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respi pharm > asthma > Flashcards

asthma Flashcards

1
Q

What are the first line drugs for asthma? (for bronchodilation)

A

Fast-acting B2 agonists SABA (Reliever)
Long-acting B2 agonists LABA (Controller)

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2
Q

What is the first line anti-inflammatory drug?

A

Glucocorticoid (Corticosteroids)

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3
Q

What is the MOA of B2-adrenoceptor agonists?

A

It promotes airway smooth muscle relaxation, mast cell stabilization which decrease microvascular leakiness and increase mucociliary clearance.

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4
Q

Name one SABA

A

Salbutamol

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5
Q

Name one LABA

A

Salmeterol/Formoterol

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6
Q

In the treatment of Asthma, Salbutamol is used as a ____ as it is fast/slow acting while _____ is used as a controller as it is fast/slow acting.

A

In the treatment of Asthma, Salbutamol is used as a reliever as it is **fast-acting **while Salmeterol is used as a controller as it is slow-acting.

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7
Q

What is one bronchodilator that can be used as both a reliever and controller?

A

Formoterol

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8
Q

What is the duration of action for Formoterol as a fast-acting agent?

A

2-3min

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9
Q

What is one medication used IV/SC in an emergency as a bronchodilator?

A

Adrenaline

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10
Q

What are the side effects of B2-adrenoceptor agonists?

A

Tremor
Muscle Cramps
Peripheral vasodilation
Palpitations & tachycardia
Hypokalaemia & hyperglycaemia
B2 adrenoreceptors tolerance

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11
Q

Why should LABA not be prescribed alone for asthma?

A

LABAs downregulate B2-adrenoreceptor expression hence increasing the risk of asthma-related death as responsiveness to B2-adrenoreceptor agonism decreases

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12
Q

What medication should LABA always be used with?

A

Inhaled corticosteroid

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13
Q

When is SAMA / LAMA used for the treatment of Asthma?

A

When patient is intolerant of B2 agonists and to prevent bronchoconstriction

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14
Q

What is the MOA of Muscarinic Receptor Antagonists?

A

It inhibits M3 receptor-Mediated bronchoconstrictions and reverses vagal nerve Mediated bronchospasm and Mucus secretion.

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15
Q

What are the adverse effects of muscarinic receptor antagonists?

A

Dry Mouth
Urinary retention

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16
Q

Name one SAMA and one LAMA

A

SAMA: Ipratropium
LAMA: Tiotropium Bromide

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17
Q

What are some examples of Methylxanthines?

A

Theophylline
Aminophylline (Theophylline + Ethylenediamine 2:1)

both can be administered via oral/IV

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18
Q

what is the MOA of methyxanthines

A

inhibits PDEs and blocks adenosine receptors

NOT a clinical anti-inflammatory but has effects

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19
Q

Name one bronchodilator which can be used via the rectal route?

A

Aminophylline

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20
Q

What are the adverse effects of Methylxanthines?

A

GIT, CNS, CVS effects
(CNS - tremor/anxiety
CVS - arrhythmias)

have to consider pt caffeine intake!!!!

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21
Q

What is the adjunct treatment of severe acute asthma?

A

Magnesium Sulphate

IV or Neb

22
Q

Name 3 examples of inhaled corticosteroids that are commonly used for the treatment of Asthma

A

Budesonide
Fluticasone
Ciclesonide

23
Q

Which corticosteroid is associated with greater risk of adrenal suppression?

A

Fluticasone

24
Q

what are the effects of corticosteroids

A

reduce pro inflammatory mediators
increase anti-inflammatory mediators

25
Q

What is the MOA of corticosteroid?

A

It decreases airway hyper-responsiveness in 4 to 6 weeks, decreases frequency of acute asthma exacerbations, possibly prevent airway wall remodelling, reduce need for B2 agonist and reduce risk of death from asthma.

26
Q

What is corticosteroid indicated for?

A

First line prophylactic for asthma treatment
Nocturnal asthma

27
Q

What are the adverse effects of corticosteroids?

A

Cough
Oropharyngeal candidiasis
Dysphonia
(below are esp common in elderly)
Easy bruising
Osteoporosis
Posterior subcapsular cataracts

28
Q

What are leukotriene pathway inhibitors indicated for?

A

Prophylaxis and chronic treatment of asthma
Exercise / Aspirin-induced / NSAID exacerbated asthma

29
Q

What are the 2 leukotriene pathway inhibitor?

A

Montelukast (Cysteinyl-leukotrine receptor antagonist)
Zileuton (5-Lipoxygenase Inhibitor)

30
Q

How can leukotriene pathway inhibitors be administered

A

Oral only

31
Q

What syndrome is leukotriene pathway inhibitors associated with?

A

Churg-Straus Syndrome
Likely due to concomitant glucocorticoid withdrawal

32
Q

what are CysLT (Cysteinyl-Leukotriene) Receptors also known as

A

weak bronchodilators, mainly prevent bronchoconstriction pathway

33
Q

Montelukast can be used as adjunct for ____ to ____ asthma

A

Mild to moderate asthma(but cannot be used alone as reliver, is a weak bronchodialator at clinical dose)

34
Q

What medication is effective in aspirin-sensitive asthma and exercise-induced asthma?

A

Montelukast

35
Q

What group of drug does Cromoglicic acid belong to?

A

Mast Cell stabiliser

36
Q

what is the MOA of cromoglicic acid (cromolyn)?

A

decreeases mast cell degranulation and inflammatory mediators secretion

37
Q

What is cromoglicic acid indicated for in the treatment of asthma?

A

Prophylactic control of asthma
Prophylactic control of allergic rhinitis, allergic conjunctivitis and vernal keratoconjunctivitis

38
Q

Cromoglicic acid should be taken _____ before antigen-challenge or exercise to prevent bronchospasm

A

Single dose

39
Q

What are the adverse effect of cromoglicic acid?

A

Throat and nasal irritation
Mouth dryness
Cough
Unpleasant taste

40
Q

Omalizumab is a _____ monoclonal antibody

A

Anti-IgE

41
Q

In what cases of asthma is Omalizumab used?

A

Severe asthmatics with allergies and an elevated IgE level

42
Q

How often is Omalizumab given?

A

Subcutaneous injection every 2 to 4 weeks

43
Q

Omalizumab _____ levels of free ____ in serum and decreases FcER expression on _____.

A

Omalizumab depletes levels of free IgE in serum and decreases FcER expression on mast cells.

44
Q

What are some limitations or adverse effects of Omalizumab?

A

Expensive
Associated with small increase in risk of heart attack, transient ischemic attack and blood clot.

45
Q

What is one medication used for eosinophilic asthma?

A

Reslizumab

46
Q

what type of antibody is reslizumab

A

Anti- IL-5/IL-4

47
Q

Can a 10 year old patient with eosinophilic asthma be prescribed Reslizumab?

A

No. Reslizumab only approved for severe, persistent eosinophilic asthma in patient >18 years old.

48
Q

How often should Reslizumab be given?

A

IV once every 4 weeks

49
Q

What is one common adverse effect of reslizumab?

A

Oropharyngeal pain

50
Q

Seretide is the combination of ____ and _____

A

Salmeterol (LABA) + Fluticasone (Corticosteroid)

51
Q

Symbicort is the combination of ____ and _____

A

Formoterol (Fast acting LABA) + Budesonide (Corticosteroid)

respi pharm (4 decks)

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