Pharmacology for COPD and Asthma Treatments

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Questions and Answers

What are potential side effects of anticholinergics used for COPD?

Palpitations, paradoxical bronchospasm, and urinary retention.

How do inhaled steroids like Budesonide assist in asthma treatment?

They reduce swelling and prevent asthma attacks, but are not for rescue use.

What caution should be noted for leukotriene receptor antagonists such as Zafirlukast?

They may interact with alcohol, warfarin, theophylline, and aspirin.

Why might a patient develop tolerance to anticholinergics over time?

Prolonged use of anticholinergics can lead to a decrease in their effectiveness. Signup and view all the answers

What serious adverse effect can occur unexpectedly when discontinuing certain medications?

Paradoxical bronchospasm, which can lead to respiratory distress. Signup and view all the answers

What is the primary action of expectorants like Guaifenesin, and when should they not be used?

Expectorants increase respiratory fluid output and should not be used for unproductive cough. Signup and view all the answers

What critical caution should be taken into account when administering mucolytics such as Acetylcysteine?

Mucolytics should be used with caution in patients with asthma as they can cause bronchospasms. Signup and view all the answers

What precautions should be considered when administering Xanthines like Theophylline?

Precautions include monitoring patients with gastrointestinal issues, respiratory dysfunction, renal/hepatic disease, alcoholism, and hyperthyroidism. Signup and view all the answers

What is the primary use of sympathomimetics like Albuterol, and what condition do they quickly relieve?

Sympathomimetics like Albuterol are primarily used as rescue drugs for asthma and COPD, providing quick relief. Signup and view all the answers

Why are smokers at higher risk for toxicity and cardiac issues when using Theophylline?

Smokers have an increased risk for Theophylline toxicity due to altered metabolism, leading to potential palpitations and arrhythmias. Signup and view all the answers

What is the primary purpose of bolus insulin, and when should it be administered?

Bolus insulin is used to manage blood sugar levels during meals and should be administered right before a meal or before bed. Signup and view all the answers

Describe the onset, peak, and duration times for rapid-acting insulin like Lispro or Aspart.

Rapid-acting insulin has an onset of 15-30 minutes, a peak effect between 0.5-3 hours, and a duration of 3-5 hours. Signup and view all the answers

What are the potential side effects of using Bolus insulin as stated in the provided content?

Potential side effects include hypoglycemia, hypokalemia, nausea, and headache. Signup and view all the answers

How does basal insulin function in relation to meal times?

Basal insulin provides background insulin coverage between meals and during the night. Signup and view all the answers

Explain the importance of the basal-bolus insulin regimen in diabetes management.

The basal-bolus regimen combines rapid-acting and long-acting insulins to better mimic normal insulin production and manage blood glucose. Signup and view all the answers

What role does oxytocin play in labor management?

Oxytocin is used to initiate or improve uterine contractions to induce labor. Signup and view all the answers

What are the potential risks associated with the use of oxytocin?

Potential risks include uterine rupture, arrhythmia, and fetal bradycardia. Signup and view all the answers

How do tocolytics function in the context of pregnancy?

Tocolytics, such as Hydroxyprogesterone, are used to reduce the risk of preterm birth. Signup and view all the answers

What are the primary uses of androgens like testosterone?

Androgens are primarily used for replacement therapy in conditions such as hypogonadism and delayed puberty. Signup and view all the answers

What should be considered when prescribing sildenafil for erectile dysfunction?

Considerations include potential bleeding disorders, use with nitroglycerin, and the risk of hypotension. Signup and view all the answers

What are bulk-forming laxatives and how do they function in treating constipation?

Bulk-forming laxatives, like Psyllium, absorb water and increase stool bulk, helping to facilitate bowel movements. Signup and view all the answers

What precautions should be considered when using lubricants to treat constipation?

Lubricants should not be used in patients with abdominal surgery and must be monitored for potential gastrointestinal upset. Signup and view all the answers

Why is it important for patients taking osmotic laxatives to avoid certain conditions, such as recent abdominal surgery?

Osmotic laxatives can exacerbate complications post-surgery, risking further complications like bowel obstruction. Signup and view all the answers

What is a potential side effect of using bulk-forming laxatives in older adults?

In older adults, bulk-forming laxatives may cause palpitations, gastrointestinal upset, or fainting. Signup and view all the answers

What role does hydration play in the effectiveness of bulk-forming laxatives?

Hydration is crucial as it helps the bulking agents absorb water and form softer stools, enhancing bowel movement. Signup and view all the answers

What condition can arise from prolonged use of cathartics?

Prolonged use of cathartics can lead to dependence, making it difficult for patients to have bowel movements without them. Signup and view all the answers

How might the use of antacids interact with laxatives?

Laxatives should not be taken with antacids as they can interfere with laxative effectiveness and balance fluid levels. Signup and view all the answers

What is the general guideline for water intake when using laxatives for constipation treatment?

Patients should aim to drink at least 64 ounces of water per day to aid the effectiveness of laxatives. Signup and view all the answers

What are two common side effects associated with antithyroid agents like Methimazole?

Nausea and liver toxicity. Signup and view all the answers

How does Levothyroxine therapy assist patients with hypothyroidism?

It replaces thyroid hormones to normalize levels in the body. Signup and view all the answers

What condition is Calcitonin used to treat in relation to parathyroid agents?

Hypoparathyroidism. Signup and view all the answers

What adverse effect should be monitored in patients receiving estrogen therapy for menopause?

Risk of stroke. Signup and view all the answers

Identify a possible side effect of using progestins like Norethindrone Acetate.

Abnormal uterine bleeding. Signup and view all the answers

What is a concerning symptom that might arise from hyperthyroidism?

Tachycardia. Signup and view all the answers

What is a common symptom of vertigo related to certain medical conditions?

Dizziness. Signup and view all the answers

Name one condition that can lead to sodium retention and weight gain.

Hypotension. Signup and view all the answers

What physiological change can occur due to menopause that is addressed by estrogen therapy?

Symptoms of menopause. Signup and view all the answers

What is bone marrow suppression, and which medication class can cause it?

A decrease in bone marrow function caused by antithyroid agents. Signup and view all the answers

Study Notes

Anti-inflammatory Agents

Salicylates (Aspirin):
- Used for mild to moderate pain and inflammatory conditions.
- Reduces the risk of stroke and myocardial infarction (MI).
- Caution: May cause bleeding issues, Reye's syndrome, impaired kidney function, nausea, vomiting, heartburn, tinnitus, and acidosis.
NSAIDs (Ibuprofen):
- Relieves symptoms of rheumatoid arthritis, osteoporosis, mild to moderate pain, and reduces fever.
- Caution: May cause cardiovascular issues, hypertension, renal or hepatic dysfunction, headaches, dizziness, myocardial infarction (MI), stroke, and constipation.
NSAIDs (Acetaminophen):
- Used for mild to moderate pain, cold/flu symptoms, and musculoskeletal pain.
- Caution: May result in severe liver toxicity or failure, rashes, and fever.
- Not recommended for chronic alcoholism.

Antiarthritis

Gold Compounds (Auranofin):
- Used for rheumatoid arthritis in adults.
- Caution: May cause diabetes, congestive heart failure (CHF), hypertension, renal or hepatic dysfunction, skin rash, nausea, vomiting, and mouth sores.

TNF blockers (Entanercept)

↓ symptoms of rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis.
Caution: May cause acute infection, cancer, or sepsis.
Colchicine:
- Used for gout flares
- Caution: May cause renal or hepatic dysfunction, gastrointestinal upset, rhabdomyolysis, or blood dyscrasias.

Immune Stimulants

Interferons (Interferon Alfa-2b):
- Used for hairy cell leukemia, malignant melanoma, AIDS sarcoma, and chronic hepatitis B and C.
- Caution: May cause cardiovascular disease, myelosuppression, central nervous system (CNS) effects, anorexia, skin discoloration, and flu-like symptoms.
Interleukins (Aldekeleukin):
- Used for metastatic renal cell carcinoma and metastatic melanoma.
- Caution: May cause effects from E. coli products, pregnancy complications, renal or liver/cardiovascular dysfunction, central nervous system (CNS) abnormalities, skin rash, and fever.

Colony Stimulating Factors (Filgrastim)

Used for patients undergoing chemotherapy, to prevent infections, and bone marrow transplants.
- Caution: May increase infection risk in chemo patients. -Common side effects include headache, fatigue, hair loss, and bone pain.

Immune Suppressants

T+B Cell Suppressors (Cyclosporine):
- Used prophylactically for organ transplants, organ rejection, and rheumatoid arthritis treatment.
- Caution: May be teratogenic, linked to cancer, and cause tremors, high blood pressure, abnormal gum growth, and other issues.

Monoclonal Clonal Antibodies (Bevacizumab)

Used for metastatic colorectal cancer, lung cancer, glioblastoma, and renal cell carcinoma. -Caution: Associated with fever and potential teratogenic effects.
- Common side effects include gastrointestinal perforation, headache, and hemorrhaging.

Vaccines

Active immunity develops through exposure to a pathogen
Passive immunity receives antibodies from another source(breastmilk, meds.)
Vaccines develop active immunity to diseases

Antibiotics

Aminoglycosides (Gentamicin):
- Used to treat serious bacterial infections.
Carbapenems (Ertapenem):
- Used in treating community-acquired pneumonia, GI infections, and skin infections
- Caution for poor renal function
Cephalosporins (Cefaclor):
- Used for respiratory, dermatological, urinary tract, and middle ear infections.
Fluoroquinolones (Ciprofloxacin):
- Used for respiratory, dermatological, urinary tract infections, eye and ear infections, and various other issues.
Penicillins (Amoxicillin):
- Treats infections by susceptible bacteria, including those caused by Heliobacter.
Sulfonamides (Trimethoprim-sulfamethoxazole/Cotrimoxazole):
- Used to treat urinary tract infections, acute otitis media, chronic bronchitis, and traveller's diarrhea.
Tetracyclines (Tetracycline):
- Used to treat susceptible bacteria.
Isoniazid:
- Used to treat and prevent Tuberculosis (TB) and infections in family members.
- Caution: Potential for severe renal or hepatic disease
Clindamycin:
- Used to treat serious infections.
Vancomycin: Important for treating severe conditions involving septicemia, infective endocarditis, skin and bone infections, and lower respiratory infections; also targets C. diff.
Erythromycin:
- For respiratory, dermatological UT and GI infections.
Linezolid:
- Used in resistant bacterial infections.
Aztreonam:
- Effective against lower respiratory tract, skin, urinary tract, and other infections.
Oseltamivir:
- For treatment of influenza A and B.
Acyclovir: Treats various Herpes and Cytomegalovirus infections

Chemotherapy

Various categories of chemotherapy drugs, including aminoglycosides, carbapenems, cephalosporins, fluoroquinolones, penicillins, etc., are listed.
Specific warnings regarding those drugs, such as potential side effects or precautions, are also included.

Other (Metronidazole/Mebendazole)

Used to treat infections from intestinal parasites like Trichomoniasis.
Used in the treatment of whipworm, pinworm, roundworm, and hookworm infections

Diuretics

Thiazide/Thiazide-like (Hydrochlorothiazide):
- First-line treatment for hypertension.
- May cause hypovolemia, renal disease, GI upset, hypotension and orthostatic hypotension
Loop Diuretics (Furosemide):
- Quickly and extensively increases urine output (diuresis); treating conditions like pulmonary edema (fluid buildup in the lungs).
- Possible side effects = gout, hypokalemia, alkalosis, hypokalemia, vertigo,
Carbonic Anhydrase Inhibitors (Acetazolamide):
- Used in combination with other diuretics for glaucoma.
- Caution for Pregnancy, renal/hepatic failure, and COPD
Osmotic Diuretics (Mannitol):
- Increase fluid output by drawing water into the renal tubules, used to treat elevated intracranial pressure.
Potassium-Sparing Diuretics (Spironolactone):
- Helps balance potassium levels in the body, usually in combination with other drugs.
- Caution : hyperkalemia, voice changes, breast growth, period irregularity

Urinary

UTI Anti-infective (Fosfomycin):
- Treatment for uncomplicated urinary tract infections.
Anti-spasmodics (Oxybutin):
- Used for neurogenic or overactive bladders, can cause Blurry vision, urinary hesitancy, dry mouth and sweating.
Urinary Analgesic:
- Pain relievers for Urinary Tract Infections, often associated with urine discoloration (orange)
Bladder Protectant:
- Supports bladder health in conditions like cystitis (kidney infections).
Benign-Prostatic Hyperplasia (Doxazosin/Finasteride):
- Treatments for enlarged prostate.
- Sexual dysfunction is a side effect

Eyes

-Prostaglandin Analogs (Lantanaprost):

Treat glaucoma by increasing outflow of aqueous humor
Beta-Adrenergic Blockers (Timolol):
- Helps treat open-angle glaucoma.
Alpha-Adrenergic Agonists:
- Apraconidine and Brimonidine. Reduce intraocular pressure in glaucoma
Cholinergic Agonists (Pilocarpine):
- Emergency treatment for angle-closure glaucoma
Cycloplegics + Mydriatics:
- Dilate eye pupils

Upper Respiratory

Antitussives (Dextromethorphan):
- Reduce coughing symptoms, cautioned on use during pregnancy, head injuries and individuals who need to cough to clear their airways
Topical Nasal Decongestants (Tetrahydrozoline):
- Relieve uncomfortable nasal congestion, can cause localized discomfort, and are not recommended for long-term use.
Oral Decongestants (Pseudophedrine/Phenylephrine):
- Treat nasal congestion, cautioned for use in individuals with certain conditions and when combined in certain ways
Steroid Nasal Decongestants (Fluticasone):
- Treat nasal congestion and inflammation associated with rhinitis.

Lower Respiratory

Bronchodilators (Theophylline):
- Relieve or prevent asthma and COPD symptoms

Sympathomimetics (Allbuterol):

Anticholinergics (Ipratropium):
- Used to maintain bronchospasm in COPD
Inhaled Steroids (Budesonide):
- Used in preventing and treating asthma
Leukotriene Receptor Antagonists (Zafirlukast):
- Prevent asthma attacks, use cautiously around certain medications.

-Immune Modulators (Omalizumab): - For severe asthma, avoid in children under 6.

Lung Surfactant (Beractant):
- Treatment for premature babies with respiratory distress syndrome.

Anti-histamines (Diphenhydramine/Guaifenesen):

Mucolytics (Acetylcysteine):
- Used to soften mucus in the airways and make them easier to clear.

Gastric Motility

Chemical Stimulants (Sema, Bisacodyl):
- Short-term treatment for constipation.
Bulk-forming laxatives (Psyllium):
- Treat constipation, ensure sufficient water intake.
Osmotic Laxatives (Mag. Citrate):
Treat constipation by pulling water into the stool
Do not use after abdominal surgery.
Lubricants (Docusate):
Soften/soften stool
Opioid Antagonists (Methylnaltrexone Bromide):
Treat constipation caused by opioid use.

GI Stimulants (Metoclopromide)

Treat GI movement issues, caution in individuals with certain conditions
Treat diarrhea, cautioned for individuals with specific conditions

Anti-Diarrheals (Loperamide)

Slows gut motility, cautioned in individuals with specific conditions.

IBS-D Drug (Alosetron/Lincosamides):

Severe IBS-D treatment (Alosetron).
Treatment for serious infections (Lincosamides).

Gastric Enzymes (Histamine antagonists cimetidine/antacids Sodium Bicarb.)

Histamine antagonists & antiacids for short-term peptic/ulcer issues

Proton-pump Inhibitors (Protonix/Omeprazole):

Short-term treatment for ulcers and indigestion.

GI Protectant (Sucralfate)

Maintains ulcers/ulcer treatment.
Avoid with antacids

Prostaglandins (Misoprostol)

Prevent ulcers, use cautiously

Digestive Enzymes (Pancrelipase):

Replaces deficient pancreatic enzymes, including N/V & proteinuria problems/risks.

Antiemetics (Phenothiazines Prochlorperazine/Non-phenothiazines Metoclopramide):

Treat nausea and vomiting associated/triggered by various conditions/treatments.

5-HT3 Receptor Blockers (Ondansetron)

First-line treatment for nausea and vomiting
Caution in those with specific conditions.

Blood Pressure

ACE Inhibitors (Captopril/ARB Losartan):
Calcium Channel Blockers (Diltiazem):
Vasodilators (Nitroprusside):
Beta blockers (Metoprolol):

Anti-arrhythmics

Class I (Lidocaine/Class II (Propranolol/Class III (Amiodarone)):
Anti-anginal (Nitrates):

Lipid Lowering

Bile Acid Sequestrants):
HMG COA Inhibitor (Atorvastatin/Cholesterol Absorption Inhibitor (Ezetimibe):

Anti-Anxiety

Benzodiazepines (Diazepam):
Barbituates (Phenobarbital):
Anti-depressants (Tricyclic):
MAOIs (Phenelzine):
SSRIs (Fluoxetine/Venlafaxine):
SNRIs (Duloxetine):

Anti-Psychotics

Typical (Haloperidol):
Atypical (Clozapine):
Bipolar (Lithium):
ADHD/Narcolepsy (Methylphenidate):

Anti-Seizure

Hydantoins (Phenytoin/Benzos + Barbituates/Succinimides/Valproic Acid/Other (Carbamazepine):

Anti-Parkinsonism

Dopaminergics (Carbidopa + Levodopa):
Anticholinergics (Benztropine):

Muscle Relaxants

Centrally Acting (Baclofen):

Disjunctive NMJ Blocking Agents (Succinylcholine):

PAIN - Opioids

Opioids Agonist (Morphine/Opioid Antagonists (Naloxone):
Anti-Migraine (Ergot Derivatives/Triptans):

Nervous System - General and Local Anesthetics

Nonbarbituate General Anaesthetic (Midazolam/NB General Anaesthetic (Propofol):
Anaesthetic Gas (Nitrous Oxide):

Endocrinology (Pituitary/Adrenal Cortical/Thyroid/Parathyroid):

-Posterior Pituitary (Desmopressin)/Adrenal Cortical Agents (Prednisone)/Thyroid Hormones (Levothyroxine)/Antithyroid Agents (Methimazole)/Parathyroid Agents (Calcitrol):

Reproductive

Estrogens (Estradiol/Progestins (Norethindone Acetate)/Estrogen Receptor Modulators (Raloxifene):
Fertility Drugs (Clomiphene, Oxytocin, Tocolytics (Hydroxyprogesterone caprole)/Male Repro Agents (Androgens (Testosterone):

Erectile Dysfunction (Sildenafil)

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Description

Test your knowledge on the pharmacological treatments for COPD and asthma, focusing on various medications such as anticholinergics, inhaled steroids, and leukotriene receptor antagonists. This quiz covers potential side effects, critical cautions, and mechanisms of action for essential respiratory therapies. Prepare to enhance your understanding of these crucial drugs used in respiratory medicine.