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Respiratory Block > Anti-Asthmatic Drugs > Flashcards

Anti-Asthmatic Drugs Flashcards

1
Q

What are the muscarinic antagonists used for asthma?

A

It is ipratropium, tiotropium, aclidinium, Umeclinidium

tropium ones are for Asthma+ COPD

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2
Q

What are the mediator release inhibitors?

A

Cromolyn and Nedocromolyn

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3
Q

What is the methyl xanthine medication used for asthma and what is its general mechanism?

A

Theophylline (PDE3 and PDE 4 inhibitor)

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4
Q

Anti-leukotriene agents are:

A

Zileuton, Zafirlukast, and Montelukast

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5
Q

What is anti-IgE antibody used for asthma?

A

Omalizumab

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6
Q

What is cetirizine used for?

A

non-FDA, seasonal rhinitis, seasonal allergic asthma

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7
Q

Roflumilast is a —-

A

PDE4 inhibitor

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8
Q

What are the IL-5 MAB?

IL-4 receptor MAB?

A

Reslizumab, Mepolizumab, Benralizumab

Dupilumab

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9
Q

For beta adrenergic agonists, what is important to keep note?

A

Whether long acting or short acting

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10
Q

What is the drug combination used for short acting acute management of tolerant asthma?

A

It is albuterol + ipratropium

SABA + SAMA

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11
Q

What are the long acting asthma management combination?

A

They are Umeclinidium+ Vilanterol (LAMA+LABA)

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12
Q

What is the LABA+ ICS combinations used to treat asthma?

A

They are Salmeterol + Fluticasone

Vilanterol+ Fluticasone

Formoterol+ Budenoside

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13
Q

What is the ULABA+LAMA combination used to treat asthma?

A

It is Olodetarol-Tiotropium

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14
Q

What is PDE? Function?

A

It is phosphodiesterase, and it is an enzyme that breaks down the second messenger cAMP to AMP

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15
Q

Mechanism of bronchial relaxation is what?

A

ATP –> cAMP via AC causes there to be relaxation.

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16
Q

Beta agonists do what? Theophylline does what?

A

Beta agonists activate AC, theophylline inhibits PDE4

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17
Q

What are the 3 factors that can increase broncho-constriction?

A

They are leukotrienes, Acetyl choline, and Adenosine

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18
Q

Epinephrine usage has what drawback?

A

it’s use should be limited for the lung (so you shouldn’t over dose it)

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19
Q

Why are sympathomimetics inhalational?

A

In order to reach mainly lung rather than other area.

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20
Q

Sympathomimetics clinical application is:

A

relaxation of bronchial smooth muscle, dialting airways, Airway diameter is the most important determinant.

They also facilitate mucociliary transport of secretions and thereby promote expectoration

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21
Q

What is the major structural difference between long acting and short acting agent?

A

They are more lipophilic.

22
Q

Why are corticosteroid co-administered with LABAs?

A

In order to re-sensitize Beta-agonist receptors

23
Q

What do Beta 2 agonistic drugs do?

A

They induce skeletal muscle tremor

Excessive use–> tachycardia, arrhythmias, loss of responsiveness to the drug

Corticosteroids are believed to restore the sensitivity

24
Q

Albuterol and Terbutaline is NOT metabolized by

A

COMT

25
Q

What does epinephrine target?

A

Alpha 1 and Alpha 2

26
Q

What for corticosteroid do?

A

Corticosteroid inhibit synthesis of leukotrienes, prostaglandins, and thomboxanes–> reductions in brochial smooth muscle contraction, vascular permeability

27
Q

What are side effects of inhalational corticosteroids?

A

Can change microflora of oropharygeal area causing candidiasis.

28
Q

Anticholinergic Bronchodilator sprays are used how?

A

Nasal spray and oral inhalational

29
Q

What is the MOA of ipratropium?

A

It is a synthetic quaternary anti-muscarinic agent and is a competitive antagonist at muscarinic cholinergic receptors

Decreases cGMP formation and decreases contractility of SM due to actions on Ca++.

Maintains basal tone.

30
Q

What is the adverse effects of Ipratropium?

A

Xerostemia

31
Q

What type of patients is ipratropium apt for?

A

COPD patients with psychogenic exacerbations

32
Q

Tiotropium is used for?

A

COPD and Asthma .
Maintanance treatment of bronchospasm associated with COPD.

M3 receptor system is the major target

33
Q

What is Aclinidium Bromide is used for what?

A

It is used for COPD, chronic bronchitis, and emphysema. M3 receptor antagonist.

34
Q

What is the methyl xanthine name that is given injection?

A

It is Aminophyllin

35
Q

What does PDE3 va PDE 4 function?

A

PDE3: bronchodilator
PDE4: anti-inflammatory

36
Q

What are side effects of theophylline?

A

CNS: headache, anxiety restlessness

GI: nausea, diarrhea, vomiting, GI reflux

Cardiac: Large overdoses lethal. SVT, VT

Renal: Diuresis

37
Q

What is the dose for theophyllin use?

A

Aminophyllin: is basically 250 mg/10 ml used for acute exacerbations. FDA no longer includes acute bronchospasm as an indication.

38
Q

Inhibitors of mast cell degranulation are:

A

Crosmolyn sodium.

No bronchodialator activity, but is a non-prescription nasal solution for allergic rhinitis

39
Q

Crosmolyn works how?

A

It inhibits mast cell degranulation by inhibiting IgE antibody-antigen induces Ca++ influx. Prevents the release of histamine. Ineffective for use of acute attack.

Nedocromil is more potent thatn Cromolyn sodium.

Used in Asthma for children.

40
Q

Leukotriene Antagonists and Lipoxygenase Inhibitors ae given through which MOA? What are some names? They are not used for —- management.

A

They are given Orally.

Zileuton, Zafitleukast, Monteleukast

Acute

41
Q

Zileuton has significant effect in —— processes.

A

CYP related metabolism

42
Q

Zafirleukast inhibits the activity of ———. What is the alternative name?

A

Cytochrome Isoenzymes CYP3A4 and CYP2C9. Accolate

43
Q

Monteleukast inhibits —– to what extent compared to Zafirleukast?

A

CYP2C9 and CYP3A4 to a much lesser extent

44
Q

Monteleukast inhibits what?

A

They inhibit Leukotriene D4 and CysLT1, found in the human airway. Leukotrienes re released via mast cells and eosinophils.

45
Q

Aspirin irreversibly acetylates

A

Cyclo-oxygenase enyzyme

46
Q

Aspirin induced asthma can be prevented with ?

A

Monteleukast

47
Q

What can Montelukast cause?

A

It can cause vasculitis due to systemic eosinophilia

48
Q

Omalizumab is used for

A

IgE asthma/ allergic asthma , and is a monoclonal antibody that binds to IgE. late phase of allergic response is prevented.

49
Q

Omalizumab is given

A

subcutaneously

50
Q

What does Roflumilast help with?

A

Roflumilast is for treatment of COPD and asthma

Bronchodilator: PDE3 inhibition

Anti-inflammatory: PDE-4 inhibition

51
Q

Magnesium Sulfate is given how, for what?

A

IV, to inhibit smooth muscle contraction

Respiratory Block (12 decks)

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