statement is true for NSAID's though)
Cortico-steroids and gluco-corticoids inhibit synthesis of ______ and suppress the recruitment of _______Prostaglandins (by inhibiting synthesis of arach acid, precursor of prostaglandins); Eosinophil recruitment (is suppressed)
T/F: patients taking inhaled steroids for asthma should rinse their mouth out after to avoid candidiasisTrue
T/F: patients taking inhaled steroids for asthma should rinse their mouth out afterward to avoid herpetic gingivostomatitisFalse (inc risk candidiasis, not herp-ging)
_____ acts as a Mast Cell Stabilzer, but is not a treatment for asthma attack, only a prophylacticCromolyn***
Methylxanthine/theophylline antagonizes the actions of ______ (bronchospastic mediator) and inhibits what enzyme?antagonizes Adenosine (br-spasm mediator); inhibits Phosphodiesterase (--> --> inc cAMP levels --> broncho dilation)
what is the IV treatment for COPD?Aminophylline (methylxanthine that is complexed with ethylenediamine, more soluble and given as IV; prevents degradation of cAMP = dec allergy)
Which receptor is more effective for affecting asthma... chlolinergic or adrenergic?Adrenergic, B2 specifically
anti-cholinergic drug that inhaled, more selective bronchodilator with less side effects than atropine (common anticholinergic); M1 antagonist; used for for long term managemtn of COPD, poorly controlled asthma, B2 agonist intoleranceIpratropium (Atrovent)
combination therapy of an adrenergic agonist and anti-cholinergic that is commonly used for chronic asthma or COPD... what 2 drugsIpratropium (anticholinergic, M1) + Albuterol (B2 agonist)
drug: IgE blocker; taken subcutaneously for poorly controlled asthma, min age is 12 yrs; asthma vaccineOmalizumab***
Hydrocodone is ____ times more potent than codeine3 times
ammonium chloride (an expectorant) in large doses cause metablic ___osisACIDOSIS
memorize

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