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pharm III exam 2 > asthma and COPD > Flashcards

asthma and COPD Flashcards

1
Q

Isoproterenol (Isuprel®)

A

B- Adrenergic Agonists

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2
Q

MOA Albuterol (Ventolin®; Proventil®)

A
  • Selective B2 agonists
  • Short Acting
    • ​rescue
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3
Q

MOA of Ipratropium (Atrovent®)

A

Muscarinic antagonist : Bronchodilator

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4
Q

MOA Theophylline (Theo-Dur®)

A
  • increases cAMP - Phosphodiesterase inhibitor
  • blocks adenosine receptor
  • effect: relaxes smooth muscle, stimulates CNS and heart
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5
Q

Fluticasone (Flovent®)

A

inhaled corticosteroid

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6
Q

Montelukast (Singulair®)

A

Leukotriene Inhibitors

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7
Q

MOA of Salmeterol (Serevent®)? use

A
  • long acting B2 agonist
  • prevention and prophylaxis
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8
Q

Formoterol/mometasone (Dulera)

A

long acting bronchodilators

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9
Q

MOA of Omalizumab (Xolair)

A
  • monoclonal antibody to IgE
    • prevents binding of IgE to cells associated with allergic response
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10
Q

list treatment strategies for asthma

A
  • dilate airways
  • decrease inflammation
  • prevention
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11
Q

bronchioles are constricted by and relaxed by receptors

A
  • contstricted: cholinergic innervation
  • relaxed: beta- 2 receptors
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12
Q

typical symptoms of asthma

A
  • wheeze (not all asthmatics wheeze)
  • tightness, burning feeling, SOB
  • mucous
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13
Q

MOA of Theophylline (Theo-Dur®)

A
  • inhibits PDE which breaks down cAMP
    • cAMP needed for bronchodilation
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14
Q

what is going on to the airways in COPD

A
  • chronic bronchitis
  • cilia immobilized- particles not kept out -> susceptible to infection
  • airways narrowed
  • increased mucous -> chronic cough
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15
Q

what is going on to the airways in emphysema

A
  • walls of alveoli break down
  • less surface area available for transfer of gas
  • fibrosis, loss of elasticity
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16
Q

what are the most widely used treatment for asthma? MOA?

A
  • B2 selective receptor agonists
    • increase cAMP -> relax airway smooth muscle and inhibit histamine release
17
Q

B2 selective receptor agonists take how long to have an effect? effects generally last?

A
  • act immediately
  • generally last 4-6 hours
18
Q

Salmeterol should always be combined with what

A
  • a steroid
    • Salmeterol/fluticasone (Advair)
    • to help reduce tolerance
19
Q

effect of Salmeterol/fluticasone takes

A
  • 20-30 min
20
Q

side effects of short acting B2 agonists

A
  • tachycardia
  • nervousness
  • dizziness
  • tremor
21
Q

route of administration of Ipratropium (Atrovent®)? when is it used

A
  • inhaled
  • useful for patients intolerant of B2 agonists
  • first line: COPD
22
Q

Ipratropium (Atrovent®) is often combined with

A
  • albuterol -> combivent
23
Q

when is Theophylline (Theo-Dur®) used

A
  • for asthma or COPD not controlled by B agonists or muscarinic antagonists
  • generally long acting form used
24
Q

therapeutic index of Theophylline (Theo-Dur®)

A
  • low
    • blood level important
    • may differ with generics
25
Q

side effects of Theophylline (Theo-Dur®)

A
  • tachycardia, arrhythmias
  • seizures
26
Q

List the three anti-inflammatory drug classes

A
  • corticosteroids
  • leukotriene inhibitors
  • Cromolyn sodium
27
Q

Effects of inhaled corticosteoids

A
  • decrease inflammation
  • reduce bronchial reactivity
  • improve response to B agonists
28
Q

when do inhaled corticosteroids come into tx of asthma

A
  • first line of treatment
  • combined with SABA, before a LABA is brought on board
29
Q

side effects of inhaled corticosteriods

A
  • oral candidiasis (thrush)
  • hoarseness
30
Q

when is Omalizumab (Xolair) used

A
  • moderate to severe allergic asthma
31
Q

side effects of Omalizumab (Xolair)

A
  • rash
  • injection site reaction
  • small decrease in platelets
32
Q

when are the “Lukast”s like Montelukast used

A
  • usually given as add on if corticosteroids aren’t enough
  • no effect on attack in progress
33
Q

MOA of Zileuton (Zyflo®)

A

Leukotriene Inhibitors

34
Q

unique use of Zileuton (Zyflo®)

A

may decrease aspirin sensitive asthma

35
Q

List the asthma step therapy

A
  1. short acting beta agonist: as needed
  2. inhaled corticosteroid
    • or Cromolyn sodium
    • or leukotriene inhibitor
  3. long acting beta agonist or bronchodilator
  4. add oral steroid when needed
36
Q

MOA of Cromolyn sodium

A
  • inhibits release of histamine from mast cells- not a bronchodilator
  • used mainly in children
  • taken 4 x /day for prevention
37
Q

first line drug for COPD

A

Ipratropium (atrovent): muscarinic antagonist

pharm III exam 2 (10 decks)

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