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Questions and Answers
What is the primary action of Beta-2 adrenergic agonists?
What is the primary action of Beta-2 adrenergic agonists?
What is a common side effect of using Beta-2 adrenergic agonists?
What is a common side effect of using Beta-2 adrenergic agonists?
Which type of bronchodilator is recommended for long-term control in asthma?
Which type of bronchodilator is recommended for long-term control in asthma?
How should albuterol be administered for acute asthma attacks?
How should albuterol be administered for acute asthma attacks?
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What is the scheduling recommendation for the use of LABAs for patients with stable COPD?
What is the scheduling recommendation for the use of LABAs for patients with stable COPD?
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What is a significant risk when using LABAs alone for asthma management?
What is a significant risk when using LABAs alone for asthma management?
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Which of the following medications is a short-acting beta agonist (SABA)?
Which of the following medications is a short-acting beta agonist (SABA)?
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For optimal medication delivery with an inhaler, what practice is recommended?
For optimal medication delivery with an inhaler, what practice is recommended?
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Which of the following is a potential systemic side effect of bronchodilators?
Which of the following is a potential systemic side effect of bronchodilators?
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When are inhaled bronchodilators typically prescribed?
When are inhaled bronchodilators typically prescribed?
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What are the common side effects of Acarbose?
What are the common side effects of Acarbose?
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Which medication primarily minimizes insulin resistance?
Which medication primarily minimizes insulin resistance?
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What is a significant concern when taking Dipeptidyl Peptidase-4 Inhibitors?
What is a significant concern when taking Dipeptidyl Peptidase-4 Inhibitors?
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What is the key mechanism of action of statins like Atorvastatin?
What is the key mechanism of action of statins like Atorvastatin?
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Which class of drugs may interact with diuretics and cause postural hypotension?
Which class of drugs may interact with diuretics and cause postural hypotension?
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What action do Incretin mimetics such as Dulaglutide have on gastric emptying?
What action do Incretin mimetics such as Dulaglutide have on gastric emptying?
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Which of the following is NOT an adverse effect associated with Gemfibrozil?
Which of the following is NOT an adverse effect associated with Gemfibrozil?
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Levothyroxine should be taken at what time for optimal absorption?
Levothyroxine should be taken at what time for optimal absorption?
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What is the primary route of excretion for Thiazolidinediones like Pioglitazone?
What is the primary route of excretion for Thiazolidinediones like Pioglitazone?
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Which medication would most likely cause hypoglycemia when used with other agents?
Which medication would most likely cause hypoglycemia when used with other agents?
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The primary action of bile acid sequestrants is to:
The primary action of bile acid sequestrants is to:
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What should patients on Acarbose monitor due to possible liver dysfunction?
What should patients on Acarbose monitor due to possible liver dysfunction?
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Which of the following is a characteristic of non-insulin injectable glucagon-like peptide (GLP-1) receptor agonists?
Which of the following is a characteristic of non-insulin injectable glucagon-like peptide (GLP-1) receptor agonists?
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What is the primary function of Theophylline in asthma management?
What is the primary function of Theophylline in asthma management?
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What is a notable side effect associated with Theophylline?
What is a notable side effect associated with Theophylline?
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Which medication is most commonly used to prevent exercise-induced bronchospasm?
Which medication is most commonly used to prevent exercise-induced bronchospasm?
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What is a contraindication for using pseudoephedrine?
What is a contraindication for using pseudoephedrine?
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What side effect is associated with antihistamines such as Diphenhydramine?
What side effect is associated with antihistamines such as Diphenhydramine?
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Which of the following medications must be taken on an empty stomach for proper absorption?
Which of the following medications must be taken on an empty stomach for proper absorption?
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Which medication is primarily used as a mucolytic agent?
Which medication is primarily used as a mucolytic agent?
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What is a common effect of using Cromolyn in asthma treatment?
What is a common effect of using Cromolyn in asthma treatment?
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What is the main action of Ipratropium in respiratory treatment?
What is the main action of Ipratropium in respiratory treatment?
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Which of the following is a potential adverse effect of Dextromethorphan?
Which of the following is a potential adverse effect of Dextromethorphan?
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Which class of medication is known to cause dry mouth as a side effect?
Which class of medication is known to cause dry mouth as a side effect?
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Which of the following is the safest option among asthma medications?
Which of the following is the safest option among asthma medications?
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Raloxifene is an example of which type of medication?
Raloxifene is an example of which type of medication?
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What is a potential effect of levothyroxine on insulin requirements?
What is a potential effect of levothyroxine on insulin requirements?
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Why should methimazole be avoided during the first trimester of pregnancy?
Why should methimazole be avoided during the first trimester of pregnancy?
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What is the primary function of methimazole?
What is the primary function of methimazole?
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What should be monitored in infants and children taking levothyroxine?
What should be monitored in infants and children taking levothyroxine?
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What serious side effect should patients taking methimazole be aware of?
What serious side effect should patients taking methimazole be aware of?
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How long can it take for methimazole to achieve a euthyroid state?
How long can it take for methimazole to achieve a euthyroid state?
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What is a key consideration for pediatric patients on levothyroxine?
What is a key consideration for pediatric patients on levothyroxine?
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What is a unique property of propylthiouracil (PTU) compared to methimazole?
What is a unique property of propylthiouracil (PTU) compared to methimazole?
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How often should blood work be conducted after changing levothyroxine formulation?
How often should blood work be conducted after changing levothyroxine formulation?
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Why is propylthiouracil generally not preferred over methimazole?
Why is propylthiouracil generally not preferred over methimazole?
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In what condition is methimazole NOT typically used?
In what condition is methimazole NOT typically used?
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What precaution should be taken regarding different brands of levothyroxine?
What precaution should be taken regarding different brands of levothyroxine?
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Which statement about levothyroxine administration is accurate?
Which statement about levothyroxine administration is accurate?
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What is the main reason for frequent follow-up and lab monitoring in patients on levothyroxine?
What is the main reason for frequent follow-up and lab monitoring in patients on levothyroxine?
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Study Notes
Bronchodilators
- Bronchodilators activate beta-2 receptors in the lung, causing bronchodilation.
- Adrenergic agonists exhibit selective but can have systemic effects like tachycardia, dysrhythmias, angina, tremors, and seizures.
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SABAs (Short-acting beta agonists):
- Albuterol (ProAir) and Levalbuterol (Xopenex) are inhaled and have a quick onset of action.
- Used for preventing or treating acute asthma attacks.
- Available as metered-dose inhalers (MDI), dry-powder inhalers (DPI), or nebulizers.
- Usually 2 inhalations with a 1-minute wait.
- Administer the first one before the next breath.
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LABAs (Long-acting beta agonists):
- Salmeterol (Serevent Diskus) and Terbutaline are inhaled or oral and used for long-term control.
- Administered on a fixed schedule.
Methylxanthines
- Theophylline relaxes bronchial smooth muscle, crucial in maintaining stable asthma, especially during nocturnal attacks.
- Toxicity includes nausea, vomiting, diarrhea, restlessness, insomnia, dysrhythmias, and convulsions.
- Avoid caffeine as it increases toxicity risks.
Anticholinergics
- Ipratropium (Atrovent) and Tiotropium (Spiriva) block muscarinic receptors in the bronchi, reducing bronchoconstriction.
- Available in both short and long-acting forms.
- Potential for anticholinergic effects such as xerostomia (dry mouth).
Anti-Inflammatory Drugs
- Montelukast (Singulair) blocks leukotriene receptor activation .
Cromolyn
- Used to prevent exercise-induced bronchospasm (EIB).
- Taken on a regular schedule to reduce mast cell inflammation, resulting in reduced histamine and other inflammatory mediators, eosinophils and other inflammatory cells.
- Considered as a third-line therapy as it is less effective compared to glucocorticoids.
Antihistamines
- Hydroxyzine (Vistaril) and Diphenhydramine (Benadryl, Unisom) block histamine receptors, reducing symptoms like flushing, edema, itching, and mucus production, and some block muscarinic receptors.
- Lipid soluble, crosses the blood-brain barrier (BBB), and can cause CNS depression/drowsiness at therapeutic doses, and CNS excitation at toxic doses.
- Use with caution with other anticholinergic drugs due to potential additive effects.
Sympathomimetics
- Pseudoephedrine (Sudafed) activates alpha-1 receptors, causing vasoconstriction, which can relieve congestion, but rebound congestion may occur.
- Long-term use or abuse can lead to the creation of methamphetamine.
Antitussives
- Dextromethorphan suppresses the cough reflex in the central nervous system (CNS).
- Benzonatate (Tessalon) decreases the sensitivity of respiratory stretch receptors, reducing cough.
- Use as directed and swallow capsules whole to avoid complications like laryngospasm, bronchospasm, and circulatory collapse.
Expectorants and Mucolytics
- Expectorants like Guaifenesin (Mucinex) increase the flow of respiratory secretions ,improving easier expulsion.
- Mucolytics like Hypertonic saline and Acetylcysteine thin the mucus, aiding in easier removal.
Drugs Affecting Calcium and Bone Metabolism
- Alendronate (Fosamax) binds to bone and inhibits osteoclasts (cells that break down bone).
- Poorly absorbed within 2 hours of calcium intake.
- Taken with 6-8 ounces of water on an empty stomach 30 minutes before other foods.
- Irritating to the stomach lining, so remain upright for 30 minutes after taking.
- Colesevelam (Welchol) reduces cholesterol absorption and increases cholesterol excretion.
- Calcitonin (salmon) inhibits bone reabsorption and increases renal calcium excretion; useful in managing hyperparathyroidism, malignancy, and hypercalcemia.
Raloxifene
- A selective estrogen receptor modulator (SERM) with both estrogenic and anti-estrogenic effects.
- Regulates bone density, minimizing risks associated with clots and menopausal symptoms.
Teriparatide
- A form of parathyroid hormone, used to stimulate osteoblast activity and increase bone formation.
- Increases osteoblastic activity to improve bone density.
Drugs for Diabetes
- Insulin Lispro (Humalog) and Aspart (NovoLog) are rapid-acting insulins.
- Insulin Glargine (Lantus) and Detemir (Levemir) are long-acting insulins.
- Used to regulate blood glucose levels.
Sulfonylureas
- Glipizide (Glucotrol) and Glyburide (DiaBeta, Micronase) stimulate insulin release, particularly in type II diabetes.
- Risk of hypoglycemia should be monitored.
Meglitinides
- Nateglinide (Starlix) also promotes insulin release, but with a faster onset and shorter duration compared to sulfonylureas.
Thiazolidinediones (Glitazones)
- Pioglitazone (Actos) decreases insulin resistance, crucial in regulating blood glucose.
Alpha-Glucosidase Inhibitors
- Acarbose (Precose) delays the absorption of carbohydrates, which plays a critical role in managing blood sugar levels.
Sodium-Glucose Co-transporter 2 (SGLT2) Inhibitors
- Dapagliflozin (Farxiga) blocks glucose reabsorption in the kidneys, allowing more glucose to be excreted in the urine.
- Increases urinary glucose excretion can potentially help lower glucose levels with minimal risk of hypoglycemia.
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors
- Sitagliptin (Januvia) stimulates glucose-dependent insulin release to control blood sugar regulation.
Incretin Mimetics
- Dulaglutide (Trulicity) is a glucagon-like peptide-1 (GLP-1) receptor agonist that activates GLP-1 receptors to increase insulin release and regulate blood sugar.
- Improves glucose control in people with Type 2 diabetes.
Drugs Affecting Lipid Levels
- Atorvastatin (Lipitor) decreases LDL cholesterol, while increasing HDL cholesterol.
- Also promotes the formation of LDL receptors in the liver.
- Take at night as most cholesterol production occurs at night.
- Avoid during pregnancy due to potential for liver enzyme elevation.
Nicotinic Acid (Niacin)
- Improves HDL levels and decreases triglyceride levels.
Bile Acid Sequestrants
- Cholestyramine (Questran) binds to bile acids in the intestine, preventing their reabsorption and encouraging the liver to use cholesterol to produce more bile.
Fibric Acid Derivatives (Fibrates)
- Gemfibrozil (Lopid) reduces triglycerides and raises HDL levels
Ezetimibe (Zetia)
- Specifically inhibits cholesterol absorption in the gastrointestinal tract.
Drugs Affecting the Thyroid
- Levothyroxine (Synthroid, Levoxyl) is a synthetic thyroid hormone used to replace or supplement low thyroid hormone levels
Methimazole (Tapazole)
- First-line medication for hyperthyroidism; inhibits thyroid hormone synthesis.
Propylthiouracil (PTU)
- Second-line medication for hyperthyroidism; also inhibits thyroid hormone synthesis, considered safer during the first trimester of pregnancy.
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Description
This quiz covers the mechanisms, types, and applications of bronchodilators, including short-acting and long-acting beta agonists, as well as the role of methylxanthines like theophylline in asthma management. Learn about their uses, side effects, and administration methods to enhance your understanding of respiratory medications.
