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Pharm Exam 4 > Asthma > Flashcards

Asthma Flashcards

1
Q

What is the definition of asthma

A

Inflammation of airway
Bronchospasms
Thickened mucous secretions
Edema

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2
Q

What is the primary response of the airway to an insult

A

Tracheal receptor activation - cough reflex

Increase in amount and stickiness of mucous produced

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3
Q

What is the secondary response of the airway to an insult

A

Prolonged irritation - immune system is activated

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4
Q

What is the result of an activated immune system

A

Release of mediators from mast cells
Bronchoconstriction and edema
Migration of immune cells to the lung
Airway inflammation

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5
Q

What kind of agents are the initial drugs of choice for short term relief of asthma

A

Bronchodilators

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6
Q

Mode of admission of B2 agonists

A

Orally, inhalation or injection

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7
Q

What are the 2 least selective B2 receptor agonists

A

Epinephrine and isoproterenol

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8
Q

Epinephrine mode of admission, mechanism of action and effects

A

Inhalation or injection
Activate all adrenergic receptors - not specific
Increase HR, vasoconstriction -> very high BP

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9
Q

Isoproterenol

A

More specific B2 agonist

Short half life

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10
Q

5 relatively more selective B2 agonists

A 
Albuterol
Pirbuterol
Bitolterol
Levalbuterol
Terbutaline
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11
Q

More selective B2 agonists characteristics

A

6 hour half lives
All can be inhaled - few systemic effects
Very rapid - lower dose

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12
Q

What causes down regulation of more selective B2 agonists

A

Any agent that acts by activating a receptor

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13
Q

4 longer acting B2 agonists

A

Formoterol
Arformoterol
Salmoterol
Indicaterol

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14
Q

Disadvantages of longer acting B2 agonists

A

Not as effective for rapid relief

More liklihood of down regulation

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15
Q

Side effects of all B2 agonists

A

Tremor, tackycardia, palpitations of heart -B1 effect

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16
Q

2 Cholinergic blockers

A

Ipratropium

Tiotropium

17
Q

What are cholinergic blockers analogs of

A

Atropine

18
Q

Cholinergic blocker side effects

A

Antimuscarinic effects - opposite DUMBBELS

CNS: psychosis

19
Q

Cholinergic blocker characteristics

A

Given as aerosol - not absorbed - few systemic effects
Slow onset of action
Used more for COPD
Careful with urinary retention and glaucoma

20
Q

Theophylline mechanism of action

A

Inhibits cAMP PDE - elevates cellular cAMP

21
Q

Theophylline characteristics

A

Given orally or IV
A methylxanthine like caffeine
Low TI

22
Q

Theophylline side effects

A

Cardiac stimulation - arrhythmias
CNS stimulation - tremors, insomnia, seizures
GI upset

23
Q

2 anti inflammatory agents

A

Cromolyn sodium

Nedocromil

24
Q

Anti inflammatory agent mechanism of action

A

Inhibit mast cells and their release of mediators

Inhibit Cl- channels and decrease Ca uptake necessary for secretion

25
Q

Anti inflammatory mode of administration

A

Inhalation - not readily absorbed - few system side effects

26
Q

What agents are the drugs of choice for prophylaxis

A

Glucocorticoids

27
Q

5 inhaled glucocorticoids

A 
Beclomethasone
Budesonide
Fluticasone
Mometasone
Ciclesonide
28
Q

2 glucocorticoids not inhaled

A

Prednisone

Dexamthasone

29
Q

Metabolism for inhaled glucocorticoids

A

1st pass metabolism

30
Q

Mechanism of glucocorticoids

A

Bind to intracellular receptor -> alter DNA transcription

Increase lipocortin - inhibits phospholipase A2

31
Q

Glucocorticoid side effects

A

Inhibitors of immune response - infections, disphonia, systemic effects

32
Q

What mouth infection is associated with glucocorticoid side effect

A

Thrush

33
Q

Omalizumab

A

Anti IgE antibody - blocks Ig receptor

Only given by injection

34
Q

Zileuton

A

Inhibits enzyme 5-lipoxygenase - synthesized leukotrienes

Increases liver enzymes

35
Q

2 leukotriene receptor blockers

A

Zafirlukast

Montelukast

36
Q

Leukotriene receptor blocker characteristics

A

Competitive antagonists

Useful for those who can’t use steroids and exercise-induced asthma

Pharm Exam 4 (4 decks)

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