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Pharm > Asthma > Flashcards

Asthma Flashcards

1
Q

Asthma Tx Strategies (2)

A
  • Dilate airways
  • Decrease inflammation
  • Prevention
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2
Q

Bronchioles are constricted by _____

A
  • Cholinergic innervation
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3
Q

Bronchioles are relaxed by _____

A
  • Beta 2 receptors
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4
Q

Used to dx asthma

A

Methacholine Challenge

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5
Q

B agonists MOA

A
  • B2 receptors relax airway and inhibit histamine release
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6
Q

B agonist Admin

A
  • Inhaled/aerosol
  • Oral
  • Injected in emergency
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7
Q

Selective B agonists- SABA, LABA

A

SABAs: Albuterol, Levalbuterol, Pirbuterol
LABAs: Salmeterol, Formoterol

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8
Q

SABA t 1/2 and Admin

A

4 - 6 hrs

  • Act IMMEDIATELY (stops attack in progress)
  • Usually inhaled
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9
Q

LABA Tx (2)

A
  • Prevention and prophylaxis asthma

- Decrease nocturnal asthma

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10
Q

LABA t 1/2

A
  • Effect takes 20-30 min
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11
Q

LABA should always be combined with _____

A

Steroid (Advair)

- to prevent down regulation and increase sensitivity

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12
Q

B2 agonist SE (4)

A
  • Tachycardia
  • Nervousness
  • Dizziness
  • Tremor (more with oral)
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13
Q

Bronchodilators (3)

A
  • Ipratropium
  • Tiotropium
  • Theophylline
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14
Q

Ipatropium MOA

A
  • Muscarinic Antagonist
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15
Q

Ipatropium Admin

A
  • Inhaled, poorly soluble, not absorbed
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16
Q

Ipatropium Tx

A
  • COPD
  • Useful for pts intolerant to B2 agonists
    (often combined with albuterol)
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17
Q

Theophyline MOA (3)

A
  • Increases cAMP phosphodiesterase inhibitor
  • Blocks adenosine receptor
  • Relaxes smooth muscle, stimulates CNS and heart
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18
Q

Theophyline Tx

A
  • Asthma not controlled by B agonists
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19
Q

Theophyline SE (5)

A
  • CNS: nervousness, insomnia, anxiety, tremor
  • Cardiac: tachy, arrhythmias
  • Muscle: decreases diaphragm fatigue, increases contraction
  • Weak diuretic
  • OD: palpitations, HA, N/V, seizures –> Low therapeutic index (blood level important)
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20
Q

Anti-inflammatory Drugs (3)

A
  • Corticosteroids
  • Leukotriene Inhibitors
  • Cromolyn sodium
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21
Q

Anti-inflammatory Drugs (3)

A
  • Corticosteroids
  • Leukotriene Inhibitors
  • Cromolyn sodium
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22
Q

Corticosteroids MOA (3)

A
  • Decrease inflammation
  • Reduce bronchial reactivity
  • Improve response to B agonists
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23
Q

Corticosteroid Tx

A
  • First line asthma (inhaled corticosteroids)

- Use orally in severe asthma or exacerbation

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24
Q

Corticosteroid SE (2)

A
  • Thrush

- Hoarseness

25
Q

Leukotriene Inhibitors (4)

A
  • Zileuton
  • Zafirlukast
  • Montelukast
  • Pranlukast
26
Q

Zileuton MOA

A
  • Inhibits 5-lipoxygenase
27
Q

Pranlukast MOA

A
  • Leukotriene receptor antagonist
28
Q

Leukotriene Inhibitors Tx

A
  • No effect on attack in progress
  • May allow decreased steroid dose
  • May decrease aspirin-sensitive asthma
29
Q

Leukotriene Inhibitors SE (3)

A
  • URI, sore throat, HA
  • Abd pain
  • Sleepiness
30
Q

May cause psychiatric symptoms

A
  • Montelukast
31
Q

Cromolyn sodium, Nedcromil MOA

A
  • Inhibits release of histamine from mast cells (NOT a bronchodilator)
32
Q

Cromolyn sodium, Nedcromil Tx

A
  • Mostly in children

- Prevention

33
Q

Cromolyn sodium, Nedcromil Admin

A
  • 4x/day, chronically
  • Nasal OTC
  • Tastes bad
34
Q

Omalizumab MOA (3)

A
  • Monoclonal antibody to IgE’s high affinity Fc receptor
  • Prevents binding of IgE to cells associated with allergic response
  • Lowers free IgE
35
Q

Omalizumab Tx

A
  • Mod - severe allergic asthma
36
Q

H1 Histamine Receptor Found in (3) and acts through ____

A
  • Smooth muscle, Endothelium, Brain
  • Gq
  • Allergic response
37
Q

H2 Histamine Receptor Found in (3) and acts through

A
  • Heart, brain, mast cells
  • Gs coupled –> increase cAMP
  • Gastric acid secretion
38
Q

Effects of Histamine on Cardiovascular system (3)

A
  • Vasodilation: H1 increases NO from endothelium; H2 receptor direct vasodilation
  • Decrease BP, tachycardia
  • Increase cap permeability –> edema and swelling
39
Q

Effects of Histamine on Smooth muscle

A
  • Bronchospasm (H1) - problematic asthmatics
40
Q

Effects of Histamine on GI

A
  • Increased gastric acid secretion (H2)
41
Q

Effects of Histamine on GI

A
  • Increased gastric acid secretion (H2)
42
Q

Effects of Histamine on Skin

A
  • Itch, pain, welt, sensory nerve stimulation
43
Q

Triple Response

A
  • Localized red spot, vasodilation
  • Flush or flare, axon reflexes
  • Wheel in 2-3 min, increased cap perm
44
Q

Effects of Antihistamines (6)

A
  • Inhibit smooth muscle response
  • Inhibit vasodilation due to H1
  • Inhibit flare and itch, wheal
  • Inhibit salivary, lacrimal secretion
  • CNS depression, stimulation
  • Counter motor sickness
45
Q

H1 Antagonists Sedating (4)

A
  • Diphenhydramine (Benadryl)
  • Hydroxyzine
  • Dimenhydrinate (Dramamine)
  • Promethazine
46
Q

2nd Gen H1 Antagonists (6)

A
  • Loratidine
  • Desloratidine
  • Levocetirizine
  • Certirizine
  • Acrivistine
  • Fexofenadine
47
Q

Motion Sickness H1 antagonists (2)

A
  • Diphenhydramine

- Dimenhydrinate

48
Q

Antiemetic/motion sickness H1 antagonist

A
  • Promethazine
49
Q

2nd Gen H1 Antagonist Features (3)

A
  • Do not enter brain well so less sedation
  • Do not have anticholinergic effects
  • Not useful for motion sickness
50
Q

H1 antagonists excreted directly by kidney

A
  • Cetirizine
  • Acrivastine
  • Levocetirizine
51
Q

H1 antagonist Tx

A
  • Allergic rhinitis (prophylactic)
  • Seasonal itching/conjunctivitis
  • Itching and hives
  • Motion sickness 1st gen (prophylactic)
  • Sedation 1st gen
  • Dry up secretion 1st gen
52
Q

1st Gen H1 antagonist SE (7)

A
  • SEDATION
  • Anticholinergic
  • CNSL dizziness, blurred vz, excitement, restlessness, insomnia
  • GI: N, anorexia, increased app
  • Possibly teratogenic
  • Allergic rxn - topical
  • DECREASE SEIZURE TRESHOLD
53
Q

Interactions with 1st Gen

A
  • CNS depressants
54
Q

Interactions with 2nd Gen

A
  • Erythromycin, ketoconazole
  • Grape fruit juice
  • Cimetidine (inhibit their metabolism)
55
Q

1st Gen OD

A
  • Similar to atropine poisoning

- Sedation

56
Q

2nd Gen OD

A
  • Cardiac arrhythmias

- Sinus tachy

57
Q

2nd Gen OD

A
  • Cardiac arrhythmias

- Sinus tachy

58
Q

Histamine Release Inhibitors (3)

A
  • Cromolyn
  • Azelastine
  • Cetirizine

Pharm (10 decks)

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