Respiratory Care Pharmacology - Unit 4 A&B

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Questions and Answers

What is the primary purpose of long-term control medications in asthma therapy?

  • To provide immediate relief during an asthma attack
  • To be taken only when symptoms worsen
  • To prevent symptoms and airway inflammation daily (correct)
  • To replace the need for quick-relief medications

Which step of asthma therapy includes the use of high-dose inhaled steroids combined with a long-acting B2 agonist?

  • Step 2
  • Step 4 (correct)
  • Step 3
  • Step 1

Which of the following symptoms is NOT typically associated with inflammation?

  • Heat
  • Dizziness (correct)
  • Pain
  • Swelling

What triggers extrinsic asthma compared to intrinsic asthma?

<p>Pollens and dust mites (C)</p> Signup and view all the answers

Which medication is generally used as a quick-relief option for asthma?

<p>Short-acting beta-agonist (C)</p> Signup and view all the answers

In which step of asthma management is an inhaled steroid combined with a low-dose long-acting B2 agonist used?

<p>Step 3 (D)</p> Signup and view all the answers

Which factor is a common trigger of intrinsic asthma?

<p>Strong emotions (C)</p> Signup and view all the answers

What is one potential side effect of using inhaled steroids in asthma management?

<p>Predisposition to pneumonia (D)</p> Signup and view all the answers

What is the primary mode of action for leukotriene inhibitors like Accolate?

<p>Inhibit leukotriene-induced inflammation (B)</p> Signup and view all the answers

Which delivery method is NOT commonly associated with the medication Nasalcrom?

<p>Eye drop solution (D)</p> Signup and view all the answers

What is a common side effect associated with Zyflo?

<p>Elevations in liver function tests (C)</p> Signup and view all the answers

Which medication is primarily indicated for the prophylactic management of asthma?

<p>Mast cell stabilizers (C)</p> Signup and view all the answers

What distinguishes intrinsic asthma from extrinsic asthma?

<p>Intrinsic asthma is not influenced by immune responses (C)</p> Signup and view all the answers

What can be a consequence of not adjusting theophylline doses when using Zyflo?

<p>Increased theophylline serum levels (B)</p> Signup and view all the answers

Which of the following is a benefit of using Singulair for asthma management?

<p>Improved control during allergy season (C)</p> Signup and view all the answers

Which of the following indicates an adverse effect of Accolate?

<p>Headaches (C)</p> Signup and view all the answers

What is the primary action of corticosteroids like Beclomethasone in managing asthma?

<p>Reduce inflammation in the airways (A)</p> Signup and view all the answers

Which of the following medications is classified as a combination drug for asthma control?

<p>Budesonide/Formoterol (D)</p> Signup and view all the answers

What is the most common cause of inflammation in the airways?

<p>Bronchitis (A)</p> Signup and view all the answers

What distinguishes extrinsic asthma from intrinsic asthma?

<p>Intrinsic asthma has genetic roots, while extrinsic asthma is triggered by environmental factors. (C)</p> Signup and view all the answers

Which medication is known for daily administration for asthma control?

<p>Montelukast (D)</p> Signup and view all the answers

What is a key symptom associated with the inflammation process in asthma?

<p>Localized swelling in the airways (A)</p> Signup and view all the answers

Which of the following statements about oral steroids and cortisol production is true?

<p>Oral steroids suppress natural cortisol production. (D)</p> Signup and view all the answers

Which type of cell is primarily involved in the exacerbation of inflammation within the respiratory system?

<p>Mast cells (A)</p> Signup and view all the answers

Flashcards

Asthma Step Approach

A stepwise treatment plan for asthma, escalating medication based on severity and symptom control.

Step 1 Asthma

Mild intermittent asthma, requiring only quick-relief medication as needed.

Step 2 Asthma

Mild persistent asthma, needing either inhaled steroids, cromolyn or leukotriene inhibitors and quick-relief medication as needed.

Step 3 Asthma

Moderate persistent asthma, requiring medium-dose inhaled steroids or low-dose inhaled steroids + long-acting bronchodilators, plus quick-relief medication as needed.

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Step 4 Asthma

Severe persistent asthma, requiring high-dose inhaled steroids, long-acting bronchodilators, and oral steroids, plus quick-relief medication as needed.

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Long-Term Control Meds

Medications taken daily to prevent asthma symptoms and inflammation.

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Quick Relief Meds

Medications used to immediately alleviate asthma symptoms during an attack.

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Extrinsic Asthma

Asthma triggered by external allergens.

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Intrinsic Asthma

Asthma triggered by internal factors within the body.

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Extrinsic Asthma Causes

Pollen, dust mites, pet dander, mold, cockroach allergens.

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Intrinsic Asthma Causes

Viral infections, stress, exercise, cold air, certain medications (like aspirin), smoke, strong emotions.

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Adult Asthma

Chronic lung disease causing inflammation/muscle tightening in the airways, making breathing difficult.

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Inflammation Symptoms

Redness, swelling, heat, and pain.

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Mode of Action of Accolate

Inhibits leukotrienes, potent stimulants of bronchoconstriction, mucus secretion and vasodilation, preventing asthma triggered by cold air, allergens, aspirin or exercise.

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Side Effects of Accolate

Possible headache, respiratory infections, and abdominal issues.

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Efficacy of Accolate

Improves morning peak flow, reduces night awakenings, and decreases bronchodilator use in asthma.

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Mode of Action of Zyflo

Blocks leukotriene's role in inflammation for asthma control.

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Side Effects of Zyflo

Potential liver issues, headaches, pain, weakness, increased theophylline levels (adjust dose), and more clotting risk (may need anticoagulant).

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Efficacy of Zyflo

Effective in preventing asthma from allergens, and cold air or aspirin. Improves FEV1(forced expiratory volume in one second)- potentially by 15-20%. Decreases reliance on bronchodilators and steroids.

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Mode of Action of Singulair

Inhibits leukotriene formation. This directly blocks leukotrienes from contributing to inflammation, providing asthma relief.

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Side Effects of Singulair

Possible stomach pain, heartburn, tiredness, fever, stuffy nose, cough, flu-like symptoms, dizziness, headache, and rash.

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Efficacy of Singulair

Effective in chronic asthma, managing asthma attacks, and symptoms, useful in allergy seasons due to its influence on symptoms (both daytime & nighttime). It may encourage reduction in B-agonist, steroid usage.

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Indications of Accolate

Prophylactic management of asthma, exercise-induced asthma, allergic rhinitis, and systemic symptoms/conjunctivitis (diarrhea, headaches, nausea).

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Indications of Zyflo

Prophylactic management of asthma, exercise-induced asthma, and allergies.

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Indications of Singulair

Chronic asthma, both allergy and non-allergy related symptoms, daytime and nighttime use.

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Aerosolized Steroids

Steroid drugs delivered as a mist to the lungs for treating respiratory conditions like asthma.

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Beclomethasone

A steroid used for asthma, delivered via metered-dose inhaler (MDI).

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Fluticasone

A steroid; available as MDI (metered-dose inhaler) or DPI (dry powder inhaler) inhalers for asthma or COPD.

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Budesonide

A steroid available in DPI (dry powder inhaler) and SVN (small volume nebulizer) forms for treating asthma.

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Mometasone Furoate

A steroid delivered by MDI (metered-dose inhaler) for treating asthma.

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Combination Inhalers

Inhalers containing multiple drugs, often a steroid and a long-acting bronchodilator, for asthma treatment.

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Cromolyn Sodium

A medication that prevents inflammation, used for asthma and allergies, available in different forms.

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Oral Steroids

Steroid drugs taken by mouth (orally).

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Diurnal Rhythm

The natural daily pattern of steroid hormone production in the body, peaking around 8 AM.

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Inflammation

A response by the body to tissue injury or infection, involving swelling, redness and pain.

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Inflammation Causes

Airway inflammation is commonly caused by bronchitis or asthma.

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Study Notes

Respiratory Care Pharmacology - Unit 4 A&B, Test 4

  • Aerosolized Drugs and Common Names: Common names and delivery methods (Oral, SVN, MDI, DPI) are listed.

Steroids and Combination Drugs

  • Beclomethasone: Quar, MDI
  • Fluticasone: Flovent, MDI/DPI
  • Budesonide: Pulmicort, DPI, Pulmicort Respules, SVN, MDI
  • Mometasone Furoate: Asmanex MDI
  • Ciclesonide: Alvesco
  • Fluticasone/salmeterol: Advair, MDI or DPI
  • Budesonide/Formoterol: Symbicort/Breyna, MDI
  • Mometasone/Formoterol: Dulera, MDI

Mediator Antagonists

  • Cromolyn Sodium: Inhalation, eye drop, nasal solution (Nasalcrom), oral solution (Gastrocrom)
  • Zafirlukast: Accolate (oral) BID
  • Zileuton: Zyflo (oral) QID
  • Montelukast: Singular (oral) DAILY

Other Information (From subsequent pages)

  • Corticosteroids: Three types naturally occurring in the body (glucocorticoids, mineralocorticoids, sex hormones)

  • Steroid Effects (Oral/Aerosolized): Suppress the natural production of cortisol

  • Diurnal Rhythm of Steroid Secretion: Peak cortisol levels around 8 a.m, lowest around 4 a.m. This is relevant to asthma attacks in asthmatics

  • Inflammation Process: Increased vascular permeability, fluid leaks into surrounding area (swelling), white blood cells (WBCs) migrate to injured areas (infiltration), Mediator cascade (histamine, chemoattractants).

  • Causes of Airway Inflammation: Bronchitis and asthma

  • T lymphocytes, B cells and Mast Cells: Role in inflammation, T lymphocytes release cytokines that affect other cells; B cells support the process, Mast cells are major effector cells

  • Steroid Actions/Mode of Action: Steroids enter cells, bind to intracellular receptors, cause gene expression for anti-inflammatory proteins (lipocortin), suppress inflammatory factors.

  • Beta Adrenergic Agents & Steroids: Steroids enhance beta-adrenergic receptor activity.

  • Indications, Mode of action, types of Administration, Side effects, Efficacy: Described for specific medications (ie: Accolate, Zyflo, Singulair).

  • Asthma Treatment with Aerosolized Steroids: Inhaled steroids are effective long-term treatment, do not provide immediate relief as B2-agonists do. Dose can increase based on peak flow measurements.

  • COPD Treatment with Steroids: Recommended by the American Thoracic Society, and in line with Global Initiative for Chronic Obstructive Lung Disease (GOLD). Consider risks/rewards (immunosuppression vs inflammation relief), frequently used with other medications (beta-agonists, anticholinergics, theophylline) when asthma control is inadequate,

  • Asthma Therapy Steps (anti-inflammatories): Stepwise approach based on asthma severity (mild intermittent, mild persistent, moderate persistent, severe persistent) with inhaled steroids and B2-agonists.

  • Extrinsic versus Intrinsic Asthma: Extrinsic triggered by external allergens, Intrinsic by internal body factors (factors within the body).

  • Adult Asthma: Chronic lung disease causing inflammation and airway tightening.

  • Symptoms of inflammation: Redness, swelling, heat, and pain.

  • Cromolyn Sodium: Prophylactic management of asthma, exercise-induced asthma, allergic rhinitis, systemic symptoms. Indication, Mode of action, forms, delivery, side effects

  • Singulair (Monoclonal Antibodies): Prevents IgE from attacking mast cells, effectively reduces leukotriene formation (contribution to inflammation)

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