3.1 Drugs for Asthma and COPD

Question 1

What is the difference between the SABA and LABA drugs?

Answer 1

LABAs have a lipophilic end that allows them to stick in the cellular membrane for longer periods of time and have a longer duration

Question 2

Name the 4 SABA drugs.

Answer 2

• Salbutamol (alubterol),
• Levalbuterol
• Terbutaline
• Metaproteronol

“Sal loves the money”

Question 3

Name the 2 LABA drugs.

Answer 3

Salmeterol

Formeterol

Question 4

What condition are muscarinic antagonists most effective against and what are the two drugs to know?

Answer 4

Muscarinic antagonists block the parasympathetics that cause bronchoconstriction and most affective in treating COPD

Drugs to know: Ipratropium, Tiotropium (longer acting)

Question 5

How do the methylxanthine drugs work and what are the two drugs?

Answer 5

Methylxanthines work by preventing cAMP breakdown and inhibiting adenosine in increasing the bronchoconstriction tone

Drugs to Know:

Theophylline and Roflumilast (Phosphodiesterase 4 inhibitor)

Question 6

Why do corticosteroid/glucocorticoid treatments need to be selectively given for the lungs?

Answer 6

• Have high potency affect on metabolism leading to increased free fatty acids, ketone bodies, glucose, and amino acids
• Have anti-inflammatory effects at concentrations above those required for metabolic effects
• Only a small percentage of inhaled corticosteroids make it to the lungs

Question 7

What are the ICS drugs to know?

Answer 7

• Budesonide and Fluticasone
  
  • High first-pass metabolism
• Beclomethasone dipropionate and Ciclesonide
  
  • ​prodrugs cleaved by esterase in the lung to the active form

Question 8

What is the function of leukotriene antagonists and what are the three drugs to know?

Answer 8

Used to prevent bronchoconstriction and treat mild to moderate asthma prophylactically

Drugs to know:

Zileuton - interferes with the activity of 5o-lipoxygenase enzyme

Montelukast and Zafirlukast - Leukotriene receptor inhbitor

Question 9

What steroidal drug(s) would you give in emergency pulmonary situations and why do you not want to use it as a first line treatment?

Answer 9

Hydrocortisone and Prednisone

Don’t want to give as first choice because of strong systemic effects

Question 10

What drug is a mast cell stabillizer and what asthma types does it treat?

Answer 10

Cromolyn

Effective in treating antigen- and exercise- induced asthma

Question 11

What drug is an immunomodulator and how does it work?

Answer 11

Omalizumab

Works my decreasing the sensitivity of IgE via anti-IgE antibody