Asthma Flashcards
What are the short acting B2 agonists?
Alburterol, terbutaline, metoproterenol, pirbutol and levalbuterol.
Other than asthma, what can the short acting B2 agonists treat?
Hyperkalemia and prophylaxis for exercise-induced bronchospasm.
What is the R isomer of albuterol?
Levalbuterol.
What are the long acting beta 2 agonists?
Salmeterol, formoterol and indacaterol.
Of the long-acting beta 2 agonists, which is only used for COPD?
Indacaterol. It is ultra long lasting.
What are the three antimuscarinic agents? Which has the most and least side effects?
Atropine (most side effects), Ipratropium bromide, Tiotropium (least).
What is a newer antimuscarinic agent that has an extremely short half life?
Aclidinium bromide. Higher doses can be given safely.
What is the first line treatment of chronic stable COPD?
Tiotropium
What are tiotropium’s uses?
Chronic stable COPD, chronic asthma, anti-inflammatory, increased mucus production and mucociliary clearance.
What drug selectively inhibits PDE4? What is it used for?
Roflumilast. It’s an anti-inflammatory agent that is used for COPD.
What are the three methyxanthines? What is their mechanism?
Theophylline, theobromine, caffein. They are non-specific phosphodiesterase inhibitors.
What are the methyxanthines used for?
- Improve contractility and reverse diaphragm fatigue in COPD
- Anti-inflammatory
- Restores corticosteroid sensitivity.
WARNING: low therapeutic window
What are leukotriene inhibitors used for? What are they NOT used for?
- Used: drug of choice for aspirin induced asthma, add on therapy in mild asthma, prophylaxis for exercise-induced bronchospasm
- NOT used: COPD
What are the side-effects of leukotriene inhibitors?
Liver toxic (zileuton), coincidental Churg Strauss syndrome association.
What do sodium cromoglycate and nedocromil sodium do?
They prevent mast cell degranulation and mediator release from macrophages and eosinophils. They’re used as an alternative treatment for mild persistent asthma and prophylaxis to allergens.
