Respiratory Agents Flashcards

Study critical respiratory medications including bronchodilators, corticosteroids, and antihistamines. (28 cards)

1
Q

What is the common brand name(s) for:

aclidinium

(ak-li-DIN-ee-um)

A

Tudorza Pressair

Class: Long‑acting muscarinic antagonist (LAMA) bronchodilator

Indication: Used for the treatment of COPD

MOA: Reversible, competitive antagonism of airway M₃ muscarinic receptors, inhibiting acetylcholine‑mediated bronchoconstriction and producing bronchodilation

Side effects: headache; cough; diarrhea; sinusitis; nausea; dry mouth; paradoxical bronchospasm

Contraindications: Severe allergy to milk proteins

Considerations:

  • Assess spirometry and patient‑reported outcomes periodically.
  • Reinforce proper device use at follow‑up visits.
  • Demonstrate inhaler assembly and cleaning.

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2
Q

What is the common brand name(s) for:

albuterol

(al-BYOO-ter-ol)

A
  • Ventolin HFA
  • ProAir HFA
  • Proventil HFA

Class: Beta-2 Adrenergic agonists, selective

Indication: Used to treat asthma and exercise-induced bronchospasm

MOA: Selective beta2-adrenoceptor agonist causing smooth muscle relaxation and bronchodilation

Side effects: tachycardia; hypertension; muscle tremor; nervousness; hypokalemia

Contraindications: Severe allergy to milk proteins (certain dry-powder formulations)

Considerations:

  • Can drive potassium into cells, sometimes leading to hypokalemia.
  • Counsel on correct inhaler use.

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3
Q

What is the common brand name(s) for:

azelastine

(AY-ze-las-teen)

A

Astelin, Astepro

Class: Antihistamine

Indication: Used for allergic rhinitis

MOA: Histamine H1-receptor antagonist and mast cell stabilizer reducing inflammatory mediators

Side effects: bitter taste; cough; dizziness; drowsiness; nasal irritation

Contraindications: Hypersensitivity to drug or any of its components

Considerations:

  • Bitter taste is common if administered incorrectly.
  • Caution against operating heavy machinery.
  • Metabolized by cytochrome P450 enzymes.

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4
Q

What is the common brand name(s) for:

beclomethasone

(be-kloe-METH-a-sone)

A

QVAR (oral inhalation), Beconase AQ (nasal)

Class: Corticosteroid, Inhaled

Indication: Used for asthma, allergic rhinitis, and nasal polyps

MOA: Binds to glucocorticoid receptors, inhibiting expression of inflammatory genes

Side effects: headache; epistaxis; throat irritation; oral candidiasis

Contraindications: Hypersensitivity to drug or any of its components

Considerations:

  • Acceptable in pregnancy and breastfeeding.
  • Monitor growth in children annually.
  • Caution with prolonged use due to adrenal suppression.

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5
Q

What is the common brand name(s) for:

benzonatate

(BEN-zoe-na-tate)

A

Tessalon Perles

Class: Antitussive

Indication: Used for cough relief

MOA: Local anesthetic effect on stretch receptors in the respiratory passages

Side effects: sedation; headache; dizziness; GI upset

Contraindications: Hypersensitivity to drug or any of its components

Considerations:

  • Do not chew, crush, or dissolve the capsules in the mouth.
  • Onset typically 15–20 minutes post‑dose.
  • Use caution in pregnancy and breastfeeding.

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6
Q

What is the common brand name(s) for:

budesonide

(byoo-DES-oh-nide)

A

Pulmicort (oral inhalation), Rhinocort Aqua (nasal)

Class: Glucocorticoid

Indication: Used for ulcerative colitis, Crohn disease, and asthma

MOA: Inhibits phospholipase A2 and suppresses proinflammatory mediators

Side effects: oral candidiasis; taste alteration; increased risk of pneumonia

Contraindications: Severe allergy to milk proteins (certain dry-powder formulations)

Considerations:

  • Monitor children for growth restrictions.
  • Available in many forms.
  • Rinse mouth after inhalation to decrease oral candida risk.

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7
Q

What is the common brand name(s) for:

cetirizine

(seh-TIR-i-zeen)

A

Zyrtec

Class: Antihistamine

Indication: Used for allergic rhinitis and urticaria

MOA: Antagonist to the histamine-1 receptor with minimal sedation effects

Side effects: sedation (minimal); agitation; urinary retention

Contraindications: Hypersensitivity to drug or any of its components

Considerations:

  • Adjust dose for renal and hepatic function.

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8
Q

What is the common brand name(s) for:

chlorpheniramine

(klor-fen-EER-a-meen)

A

Chlor-Trimeton

Class: Antihistamine

Indication: Used for allergic reactions to pollen, mold, and other allergens

MOA: Antagonizes H1 receptor sites and blocks cholinergic muscarinic receptors

Side effects: cns depression; poor coordination; anticholinergic effects

Contraindications: Use in children to cause drowsiness

Considerations:

  • Avoid driving or using heavy machinery due to sedating properties.
  • Children and elderly adults are more susceptible to side effects.
  • Do not use for sleep in children.

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9
Q

What is the common brand name(s) for:

cromolyn sodium

(KROE-moe-lin SOE-dee-um)

A

Nasalcrom (nasal), Crolom (ophthalmic)

Class: Mast cell stabilizer

Indication: Used for mastocytosis, allergic rhinitis, conjunctivitis, and asthma

MOA: Prevents degranulation of mast cells, inhibiting histamine release

Side effects: throat irritation; cough; eye stinging

Contraindications: Hypersinsitivity to drug or any of its components

Considerations:

  • Used for prophylaxis, not acute relief.
  • Therapeutic effect can take 1–4 weeks.

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10
Q

What is the common brand name(s) for:

dextromethorphan

(dex-troe-meth-OR-fan)

A

Delsym

Class: Antitussive

Indication: Used for mastocytosis, allergic rhinitis, conjunctivitis, and asthma

MOA: Prevents degranulation of mast cells, inhibiting histamine release

Side effects: throat irritation; cough; eye stinging

Contraindications: Use within 2 weeks of monoamine oxidase inhibitor

Considerations:

  • Used for prophylaxis, not acute relief;
  • Therapeutic effect can take 1–4 weeks;

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11
Q

What is the common brand name(s) for:

diphenhydramine

(dye-fen-HYE-dra-meen)

A

Benadryl

Class: Antihistamine

Indication: Used for cough suppression

MOA: Direct action on the medullary cough center

Side effects: rash; nausea; dizziness; constipation

Contraindications: Use within 2 weeks of monoamine oxidase inhibitor

Considerations:

  • Dependence is an issue, more so when used recreationally.
  • Rapidly absorbed in the GI tract.

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12
Q

What is the common brand name(s) for:

fexofenadine

(fex-oh-FEN-a-deen)

A

Allegra

Class: Antihistamine

Indication: Seasonal allergic rhinitis

MOA: Selectively blocks peripheral H₁‑histamine receptors, reducing histamine-related allergic symptoms

Side effects: headache; dizziness; fatigue; mild nausea; dyspepsia

Contraindications: Hypersensitivity to the drug or its components

Considerations:

  • Dose adjustments or caution may be needed in renal impairment.

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13
Q

What is the common brand name(s) for:

fluticasone

(floo-TIK-a-sone)

A

Flonase

Class: Corticosteroid, inhaled

Indication: Allergic rhinitis (moderate to severe), asthma, eosinophilic esophagitis

MOA: Activates glucocorticoid receptors, reducing proinflammatory cytokines and eosinophil formation

Side effects: headache; oral candidiasis; increased risk of pneumonia in copd patients; taste and voice alterations; risk of growth restriction in children

Contraindications: Hypersensitivity to the drug or its components

Considerations:

  • Monitor children for growth restriction.
  • Educate on rinsing mouth after use to decrease risk of oral candida.

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14
Q

What is the common brand name(s) for:

fluticasone; vilanterol

(floo-TIK-a-sone; vye-LAN-te-role)

A

Breo Ellipta

Class: Fluticasone - Inhaled Corticosteroid (ICS)
Vilanterol - Long‑Acting Beta-2 Agonist (LABA)

Indication: COPD, asthma

MOA: Fluticasone reduces airway inflammation; vilanterol stimulates β₂ receptors for bronchodilation

Side effects: severe hypersensitivity to milk proteins; not for primary treatment of status asthmaticus or acute copd/asthma

Contraindications: Acute COPD or asthma episode; severe allergy to milk proteins (certain dry-powder formulations)

Considerations:

  • Not a rescue inhaler.
  • Rinse mouth after use.
  • Strong CYP3A4 inhibitors increase systemic levels, raising risk of side effects.

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15
Q

What is the common brand name(s) for:

formoterol

(for-MOE-ter-ol)

A

Foradil, Perforomist

Class: Long‑acting Beta-2‑adrenergic agonist (LABA)

Indication: COPD

MOA: Binds to β₂ adrenergic receptors in bronchial smooth muscle for relaxation and bronchodilation

Side effects: tremor; headache; palpitations; nervousness; throat irritation; cough; muscle cramps; paradoxical bronchospasm

Contraindications: Hypersensitivity to the drug or its components

Considerations:

  • Symbicort is a combination product with budesonide and formoterol.

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16
Q

What is the common brand name(s) for:

guaifenesin

(gwye-FEN-e-sin)

A

Mucinex

Class: Expectorant

Indication: Chest congestion, productive cough

MOA: Increases volume and reduces viscosity of respiratory secretions to aid mucus clearance

Side effects: gastrointestinal upset; dizziness; mild rash

Contraindications: Do not use extended-release in patients younger than 12 years old

Considerations:

  • Maintain good hydration.
  • Only use with productive cough.

17
Q

What is the common brand name(s) for:

hydroxyzine

(hye-DROX-i-zeen)

A

Atarax, Vistaril

Class: Antihistamine

Indication: Anxiety, pre-surgery sedation, pruritus, urticaria, peripartum management

MOA: Inverse agonist to histamine-1 receptors, preventing mast cell degranulation

Side effects: lethargy; drowsiness; agranulocytosis; anticholinergic syndrome; dyskinesia; QT prolongation; tinnitus; seizures

Contraindications: Early pregnancy, prolonged QT interval

Considerations:

  • Crosses the blood-brain barrier.
  • Caution in patients with benign prostatic hyperplasia.
  • Younger patients and elderly may require lower dosing.

18
Q

What is the common brand name(s) for:

ipratropium

(i-pra-TROE-pee-um)

A

Atrovent

Class: Anticholinergic

Indication: Used to treat COPD

MOA: Blocks the action of acetylcholine at parasympathetic sites in bronchial smooth muscle, causing bronchodilation

Side effects: bronchitis; sinusitis; headache; dizziness; dyspepsia; nausea; uti; cough; flu-like symptoms

Contraindications: Hypersensitivity to the drug or any of its components

Considerations:

  • DuoNeb and Combivent are combinations of albuterol and ipratropium.

19
Q

What is the common brand name(s) for:

levalbuterol

(lev-al-BYOO-ter-ol)

A

Xopenex

Class: Short‑acting Beta-2 adrenergic receptor agonist (SABA)

Indication: Rescue medication for acute episodes of bronchoconstriction

MOA: Selectively binds and activates beta-2-adrenergic receptors in bronchial smooth muscle, inducing rapid bronchodilation

Side effects: tremor; nervousness; headache; tachycardia; palpitations; throat irritation; cough; dizziness

Contraindications: Hypersensitivity to drug or any of its components

Considerations:

  • R-enantiomer of albuterol - may offer similar efficacy with a potentially reduced incidence of side effects such as tachycardia and tremor.
  • Counsel on proper technique.
  • Intended solely for acute symptom relief.

20
Q

What is the common brand name(s) for:

loratadine

(lor-AT-a-deen)

A

Claritin

Class: Antihistamine

Indication: Allergic rhinitis, chronic idiopathic urticaria

MOA: Antagonist to the histamine-1 (H1) receptor; minimal sedation effects due to poor blood-brain barrier penetration

Side effects: headache; fatigue; dry mouth; mild drowsiness; rash

Contraindications: Hypersensitivity to drug or any of its components

Considerations:

  • Desloratadine (Clarinex) is the active metabolite of loratadine.
  • Loratadine available OTC as an alternative to desloratadine.

21
Q

What is the common brand name(s) for:

mometasone

(moe-MET-a-sone)

A

Nasonex (nasal), Asmanex (oral inhalation)

Class: Corticosteroid, Inhaled

Indication: Asthma, allergic rhinitis, nasal polyps

MOA: Binds to glucocorticoid receptors, inhibiting the expression of genes coding for chemokines and cytokines involved in inflammation

Side effects: headache; altered sense of smell; epistaxis; throat irritation; oral candidiasis; altered sense of taste; altered voice; pneumonia (when patients already have COPD); rare: bronchospasm; anxiety; adrenal suppression; glaucoma; nasal septum perforation; pediatric growth retardation; sleep disorders

Contraindications: Hypersensitivity to milk protein; primary treatment of status asthmaticus

Considerations:

  • Acceptable in pregnancy and breastfeeding.
  • If used in children, measure growth annually in case of growth retardation.
  • Caution with prolonged use due to risk of adrenal suppression.
  • Always use glucocorticoids (fludrocortisone, hydrocortisone) in HPA-axis suppressed patients.
  • Also available as topical (Elocon) - used for atopic dermatitis, psoriasis, and eczema.

22
Q

What is the common brand name(s) for:

montelukast

(mon-TELL-oo-kast)

A

Singulair

Class: Leukotriene receptor antagonist

Indication: Allergic rhinitis, asthma, exercise-induced bronchoconstriction

MOA: Leukotriene receptor antagonist; blocks calcium influx into mast cells, stabilizing plasma membranes of mast cells and eosinophils, preventing degranulation and release of histamine, leukotrienes, and other substances causing airway inflammation

Side effects: allergic granulomatous vasculitis (churg-strauss syndrome) - rare; hypersensitivity reactions; liver injury; neuropsychiatric disorders

Contraindications: Hypersensitivity to drug or any of its components

Considerations:

  • Caution in liver disease.

23
Q

What is the common brand name(s) for:

olopatadine

(oh-LOE-pa-ta-deen)

A

Patanol, Pataday

Class: Antihistamine

Indication: Seasonal allergic conjunctivitis

MOA: Selective H1 antagonist inhibits release of histamines from mast cells

Side effects: irritation of the eyes; rash

Contraindications: Hypersensitivity to drug or any of its components

Considerations:

  • In patients with coexisting ocular surface disorders (severe dry eye, keratitis), caution is advised.
  • Patients may experience transient burning, stinging, or discomfort upon instillation.

24
Q

What is the common brand name(s) for:

promethazine

(proe-METH-a-zeen)

A

Phenergan

Class: Phenothiazines

Indication: Seasonal allergic conjunctivitis

MOA: Selective H1 antagonist inhibits release of histamines from mast cells

Side effects: irritation of the eyes; rash

Contraindications: Hypersensitivity to drug or any of its components

Considerations:

  • In patients with coexisting ocular surface disorders (severe dry eye, keratitis), caution is advised.
  • Patients may experience transient burning, stinging, or discomfort upon instillation.

25
# What is the common brand name(s) for: salmeterol | (sal-ME-ter-ol)
Serevent | Class: Long acting beta 2 agonist (LABA) ## Footnote **Indication:** Asthma/bronchospasm, COPD, exercise-induced bronchospasm **MOA:** Increases cAMP concentrations in smooth muscle, causing relaxation; selective for smooth muscle without affecting the heart **Side effects:** hypertension; headache; dizziness; sleep disorder; influenza; nasal congestion; throat irritation **Contraindications:** Monotherapy in asthma treatment; severe allergy to milk proteins (certain dry-powder formulations); treatment of status asthmaticus or other acute asthma/COPD episode **Considerations:** * Slower onset but more prolonged effect than other beta-2 agonists. * Potential for paradoxical bronchospasm.
26
# What is the common brand name(s) for: terbutaline | (ter-BYOO-ta-leen)
Brethine | Class: Beta-2 Adrenergic agonists, selective ## Footnote **Indication:** Asthma, bronchospasm **MOA:** Selective beta2-adrenoceptor agonist; causes smooth muscle relaxation, producing bronchodilation **Side effects:** tachycardia; hypertension; muscle tremor; nervousness; hypokalemia; seizures (rare); hyperthyroidism; increased IOP **Contraindications:** Tocolysis (48–72 hours) **Considerations:** * Not used in pregnant women for prevention or prolonged treatment (fatal maternal heart problems).
27
# What is the common brand name(s) for: tiotropium | (tee-oh-TROE-pee-um)
Spiriva | Class: Anticholinergic ## Footnote **Indication:** Asthma, COPD **MOA:** Competitively and reversibly inhibits the action of acetylcholine at M3 receptors in the bronchial smooth muscle, causing bronchodilation **Side effects:** xerostomia; pharyngitis; sinusitis; upper respiratory infection; edema; pruritus; abdominal pain **Contraindications:** Hypersensitivity to drug or any of its components **Considerations:** * Not used for acute bronchospasm.
28
# What is the common brand name(s) for: umeclidinium | (yoo-me-KLID-ee-nee-um)
Incruse Ellipta | Class: Anticholinergic ## Footnote **Indication:** COPD **MOA:** Competitively and reversibly inhibits the action of acetylcholine at M3 receptors in the bronchial smooth muscle, causing bronchodilation **Side effects:** tachycardia; toothache; upper abdominal pain; arthralgia; cough; nasopharyngitis **Contraindications:** Severe hypersensitivity to milk proteins **Considerations:** * Trelegy Ellipta is a combination of fluticasone, umeclidinium, and vilanterol. * Anoro Ellipta is a combination of umeclidinium and vilanterol.