17 respiratory pharm

Question 0

Bronchodilators

Answer 0

B2 andrenergic agonists
Theophilline (methylxanthine)
Anticholinergic(muscarinic receptor antagonistt)

Question 1

Omalizumab

Answer 1

Anti IgE receptor antibody for severe refracory asthma or concomitant allergic rhinitis

SubQ every 2-4 wks

SE/ Inection site RXN or anaphylaxis

Question 2

Albutereal, Salmeterol and formoterol

Answer 2

B2 agonists MOA:
*decrease calcium and SM constriction 
*prevent mast cell degranulation
*prevvent bronchial edema
*enhance mucocilliar escalator
Reduce reflex cholinergic constriction

Albuterol 3-6hr -acute asthma attacks
Salmeterol and fomotorl 12 hr- Asthma, bronchospasm, COPD (use with caution can cause problems n children

Question 3

B2 agonist SE

Answer 3

Dose related and worse in patients with CV disease

tremor, tachycardia(direct and reflex), hypokalemia, restlessnes, VQ mismatch hypoxemia

Question 4

Theophilline

Answer 4

Methylxanthine- PDE inhibitor (SM relaxant) and antagonizes adenosine receptors (blockse release of leuks and histamines)

Inexpensive treatment for severe asthma and COPD

Toxicity:
HA, dizziness, palpitation, nausea, hypotention, tachycardia, restlessness,agitation, seizures

Question 5

Ipratropium bromide/ tiotropium

Answer 5

Anticholinergics- blockade of M3-CA pathway *COPD!!!
Treats severe acute asthma after B2 agonists failadditive (or 2nd choice)
Ipratropium short acting- 30-90 min onset, 4-6 hour duration,
tiotropium longer onset 24hr duration

*Relaxes airways, Dcr. mucous secretion

SE: Dry as a bone, Blind as a bat, hot as a hare, sick as a dog, red as a beet, mad as a hatter

Question 6

Beclomethasone

Answer 6

Inhaled Steroid.
FIRST LINE ASTHMA TREATMENT for persistant asthma requiring rescue inhalor >2 times per week(NOT RESCUE HOWEVER)

Twice daily

*antiinflammatory for treatment of chronic asthma inflammation
recruits histone deacetylase and blocks HAT

Deccreases cytokines, inflammatory cells, endoothelial leakage, mucous secretion, increases B receptors on SM muscle

Question 7

combined inhalor

Answer 7

LABA and corticosteroid
enhance each others receptors
additive effect

Question 8

Systemic steroid treatment

Answer 8

Predisolone and prednisone oral
for acute exacerbations of asthma (though not rescue)
Givven morning to decrease adrenalsuppression

IV Hydrocortisone for sevver decline inlung function <30% and non responsive to B2agonists

Question 9

Inhaled steroid SE

Answer 9

Dermal thinning and skin capillary fragility, cateracts and osteoporosis - especially if oral as well, vocal atrophy (40%),

Question 10

Zileutan

Answer 10

blocks formation of LTEs

Question 11

Zafirlukast

Answer 11

LTE receptor antagonist

used for mild to moderate asthma (though less effective than ICS) Add on

SE: rare hepatic dysfunction

Question 12

COPD treatment

Answer 12

1) smoking cessation and self management
2) bronchodilators (antimuscarinic)
3) inhaed corticosteroidds
4) pulmonary rehab
5) oxygen
6) surgery

Question 13

Dornase Alpha

Answer 13

Inhaled DNASe -decreasessputum viscosity

Question 14

IVacaftor

Answer 14

Very expensive treatment dor patients with G551Dmutation

helps open these channels