Asthma and COPD

Question 1

extrinsic asthma

Answer 1

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

Question 2

intrinsic astham

Answer 2

non allergic factors such as dry air, stress, viruses

Question 3

four things in airway hypertrophy

Answer 3

fibrosis
muscle hypertrophy
mucus hypersecretion
angiogenesis

Question 4

bronchodilator drugs

Answer 4

leukotriene modifiers
beta agonists
anticholinergic
methylxanthine

Question 5

anti inflammatory drugs

Answer 5

leukotriene modifiers
corticosteroids
mast cell stabilizers
anti - IgE monoclonal antibodies

Question 6

examples of beta agonists

Answer 6

salbutamol
salmeterol - long acting
terbutaline
albuterol

Question 7

example of methylxanthine

Answer 7

theophylline

Question 8

example of leukotriene modifier

Answer 8

montelukast
zileuton
zafirlukast

Question 9

example of anticholingerics

Answer 9

ipratropium

tiotropium

Question 10

autonomic effects on airway smooth muscle

Answer 10

para muscarinic - contraction, increased secretion

sym adrenergic - dilation

Question 11

how is calcium decreased to cause dilation

Answer 11

increase in camp causes SR to pump out calcium

Question 12

how is calcium increased to cause constriction

Answer 12

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

Question 13

beta agonist moa

Answer 13

increase adenylate cyclase which causes a decrease in calcium so dilation

Question 14

routes of bate agonists

Answer 14

inhlaed
tablet albuterol and terbutaline
sc terbutaline

Question 15

indication of beta agonists

Answer 15

acute attacks

epinephrine or sc for severe attacks

Question 16

what else should beta agonists be administered with and why

Answer 16

corticosteroids to prevent desensitization of teh recepors and improve efficacy

Question 17

adverse effect of beta agonists

Answer 17

tachycardia
muscle tremor
tolerance

Question 18

drug interactions with beta agonists

Answer 18

propranolol

Question 19

mechanism of methylxanthines

Answer 19

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

Question 20

theophylline route

Answer 20

aerosol safest

other have heart and cns effects

Question 21

indication of theophylline

Answer 21

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

Question 22

common side effects of teophylline

Answer 22

headache
tremor
insomnia

Question 23

drug interactions with theophylline

Answer 23

metabolized by cyp enzymes

increased cardiac effects if given with a beta agonist

Question 24

anticholinergics moa

Answer 24

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

Question 25

anticholinergics route of admin

Answer 25

aerosol

Question 26

indications for ipatropium

Answer 26

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

Question 27

why do leukotriene modifiers help with nsaid induced asthma

Answer 27

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

Question 28

zileuton moa

Answer 28

inhibit 5 lipoxygenase

Question 29

zileuton admine

Answer 29

oral 4 times a day

Question 30

indication of zileuton

Answer 30

asa induced asthma severe asthma in adults exercise inducced

Question 31

adverse effects of zileuton

Answer 31

possible hepatotoxicity monitor liver enzymes

Question 32

drug interactions of zileuton

Answer 32

inhibits cyp 450, dont take with theophylline or warfarin

Question 33

zafirlukast and montelukast moa

Answer 33

inhibit cyslt1 receptor | prevents bronchoconstriction, airway wall edema, chemotaxis

Question 34

zafirlukast adverse reactions ad montelukast

Answer 34

headache gi disturbance liver hepatotoxicity - monitor

Question 35

drug interactions of zafirlukast and montelukast

Answer 35

inhibits cyp450

Question 36

mast cell stabilizers

Answer 36

cromolyn sodium | nedocromil

Question 37

anti IgE monoclonal antibody

Answer 37

omalizumab

Question 38

corticosteroid moa

Answer 38

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

Question 39

coticosteroid route of admin

Answer 39

aerosol for moderate asthma and copd | iv or oral for severe cases

Question 40

adverse effects of aerosol glucocorticoids

Answer 40

thrush | hoarseness

Question 41

why take glucocorticoids in the morning

Answer 41

night is when they are normally synthesized endogenously by the body

Question 42

mast cell blockers moa

Answer 42

inhibt release of mediators from mast cells

Question 43

route of admin for mast cell blockers

Answer 43

aerosol 3-4 times a day

Question 44

mast cell blocker indication

Answer 44

mild to moderate asthma in children of all ages | does not inhibit ongoing bronchoconstriction but reduces hypersensitivity

Question 45

side effects of mast cells blockers

Answer 45

throat irriation cough congestion

Question 46

moa of omalizumab

Answer 46

binds to free IgE reducing the amount and preventing binding

Question 47

indication for omalizumab

Answer 47

allergic asthma

Question 48

route of admin for omalizumab

Answer 48

subcutaneous

Question 49

adverse reaction for omalizumab

Answer 49

anaphylaxis

Question 50

mild copd treatment

Answer 50

bronchodilators

Question 51

moderate copd treatment

Answer 51

bronchodilators and anti inflammatory

Question 52

severe copd therapy

Answer 52

bronchodilators anti inflammatory antibiotics oxygen therapy