Asthma and COPD

Question 1

Major MOA of beta-2 agonists

Answer 1

stimulate beta-2 receptors on BSM; elevates cAMP

Question 2

Minor MOA of beta-2 agonists

Answer 2

anti-inflammatory effect, inhibits release of histamine from mast cells

Question 3

Prototype SABA

Answer 3

albuterol

Question 4

Prototype LABA

Answer 4

salmeterol

Question 5

Therapeutic use of SABA

Answer 5

first-line agent taken to releave attacks, onset 1-5 min, durtation 4 hrs
Prevention of exercise induced asthma-taken 10-20 min prior to activity

Question 6

Therapeutic use of LABA

Answer 6

Not for acute attacks, scheduled for prophylaxis
Always in combo with glucocorticoid
Effects last 10-12 hrs

Question 7

Which drug is used for long-acting oral use in children that cannot use an inhabler

Answer 7

albuterol

Question 8

Adverse effects of beta2 agonists

Answer 8

Thachycardia, palpitations and tremor at high/oral doses

When used alone can increase the risk of severe asthma attacks and asthma-related death

Question 9

Methylzanthines prototype

Answer 9

theophylline

Question 10

MOA of theophylline

Answer 10

Analog of caffeine, weak bronchodilator
Non-specific inhibitor of PDE (increase cAMP)
PDE3 inhibiton- bronchodilation
PDE4 inhibition- inflammation

Question 11

therapeutic use of theopylline

Answer 11

alternative to LABAs with ICS, lower efficacy, longer duration of action
patients who cannot take inhaled medications if montelukast is ineffective
IV for emergencies if patients fail to respond to SABAs

Question 12

Adverse effects of theopylline

Answer 12

High- nausea, nervousness, anxiety, headache, insomnia

Toxic- sever dysrhythmias and seizures

Question 13

Drug interactions with theopylline

Answer 13

metabolized by CYPs

Question 14

Anticholinergic agent prototype

Answer 14

ipratropium

Question 15

MOA of ipratropium

Answer 15

atropine like quaternary ammonium, blocks M3 receptors to attenuate vagal-stimulated bronchoconstriction, slower onset and less intense than beta agonists

Question 16

Therapeutic uses of ipratropium

Answer 16

approved only for COPD; more efficacious than beta agonists

Can be given with beta agonists or alone

Question 17

adverse effects of ipratropium

Answer 17

limited due to poor absorption

dry mouth and pharyngeal irritation

Question 18

Inhaled corticosteroids (ICS) prototype

Answer 18

fluticasone

Question 19

MOA of ICS

Answer 19

bind GC receptors, anti-inflammatory effects

Question 20

Therapeutic use of ICS

Answer 20

first-line therapy for chronic asthma prophylaxis; inhalation dosing on a fixed schedule in combination with beta 2 agonists

Question 21

Standard ICS, LABA combo

Answer 21

salmeterol and fluticasone

Question 22

Therapeutic use of prednisone

Answer 22

reserved for severe, unresponsive asthma

Question 23

Adverse effects of ICS

Answer 23

oropharyngeal candidiasis and dysphonia
prolonged- adrenal insufficiency, osteoperosis, hypertension, immune suppression, cataracts, glaucoma
Use cautiously in young children

Question 24

Prototype mast cell stabilizer

Answer 24

cromolyn

Question 25

MOA of cromolyn

Answer 25

prevents release of histamine

Question 26

Therapeutic use of cromolyn

Answer 26

inhalation on fixed schedule of prophylaxis

Question 27

Leukotriene modifier prototypes

Answer 27

LTD4- montelukast

Leukotriene synthesis inhibitor zileuton

Question 28

Therapeutic use of leuckotiene modifiers

Answer 28

alternative and add-on therapy

Question 29

IgE antagonist prototype

Answer 29

omalizumab

Question 30

MOA of omalizumab

Answer 30

binds to

Question 31

Therapeutic use of omalizumab

Answer 31

allergy related asthma