Respiratory Care Pharmacology Study Guide: Xanthines & Corticosteroids

Vocabulary flashcards covering Xanthines (Chapter 8) and Corticosteroids (Chapter 11) key terms, therapeutic ranges, trade/generic names, physiological mechanisms, and adverse effects.

Theophylline

An alkaloid derived from tea leaves that reacts with acids to form salts; a methylxanthine structurally related to xanthine.

Methylxanthines

Xanthine derivatives comprising theophylline (found in tea leaves), theobromine (found in cocoa seeds/beans), and caffeine (found in coffee beans, kola nuts, cocoa seeds/beans, and tea leaves).

Phosphodiesterase (PDE) Inhibition

The leading theoretical mechanism of action of theophylline, which leads to increased cyclic adenosine monophosphate ($\text{cAMP}$), relaxation of bronchial smooth muscle, and bronchodilation.

Apnea of Prematurity (AOP)

A neonatal condition in which xanthines are the first-line pharmacological treatment when nonpharmacological methods fail, serving to stimulate breathing until the central nervous system matures.

Caffeine Citrate Loading Dose

A loading dose of $20\,mg/kg$ administered in neonates for the management of Apnea of Prematurity (AOP).

Caffeine Citrate Maintenance Dose

A daily maintenance dose of $5\,mg/kg$ administered in neonates for the management of Apnea of Prematurity (AOP).

Classic Therapeutic Range (Theophylline)

A blood serum theophylline level of $10\text{--}20\,\mu g/mL$.

Asthma Target Serum Level (Theophylline)

A target blood serum theophylline range of $5\text{--}15\,\mu g/mL$ for managing asthma.

COPD Target Serum Level (Theophylline)

A target blood serum theophylline range of $5\text{--}10\,\mu g/mL$ for managing Chronic Obstructive Pulmonary Disease.

QVAR

The brand/trade name for Beclomethasone dipropionate HFA.

AeroSpan

The brand/trade name for Flunisolide hemihydrate HFA.

Flovent HFA / Flovent Diskus

The brand/trade names for Fluticasone propionate.

Arnuity Ellipta

The brand/trade name for Fluticasone furoate.

Pulmicort Flexhaler / Pulmicort Respules

The brand/trade names for Budesonide.

Asmanex Twisthaler / Asmanex HFA

The brand/trade names for Mometasone furoate.

Alvesco

The brand/trade name for Ciclesonide.

Advair Diskus / Advair HFA

An inhaled combination drug consisting of Fluticasone propionate (ICS) and Salmeterol (LABA).

Symbicort

An inhaled combination drug consisting of Budesonide (ICS) and Formoterol fumarate HFA (LABA).

Dulera

An inhaled combination drug consisting of Mometasone furoate (ICS) and Formoterol fumarate HFA (LABA).

Breo Ellipta

An inhaled combination drug consisting of Fluticasone furoate (ICS) and Vilanterol (LABA).

Glucocorticoids

Adrenal cortical hormones (such as cortisol) produced in the adrenal cortex that exert anti-inflammatory effects.

Mineralocorticoids

Adrenal cortical hormones produced in the adrenal cortex that regulate body water.

Hypothalamic--Pituitary--Adrenal (HPA) Axis

The physiological pathway for endogenous corticosteroid release involving CRF from the hypothalamus, ACTH from the anterior pituitary, and cortisol from the adrenal cortex.

HPA Suppression

Adrenal suppression caused by exogenous corticosteroid administration, which elevates systemic hormone levels and inhibits the hypothalamus and pituitary, requiring patients to taper off steroids.

Alternate-Day Steroid Therapy

A steroid regimen administered early in the morning every 12 to 36 hours on alternate days to mimic natural diurnal cortisol secretion and permit regular HPA activity on off days.

Classic Triple Response of Inflammation

The vascular inflammatory response consisting of redness (local blood vessel dilation in seconds), flare (reddish color several cm from site in 15--30 seconds), and wheal (local swelling in minutes).

Early Asthmatic Response

An IgE-mediated asthmatic reaction that peaks at approximately 15 minutes to 1 hour following exposure.

Late-Phase Reaction (Asthma)

An asthmatic inflammatory reaction where mast-cell mediators and cytokines recruit additional inflammatory cells, occurring after approximately 6--8 hours and lasting up to 24 hours.

Oropharyngeal Candidiasis

Oral thrush, a common topical side effect of aerosolized corticosteroids that can be minimized by using a reservoir/spacer device and rinsing the mouth after use.

Dysphonia

Difficulty speaking due to a disorder of the mouth, tongue, throat, or vocal cords; a common local side effect of aerosolized corticosteroids.