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PHARMACOLOGY II > Anti-Asthma Drugs > Flashcards

Anti-Asthma Drugs Flashcards

1
Q

Responsible for processing the oxygen into the blood system and exhaling carbon dioxide

A

Respiratory System

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2
Q

Episodic narrowing and inflammation of the airway caused by stimuli

A

Asthma

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3
Q

What are the possible causes of asthma?

A

Allergens, exercise, stress

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4
Q

Two types of COPD (Chronic Obstructive Pulmonary Disorder)

A

Chronic bronchitis and Emphysema

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5
Q

COPD characterized by problems with mucous secretion that leads to bronchoconstriction

A

Chronic bronchitis (aka “Blue Bloaters”)

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6
Q

COPD characterized by elasticity of the alveoli which results into difficulty of inhaling air

A

Emphysema (aka “Pink Puffers”)

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7
Q

Thick mucous secretion excreted into the lungs; these mucous are stuck in the lungs

A

Cystic Fibrosis

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8
Q

Infection caused by Mycobacterium tuberculosis

A

Tuberculosis

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9
Q

Asthma is referred to as the inflammation of airways, what could be a possible result?

A

Cascade of inflammatory mechanisms, resulting to bronchoconstriction -> no passage of air

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10
Q

Treatment of Asthma

A
  1. Dilation of airway
  2. Reduction of inflammation
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11
Q

Class of drugs that binds to the beta receptors, stimulating cAMP in the smooth muscles causing relaxation

A

Sympathomimetic agents

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12
Q

Sympathomimetic agents are similar to ____ and ____?

A

Epinephrine and Norepinephrine

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13
Q

Sympathomimetic agents are best delivered how?

A

Through inhalation -> concentrated in the lungs

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14
Q

Rapid acting bronchodilator when injected subQ or inhaled

A

Epinephrine

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15
Q

Epinephrine’s maximal bronchodilation is achieved _____ and lasts for _____?

A

15 minutes after inhalation, lasts for 60-90 minutes

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16
Q

T or F: Epinephrine causes adverse reactions when inhaled?

A

False, when injected subQ

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17
Q

Adverse effects of Epinephrine when injected subQ

A

Tachycardia, Arrhythmia, Worsening of angina pectoris

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18
Q

Indications of Epinephrine

A
  1. Acute vasodilation
  2. Shock
  3. Bronchospasm of anaphylactic shock
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19
Q

Has a more pronounced central activity and much lower potency; longer duration of action than Epinephrine

A

Ephedrine

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20
Q

T or F: Ephedrine is frequently used in the management of asthma

A

False

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21
Q

Potential non-selective B1 and B2 bronchodilator

A

Isoproterenol

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22
Q

T or F: Isoproterenol is rarely used in the management of asthma

A

True, due to its non-specificity (B1 and B2)

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23
Q

Drugs that are commonly used for asthma and is a part of maintenance drugs

A

Beta-selective Drugs

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24
Q

T or F: Beta-selective drugs are effective after ingestion and have a longer duration of action than Epinephrine and Isoproterenol

A

True

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25
Q

Can long-acting and ultra long-acting beta-selective drugs be combined?

A

Yes

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26
Q

Sympathomimetic agents that given as “relievers” because it can only be given if the patient/s already know the cause of asthma

A

Short Acting Beta-2 Agonists (SABA)

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27
Q

SABA drugs

A

Terbutaline, Albuterol, Metaproterenol, Pirbuterol (PAMT)

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28
Q

Route of Admin of Albuterol (SABA)

A

Inhaled or Oral

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29
Q

Route of Admin of Terbutaline

A

Inhaled, Oral, SubQ

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30
Q

Route of Admin of Metaproterenol and Pirubterol

A

Inhaled

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31
Q

Possible effect of Terbutaline when given large doses

A

Inhibition of uterine contraction for premature labor

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32
Q

Sympathomimetic agents that are given as “controllers” because they can be given even without asthma attacks

A

Long Acting Beta-2 Agonists (LABA)

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33
Q

LABA that is a partial agonist

A

Salmeterol

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34
Q

LABA that is a full agonist

A

Formeterol

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35
Q

Why does LABA drugs have a duration of action of 12 or more hours?

A

Due to their high lipid solubility

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36
Q

Beta-blocker agonist that is used for the treatment of COPD

A

Ultra Long-Acting Beta-2 Agonist

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37
Q

Ultra Long-Acting Beta-2 Agonists are taken ____ daily?

A

Once daily

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38
Q

Purine derivates who’s MOA is the inhibition of phosphodiesterase to increase cAMP levels

A

Methylxanthines

39
Q

Methylxanthine drugs

A

Caffeine, Theophylline, Theobromine

40
Q

Stimulates cardiac function, relaxation of smooth muscles, and reduction in immune and inflammatory activity

A

cAMP

41
Q

T or F: Theophylline is absorbed well in the GI and is metabolized by the liver

A

True

42
Q

Side-effects of Theophylline

A

GI distress, Tremor, Insomnia

43
Q

Toxicities of Theophylline

A

Arrhythmia, Hypotension, Vomiting

44
Q

Antidote for Methylxanthine overdose

A

Beta-blockers

45
Q

Class of drugs that competitively inhibits the action of acetylcholine at the muscarinic receptor

A

Antimuscarinic agents

46
Q

T or F: Antimuscarinic agents blocks the contraction of the airway smooth muscles and decreases secretion of mucus

A

False, increases secretion of mucus

47
Q

Prototypic muscarinic antagonist

A

Atropine

48
Q

T or F: Muscarinic antagonists can be given for asthma without Beta-agonists

A

False, cannot be given (MA and BA comes hand in hand)

49
Q

Short-acting Muscarinic Antagonist (SAMA)

A

Ipratropium

50
Q

Selective quaternary ammonium derivative of atropine

A

Ipratropium

51
Q

T or F: Ipratropium can be delivered into the circulation and does not readily enter the CNS

A

True

52
Q

Ipratropium is effective in patients with ______ just like _____

A

COPD, Albuterol

53
Q

Long-acting Muscarinic Antagonists (LAMA)

A

Tiotropium, Aclidinium

54
Q

Binds to the M1, M2, and M3 receptors with equal affinity but dissociates most rapidly from M2 receptors

A

LAMA (Tiotropium, Aclidinium)

55
Q

LAMA are taken in by _____

A

Inhalation

56
Q

T or F: LAMA are part of the maintenance medications for patients with Asthma

A

False, they are only given as add ons

57
Q

Class of drugs that inhibit phospholipase A2 and COX-2 expression -> reducing inflammatory cytokines and reduced thickness on the respiratory mucosa

A

Corticosteroids

58
Q

T or F: Corticosteroids has an effect on dilation

A

False

59
Q

What kind of corticosteroids are commonly used?

A

Inhaled

60
Q

Corticosteroids are routinely used in combination with what?

A

Beta-agonists

61
Q

Are oral and parenteral corticosteroids used on a normal basis?

A

No, they are reserved for patients requiring urgent treatment

62
Q

Corticosteroids given for urgent treatment

A

Prednisolone (oral)
Methylprednisolone (IV)

63
Q

Inhalational corticosteroids

A

Beclomethasone, Budesonide, Ciclesonide, Flunisolide, Fluticasone, Mometasone, Triamcinolone

64
Q

T or F: Inhalation Corticosteroids (ICS) are delivered with minimal system absorption

A

True, hence, more concentrated in the lungs

65
Q

Side effect of ICS

A

Oropharyngeal candidiasis - fungal infection around oral cavity that can be combatted with oral hygiene

66
Q

Class of drugs that has no effect on the airway’s smooth muscle tone

A

Anti-inflammatory drugs; Release inhibitors

67
Q

Drugs that are effective in inhibiting both antigen and exercise-induced asthma

A

Release inhibitors

68
Q

Release inhibitors drugs

A

Cromolyn, Nedocromil

69
Q

T or F: Release inhibitors have low solubility and are poorly absorbed from the GI tract

A

True, hence should be inhaled

70
Q

Alters the function of delayed chloride channel in cell membrane -> inhibiting its activation

A

Release inhibitors

71
Q

Release inhibitors acts on _____ and _____ both containing _____ that leads to inflammatory cascade

A

Mast cells and Eosinophils, collectively known as Histamine

72
Q

Release inhibitors are useful for reducing __________

A

Allergic Rhinoconjunctivitis

73
Q

Side effects of Release inhibitors include:

A

Throat irritation, cough, mouth dryness, wheezing, chest tightness

74
Q

T or F: To prevent release inhibitors symptoms, B2 agonist is needed to be administered beforehand

A

True

75
Q

Results from the action of 5-lipoxygenase on arachidonic acid, synthesized by various inflammatory cells in the airways

A

Leukotrienes

76
Q

Potent neutrophil chemoattractant

A

LTB4

77
Q

Exerts many effects known to occur in asthma such as bronchoconstriction, increased bronchial activity, mucosal edema, and mucus hypersecretion

A

LTC4 and LTD4

78
Q

Class of drugs whose MOA is to either inhibit 5-lipoxygenase or inhibit binding of LTD4 to its receptor

A

Leukotriene Pathway inhibitors

79
Q

Drugs classified as LT Pathway inhibitors

A

Zileuton, Zafrilukast, Montelukast

80
Q

5-lipoxygenase inhibitor

A

Zileuton

81
Q

LTD4 receptor antagonists

A

Zafrilukast and Montelukast

82
Q

Route of admin of LTD4 receptor antagonists

A

Oral

83
Q

Most prescribed Leukotriene Receptor Antagonist which is approved for children and is taken once daily

A

Montelukast

84
Q

T or F: Montelukast should be taken with meals

A

False, it has no regard to meals

85
Q

Least prescribed Leukotriene Receptor Antagonist due to its liver toxicity

A

Zileuton

86
Q

T or F: Leukotriene Receptor Antagonists are as effective as inhaled steroids

A

False

87
Q

T or F: Leukotriene Receptor Antagonist are recommended for acute asthma

A

False

88
Q

Leukotriene Receptor Antagonist are effective in:

A
  1. Exercise-induced bronchospasm
  2. Antigen 2-induced bronchospasm and aspirin allergy
  3. Aspirin-induced bronchospasm
89
Q

Humanized murine monoclonal antibody

A

Omalizumab

90
Q

Prevents the activation by asthma trigger antigens

A

Omalizumab

91
Q

Class of drug that inhibits the binding of IgE but does not activate IgE already bound to mast cells

A

Anti-IgE Monoclonal Antibodies

92
Q

Route of administration of Anti-IgE

A

Subcutaneous

93
Q

T or F: Omalizumab is given as last line treatment

A

True

PHARMACOLOGY II (4 decks)

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