Medication Midterm study

What are mucolytics?

Medications that thin and break down mucus, making it easier to cough up and clear from the airways.

What is the primary mechanism of action of mucolytics?

A. Break down disulfide bonds in mucus (primary)

B. Reduce mucus viscosity (secondary)

What are common examples of mucolytics?

A. Acetylcysteine (Mucomyst) (primary)

B. Dornase alfa (Pulmozyme) (secondary)

What is acetylcysteine used for?

A. To thin mucus in conditions like COPD, bronchiectasis, and cystic fibrosis (primary)

What is dornase alfa used for?

A mucolytic specifically used in cystic fibrosis to break down DNA in thick mucus, reducing its viscosity.

What are the common indications for mucolytics?

A. Chronic obstructive pulmonary disease (COPD) (primary)

B. Cystic fibrosis (secondary)

C. Bronchiectasis (tertiary)

What are the common side effects of acetylcysteine?

A. Nausea (primary)

B. Bronchospasm (secondary)

C. Unpleasant sulfur-like smell (tertiary)

What is the role of mucolytics in COPD management?

Mucolytics help reduce the frequency of exacerbations by thinning mucus, making it easier to clear.

How does dornase alfa differ from acetylcysteine?

Dornase alfa specifically targets DNA in mucus, while acetylcysteine breaks down disulfide bonds in mucus proteins.

Why is hydration important when using mucolytics?

Staying hydrated helps naturally thin mucus, enhancing the effectiveness of mucolytics.

What are inhaled corticosteroids (ICS)?

Anti-inflammatory medications delivered directly to the lungs to reduce airway inflammation, swelling, and mucus production in asthma and COPD.

What are common examples of inhaled corticosteroids (ICS)?

A. Budesonide (primary)

B. Fluticasone (secondary)

C. Beclomethasone (tertiary)

D. Mometasone (quaternary)

What is the primary mechanism of action of ICS?

A. Suppression of airway inflammation (primary)

B. Reduction of inflammatory mediators (secondary)

C. Decreased airway hyperresponsiveness (tertiary)

What are the indications for inhaled corticosteroids?

A. Asthma (primary)

B. Chronic obstructive pulmonary disease (COPD) (secondary)

C. Eosinophilic airway inflammation (tertiary)

How do ICS improve asthma symptoms?

A. Reduce frequency of exacerbations (primary)

B. Improve lung function (secondary)

C. Decrease airway hyperreactivity (tertiary)

What are common side effects of ICS?

A. Oral thrush (candidiasis) (primary)

B. Hoarseness (secondary)

C. Sore throat (tertiary)

D. Cough after inhalation (quaternary)

How can oral thrush be prevented when using ICS?

A. Rinse mouth with water after use (primary)

B. Use a spacer device (secondary)

What are examples of combination ICS and long-acting beta-agonists (LABAs)?

A. Budesonide + Formoterol (e.g., Symbicort) (primary)

B. Fluticasone + Salmeterol (e.g., Advair) (secondary)

C. Fluticasone + Vilanterol (e.g., Breo Ellipta) (tertiary)

Why are ICS considered maintenance medications?

A. They provide long-term control of inflammation (primary)

B. They prevent asthma exacerbations (secondary)

C. They improve overall lung function over time (tertiary)

Why are ICS not used for immediate symptom relief?

A. They do not act quickly enough to relieve acute bronchospasm (primary)

B. Their effects take time to reduce inflammation (secondary)

What do you use for severe Asthma?

Solu-Medrol (Methylprednisolone)

What is Candidiasis?

Thrush

Medication to treat Thrush

Nystatin B

A Pt taking inhaled Corticosteroids is at risk for developing?

Cushing's disease

due to prolonged use, which can lead to adrenal suppression and other systemic effects.

Acetylcysteine, Nalaxone, Narcan, Prostigmin are what type of drug?

Reversal

Cisatracurium, Pancuronium, Rocuronium, Succinylcholine are what type of drug?

Neuro

Amiodarone, Cordarone, Lidocaine, Pronestyl, Esmolol, Brevibloc, Dopamine, Nipride, Epinephrine are what type of drug?

Cardiac

Fentanyl, morphine, sublimaze, Dilaudid, Hydromorphone are what type of drug?

Opioid

Haloperidol and Haldol are what type of drug?

Antipsychotic

Lorazepam, Ativan, Midazolam, Versed are what type of drug?

Benzo

Diprivan, propofol, Etomidate are what type of drug?

sedative/hypnotic

Revefenacin (Yupelri) is what type of drug?

Long-acting anticholinergic

Ipratopium Bromide (Atrovent) is what type of drug?

Short-acting anticholinergic

Fluticasone propionate (Flovent) is what type of drug?

Inhaled corticosteroid

Albuterol and Levalbuterol (Xopenex) are what type of drug?

Short-acting beta adrenergic (SABA)

Formoterol (Perforomist) is what type of drug?

Long-acting beta adrenergic (LABA)

Tiotropium bromide (Spiriva) is what type of drug?

Long-acting anticholinergic (LAMA)used for chronic obstructive pulmonary disease (COPD) and asthma management.

Budesonide (Pulmicort) is what type of drug?

Inhaled corticosteroid

what does SAMA's stand for?

Short-acting muscarinic Antagonist

SAMA's mechanism of action?

Block muscarinic receptors

What neurotransmitter does SAMA's block?

Acetylcholine

Example of SAMA and dosage

ipratropium bromide (atrovent)

20-40 mcg via inhalation Q6H or Q8H

Adrenergic refers to the actions or effects produced by the stimulation of what system?

Sympathetic nervous system

What are examples of Adrenergic agonist?

Epinephrine

Norepinephrine

When the sympathetic nervous system releases neurotransmitters that then bind with adrenergic receptors this response is commonly known as?

Fight or Flight

Adrenergic Stimulation does what to the Heart?

Increase heart rate, cardiac output and blood pressure

Adrenergic Stimulation causes what in the respiratory system?

Bronchodilation

What is the mechanism of action of anticholinergic bronchodilators used in COPD treatment?

Block muscarinic receptors responsible for bronchoconstriction

How do anticholinergic bronchodilators lead to bronchodilation?

By inhibiting acetylcholine signaling which leads airway smooth muscle to relax

suffix for Anticholinergic's

-pium

What is the primary mechanism of action of Long-Acting Beta-2 Agonists

activation of receptors in the bronchial smooth muscle, leading to bronchodilation.

Explain the significance of beta-2 adrenergic receptors in the respiratory system.

They play a crucial role in relaxing the smooth muscle of the bronchi and bronchioles, resulting in increased airflow in the respiratory system.

How soon before LABAs display a therapeutic effect

Onset is typically within 30-60 minutes after inhalation

LABA's offer relief such of symptoms such as?

coughing, wheezing and shortness of breath

What are Three LABA's

and Duration of action

Salmeterol = 12hr

Formoterol = 12hr

Indacaterol = 24hr

What is The main Mechanism of action of SABA's

Activate beta-2 adrenergic receptors which lead to bronchodilation by relaxation of airway smooth muscles

How long does it take inhaled SABA's to exert their Therapeutic effect and how long do effects last?

Onset of action?

Duration of action?

Onset of action : 5-15 mins

Duration of action: is 4-6 hours

Commons side effects of SABA's?

Tremors, nervousness, headaches, tachycardia, Palpitations

Why are SABA's only recommended for short-term or intermittent use in asthma management?

They do not address underlying inflammation so should not be used as monotherapy for persistent asthma

Overuse of SABA's can increase what?

Increase serious asthma exacerbations

What are the main indications for the use of short-acting beta-agonists

quick relief of acute bronchoconstriction in conditions such as asthma, chronic obstructive pulmonary disease (COPD), and exercise-induced bronchoconstriction.

Differentiate between the use of short-acting beta-agonists as rescue medication and as part of maintenance therapy.

SABAs are used as rescue medication for quick relief of acute symptoms, while maintenance therapy involves regular, scheduled use of other long-acting medications.

What is DuoNeb? and it’s dosage?

Combo SABA/SAMA, ipratropium/albuterol

3mL neb Q6H (4x/day) no more than 6/24hr

What is perforomist? and it’s dosage?

LABA (formeterol)

20 mcg/2mL via nebulization twice daily