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Pharmacology part B > Asthma and COPD > Flashcards

Asthma and COPD Flashcards

1
Q

extrinsic asthma

A

external stimuli trigger IgE antibody formation causing mast cell degranulation and inflammation

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2
Q

intrinsic astham

A

non allergic factors such as dry air, stress, viruses

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3
Q

four things in airway hypertrophy

A

fibrosis
muscle hypertrophy
mucus hypersecretion
angiogenesis

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4
Q

bronchodilator drugs

A

leukotriene modifiers
beta agonists
anticholinergic
methylxanthine

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5
Q

anti inflammatory drugs

A

leukotriene modifiers
corticosteroids
mast cell stabilizers
anti - IgE monoclonal antibodies

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6
Q

examples of beta agonists

A

salbutamol
salmeterol - long acting
terbutaline
albuterol

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7
Q

example of methylxanthine

A

theophylline

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8
Q

example of leukotriene modifier

A

montelukast
zileuton
zafirlukast

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9
Q

example of anticholingerics

A

ipratropium

tiotropium

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10
Q

autonomic effects on airway smooth muscle

A

para muscarinic - contraction, increased secretion

sym adrenergic - dilation

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11
Q

how is calcium decreased to cause dilation

A

increase in camp causes SR to pump out calcium

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12
Q

how is calcium increased to cause constriction

A

ach binds to GPCR which activates PLC and cause release of IP3 and DAG
adenosine also activates PLC

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13
Q

beta agonist moa

A

increase adenylate cyclase which causes a decrease in calcium so dilation

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14
Q

routes of bate agonists

A

inhlaed
tablet albuterol and terbutaline
sc terbutaline

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15
Q

indication of beta agonists

A

acute attacks

epinephrine or sc for severe attacks

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16
Q

what else should beta agonists be administered with and why

A

corticosteroids to prevent desensitization of teh recepors and improve efficacy

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17
Q

adverse effect of beta agonists

A

tachycardia
muscle tremor
tolerance

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18
Q

drug interactions with beta agonists

A

propranolol

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19
Q

mechanism of methylxanthines

A

inhibit adenosine receptors
inhibit phosphodiesterase resulting in an increase in camp
stimulate contractility of diaprahgm muscles

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20
Q

theophylline route

A

aerosol safest

other have heart and cns effects

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21
Q

indication of theophylline

A

second choice for acute exacerbations
copd
must be monitored due to narrow TI

22
Q

common side effects of teophylline

A

headache
tremor
insomnia

23
Q

drug interactions with theophylline

A

metabolized by cyp enzymes

increased cardiac effects if given with a beta agonist

24
Q

anticholinergics moa

A

block muscarinic receptors resulting in decreased mucus secretion and bronchoconstrition
no effect on inflammation

25
Q

anticholinergics route of admin

A

aerosol

26
Q

indications for ipatropium

A

copd
asthma if intolerant to beta agonists
chronic bronchitis
can be used in combo with beta agonists

27
Q

why do leukotriene modifiers help with nsaid induced asthma

A

nsaids inhibit cox enzymes so increase in leukotriene synthesis. block lipoxygenase to prevent the leukotriene synthesis

28
Q

zileuton moa

A

inhibit 5 lipoxygenase

29
Q

zileuton admine

A

oral 4 times a day

30
Q

indication of zileuton

A

asa induced asthma
severe asthma in adults
exercise inducced

31
Q

adverse effects of zileuton

A

possible hepatotoxicity monitor liver enzymes

32
Q

drug interactions of zileuton

A

inhibits cyp 450, dont take with theophylline or warfarin

33
Q

zafirlukast and montelukast moa

A

inhibit cyslt1 receptor

prevents bronchoconstriction, airway wall edema, chemotaxis

34
Q

zafirlukast adverse reactions ad montelukast

A

headache
gi disturbance
liver hepatotoxicity - monitor

35
Q

drug interactions of zafirlukast and montelukast

A

inhibits cyp450

36
Q

mast cell stabilizers

A

cromolyn sodium

nedocromil

37
Q

anti IgE monoclonal antibody

A

omalizumab

38
Q

corticosteroid moa

A

blocks release of arachidonic acid
increase sensitivity of beta adrenergic receptos
prevents airway remodelling

39
Q

coticosteroid route of admin

A

aerosol for moderate asthma and copd

iv or oral for severe cases

40
Q

adverse effects of aerosol glucocorticoids

A

thrush

hoarseness

41
Q

why take glucocorticoids in the morning

A

night is when they are normally synthesized endogenously by the body

42
Q

mast cell blockers moa

A

inhibt release of mediators from mast cells

43
Q

route of admin for mast cell blockers

A

aerosol 3-4 times a day

44
Q

mast cell blocker indication

A

mild to moderate asthma in children of all ages

does not inhibit ongoing bronchoconstriction but reduces hypersensitivity

45
Q

side effects of mast cells blockers

A

throat irriation
cough
congestion

46
Q

moa of omalizumab

A

binds to free IgE reducing the amount and preventing binding

47
Q

indication for omalizumab

A

allergic asthma

48
Q

route of admin for omalizumab

A

subcutaneous

49
Q

adverse reaction for omalizumab

A

anaphylaxis

50
Q

mild copd treatment

A

bronchodilators

51
Q

moderate copd treatment

A

bronchodilators and anti inflammatory

52
Q

severe copd therapy

A

bronchodilators
anti inflammatory
antibiotics
oxygen therapy

Pharmacology part B (17 decks)

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