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4. Pharm III > 2- Asthma > Flashcards

2- Asthma Flashcards

1
Q

What is first line tx for asthma?

A

Beta 2 agonists

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2
Q

What is the MOA for beta 2 agonists in the tx of asthma?

A

Increase cAMP, relax airway smooth muscle, inhibit histamine release

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3
Q

How is a beta 2 agonist delivered in an emergency situation?

A

Injected

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4
Q

What drugs are SABAs? (5)

A

Albuterol

Levalbuterol

Pirbuterol

Terbutaline

Bitolterol

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5
Q

What is the use of SABAs?

(Albuterol, Levalbuterol, Pirbuterol, Terbutaline, Bitolterol)

A

Asthma attack in progress (act immediately)

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6
Q

Salmeterol drug class?

A

Long acting beta 2 agonist (LABA)

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7
Q

What is the use of Salmeterol?

A

Asthma prevention and prophylaxis (act after 20-30 min)

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8
Q

Salmeterol should always be used in conjunction with what?

A

Steroid (Advair)

(to avoid tolerance)

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9
Q

What are the SEs of beta agonists?

A

Tachycardia, nervousness, dizziness, tremor (oral)

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10
Q

Pt with asthma presents to your office in need of an inhaled medication to help with sxs. Hx reveals intolerance to beta 2 agonists. What should you prescribe them?

A

Ipratropium (Atrovent)

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11
Q

What is the MOA for Ipratropium?

A

Muscarinic antagonist

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12
Q

Pt presents with COPD and is in need of an inhaled medication to control sxs. What should you prescribe?

A

Ipratropium (Atrovent)

(if Combivent, give w/ albuterol)

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13
Q

The following are the MOAs for what drug?

PDE inhibitor (increases cAMP), blocks adenosine receptor, relaxes smooth muscle

A

Theophylline

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14
Q

What is the drug of choice for a pt whose asthma or COPD is NOT controlled by beta agonists or muscarinic antagonists?

A

Theophylline

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15
Q

Pt with asthma/ COPD presents to your office in need of tx. Upon taking hx, pt states they currently take cimetidine for acid reflux. What drug should you NOT prescribe them?

A

Theophylline

(caution w drug interactions in general)

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16
Q

What is the caution with Theophylline?

(asthma/ COPD 3rd line tx)

A

Low therapeutic index

17
Q

What are the SEs of Theophylline?

A

CNS, cardiac, muscle, diuretic

18
Q

Pt who has overdosed on Theophylline will display what sxs? (5)

A

Palpitations, HA, nausea, emesis, seizures

19
Q

What anti-inflammatory drugs are used in the tx of asthma?

A

Corticosteroids, Leukotriene inhibitors, Cromolyn sodium

20
Q

What drugs are used orally in severe asthma or asthma exacerbations and improve response to beta agonists?

A

Corticosteroids

(can also be inhaled)

21
Q

What are the SEs of inhaled corticosteroids?

A

Oral candidiasis (thrush), hoarseness

22
Q

What drugs are Leukotriene Inhibitors?

A

Zileuton (Zyflo CR)- 5-LO inhibitor

Zafirlukast (Accolate)- LT antagonist

Montelukast (Singulair)- LT antagonist

23
Q

What drug is used for pt with aspirin-sensitive asthma?

A

Zileuton

24
Q

What drugs have NO effect on asthma attack in progress (still need beta 2 agonist) but may allow for decreased steroid dose?

A

Leukotriene inhibitors

(Zileuton (Zyflo CR), Zafirlukast (Accolate), Montelukast (Singulair))

25
Q

What are the SEs for leukotriene inhibitors?

A

URIs, sore throat, HA, abd pain, sleepiness

26
Q

What asthma drug is a monoclonal antibody and prevents binding of IgE to cells a/w allergic response?

A

Omalizumab (Xolair)

27
Q

What drug is used in the tx of moderate to severe allergic asthma?

A

Omalizumab (Xolair)

28
Q

What are the SEs for Omalizumab (Xolair)?

(used in mod to severe allergic asthma)

A

Rash, injection site reactions, small decrease in platelets

29
Q

What asthma drugs inhibit release of histamine from mast cells?

A

Cromolyn sodium, Nedcromil

(NOT bronchodilators)

30
Q

What asthma drug is used for a pediatric patient or for prevention and is taken 4x daily (takes time to be effective)?

A

Cromolyn sodium, Nedcromil

31
Q

What asthma drug can also be used for conjunctivitis? (eye drops)

A

Cromolyn

32
Q

What is the asthma step therapy? (5 steps)

A
  1. SABA
  2. SABA + low dose ICS
  3. SABA + low dose ICS + LABA
  4. SABA + med dose ICS + LABA
  5. SABA + high dose ICS + LABA
  6. SABA + high dose ICS + LABA + oral steroid

4. Pharm III (16 decks)

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