Pharmacology Review: Asthma, Respiratory & Cardiovascular Drugs

A 40-card flashcard set covering key points from the lecture on asthma pharmacology, respiratory adjuncts, and related cardiovascular and lipid-lowering drugs. Each card follows a question-and-answer format to aid exam preparation.

What three airway changes characteristically occur during an asthma attack?

Bronchoconstriction (smooth-muscle tightening/narrowing), excess mucus production, and inflammation mediated by histamine & leukotrienes.

Which drug class is considered the first-line "rescue inhaler" for acute asthma symptoms?

Short-acting β2-agonist bronchodilators (SABAs) such as albuterol.

List four common brand names for albuterol.

ProAir, Proventil, Ventolin, and Maxair.

How frequently should a well-controlled patient need a SABA like albuterol?

Ideally no more than twice per week; more frequent use signals poor control.

Which bronchodilator class must NEVER be used to treat sudden asthma symptoms?

Long-acting β2-agonists (LABAs).

Give two examples of long-acting β2-agonists.

Formoterol and Salmeterol (others include Arformoterol, Indacaterol).

What is ipratropium bromide better known as, and what class is it?

Atrovent; an anticholinergic bronchodilator.

Name two systemic side effects to monitor with inhaled anticholinergics.

Increased blood pressure and urinary retention (also dry mouth/eyes).

Why should patients avoid spraying Atrovent into their eyes?

It can precipitate ocular problems such as blurred vision or glaucoma.

Which medication group treats the inflammatory component of asthma directly?

Corticosteroids (inhaled, oral, or IV).

Give three examples of inhaled corticosteroids (ICS).

Beclomethasone, Budesonide (Pulmicort), and Fluticasone (Flovent) (also Mometasone).

What oral complication necessitates rinsing the mouth after ICS use?

Oral candidiasis (thrush).

Why must systemic corticosteroids be tapered rather than stopped abruptly?

To prevent adrenal suppression and withdrawal reactions.

What are leukotriene modifiers and provide one example.

Drugs that block leukotriene receptors to reduce inflammation; e.g., Montelukast (Singulair).

Which laboratory study should be checked periodically with leukotriene modifiers?

Liver function tests (LFTs).

Theophylline belongs to which drug class and when is it typically used?

Methylxanthine bronchodilators; reserved for refractory cases or severe exacerbations.

List three prominent signs of theophylline toxicity.

Headache, tremors/ restlessness, and palpitations (also insomnia, seizures at high levels).

In respiratory pharmacology, what does the acronym LABA stand for?

Long-Acting Beta-2 Agonist.

Name a common combination inhaler that contains both an ICS and a LABA.

Advair Diskus (Fluticasone + Salmeterol) (others: Symbicort, Dulera).

For which asthma patients are anti-IgE biologics like omalizumab (Xolair) indicated?

Patients with severe allergic (IgE-mediated) asthma not controlled by standard therapy.

What is the mechanism of mast-cell stabilizers such as cromolyn sodium?

They inhibit histamine release from mast cells, preventing airway inflammation.

What is the most commonly used expectorant for productive cough?

Guaifenesin (Mucinex or Robitussin).

What key instruction must accompany benzonatate (Tessalon Perles) administration?

Swallow capsules whole; chewing can numb the throat and risk aspiration.

Why is pseudoephedrine kept behind the pharmacy counter?

It has abuse potential and sympathomimetic effects; can be used illicitly to make methamphetamine.

List two cardiovascular side effects of systemic decongestants.

Tachycardia/palpitations and elevated blood pressure.

What distinguishes cardio-selective from non-selective beta blockers?

Cardio-selective block only β1 receptors (heart), sparing β2 (lungs); non-selective block both.

Give one example each of a cardio-selective and a non-selective beta blocker.

Metoprolol (cardio-selective); Propranolol (non-selective).

What serious event can sudden discontinuation of beta blockers provoke?

Rebound hypertension, angina, or myocardial infarction.

Why are ACE inhibitors contraindicated during pregnancy?

They reduce placental blood flow and can harm fetal development.

Identify two hallmark adverse effects of ACE inhibitors.

Dry non-productive cough and angioedema (also hyperkalemia).

Mechanistically, how do ARBs differ from ACE inhibitors?

ARBs block angiotensin II receptors, preventing aldosterone release, rather than inhibiting ACE itself.

What dietary advice should be given to patients starting an ACE inhibitor?

Limit high-potassium foods to avoid hyperkalemia.

Which antihypertensive class has a notable interaction with grapefruit juice?

Calcium channel blockers (e.g., Verapamil, Nifedipine).

Which common diuretic is potassium-sparing rather than potassium-wasting?

Spironolactone (also Amiloride, Triamterene).

What supplement or dietary change may be recommended with hydrochlorothiazide therapy?

Increase potassium intake (bananas, spinach) or take potassium supplements.

Which lipid-lowering drug class ends in “-statin” and what enzyme does it inhibit?

HMG-CoA reductase inhibitors; they block the HMG-CoA reductase enzyme to reduce cholesterol synthesis.

What symptom suggests statin-induced rhabdomyolysis requiring immediate drug cessation?

Unexplained muscle pain, tenderness, or weakness.

What classic side effect of niacin can be minimized by giving aspirin 30 minutes before?

Flushing/vasodilation of the face and chest.

Which lipid-lowering agents can cause severe constipation and fat-soluble vitamin deficiency?

Bile acid sequestrants (e.g., Cholestyramine/Questran).

Fibric acid derivatives such as gemfibrozil primarily lower which lipid parameter?

Triglyceride levels (and they modestly raise HDL).