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Respiratory Medicine > Asthma And COPD Pharm 2: ICS, Luekotriene, And Monoclonals > Flashcards

Asthma And COPD Pharm 2: ICS, Luekotriene, And Monoclonals Flashcards

1
Q

What are the most effective anti inflammatory agents used in asthma therapy?

A

ICS

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2
Q

What are the 3 Anti inflammatory effects of ICS for asthma patients?

A

Reduce eosinophils, T cells and mast cells.

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3
Q

What is the MOA for ICS for asthma? 3 things.

A

Switch off transcription of inflammatory cells and turn on anti inflammatory cells and increase expression of b2 receptors.

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4
Q

What are the indications for beclomethasone?

A

Maintenance treatment for asthma of 5 years of age and older.

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5
Q

What is a caution/warning for using beclomethasone?

A

Be careful transitioning someone from systemic corticosteroids to oral because of adrenal insufficiency.

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6
Q

What is budesonide indicated for?

A

Maintenance treatment of asthma 6 years and older.

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7
Q

What is the main route of metabolism for budesonide?

A

Cyp p450 3a4

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8
Q

What is the indication for ciclesonide?

A

Maintenance treatment of asthma for 12 years of age and older

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9
Q

What is a caution or warning for ccilesonide?

A

Don’t use in the presence of Candida albicans, TB or really any other infection.

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10
Q

Main indication for flunisolide?

A

Maintenance treatment of asthma of 6 years of age and older.

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11
Q

Main indication for fluticasone?

A

Maintenance treatment for asthma of 4 years of age and older.

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12
Q

What drug interaction is a no no with fluticasone?

A

Don’t use with cyp 3a4 inhibitors like ritonavir or ketoconazole.

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13
Q

What is the caution/warning for fluticasone?

A

At risk for Candida albicans infection.

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14
Q

What is the indication for mometasone?

A

Maintenance treatment for asthma of 4 years of age and older.

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15
Q

What is the clinical indication for triamcinolone?

A

Maintenance treatment of asthma.

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16
Q

Caution/Warning for use of triamcinolone?

A

Carefully watch if you use this medicine to transition an asthma patient from systemic corticosteroids to this ICSs.

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17
Q

What are three drug combos that can be used for maintenance of asthma? ICS + LABA.

A

Fluticasone and Salmeterol
Mometasone and formoterol
Budesonide and formoterol

18
Q

How and why do we use oral corticosteroids?

A

We use them in conjunction with a short acting beta agonist to treat moderate to severe asthma flare ups.

19
Q

What is prednisone indicated for?

A

Anti inflammatory or immunosuppressant for allergic asthma

20
Q

What is the caution/warning for prednisone?

A

Monitor for Cushing syndrome and hyperglycemia. Make sure to taper off.

21
Q

What is the MOA for leukotriene antagonists?

A

Bind to the CycLT receptor and block its activation which blocks all the inflammatory mess they can cause

22
Q

What is the MOA of Montelukast?

A

Oral compound that binds and selectively inhibits CysLT1 and also blocks the action of LTD4.

23
Q

What is a big time action that is being blocked when we block LTD4?

A

Bronchoconstriction.

24
Q

What is the indication for montelukast?

A

Treat allergies and prevent asthma attacks.

25
Q

What is montelukast not indicated for which means what?

A

Not indicated for acute attacks so have a beta 2 agonist on hand.

26
Q

What is the MOA for zafirlukast?

A

Block D4 and E4, so blocking bronchoconstriction

27
Q

What is the clinical indication for zafirlukast?

A

Treatment for chronic asthma.

28
Q

What is the drug interaction we need to remember for zafirlukast?

A

Got to monitor PTT with patients on warfarin.

29
Q

What is a warning/caution for zafirlukast?

A

Life threatening liver failure.

30
Q

What is the MOA for zileuton?

A

Blocks 5 lipoxygenase which inhibits all luekotriene formation

31
Q

Clinical indication for zileuton?

A

Treatment for chronic asthma

32
Q

What is the drug interaction we need to be aware of with zileuton?

A

PTT levels need to be monitored because of interaction with warfarin.

33
Q

Caution/warning for the use of zileuton?

A

Don’t use in patients with liver problems.

34
Q

What is the MOA for omalizumab?

A

Anti IgE antibody

35
Q

What are the two big clinical indications for omalizumab?

A

Moderate to severe asthma that isn’t being helped by corticosteroids and chronic idiopathic hives and rashes.

36
Q

What is the BBW for omalizumab?

A

Anaphylaxis

37
Q

What are 4 actions of omalizumab?

A

Anti IgE antibody, decreases high affinity receptors for IgE on mast cells, decreases mediator release from mast cells, anti inflammatory properties itself.

38
Q

What drug family do we prescribe for mild intermittent asthma?

A

Beta 2 agonist

39
Q

What 2 drug families do we prescribe for mild persistent asthma?

A

Beta 2 agonist and low dose ICS

40
Q

What 3 drug families do we prescribe for moderate persistent asthma?

A

Beta 2 agonist, low dose ICS and LABA.

41
Q

What 3 drug families do we prescribe for severe persistent asthma?

A

Beta 2 agonist, LABA, and high dose ICS

42
Q

What 4 drug families do we prescribe for very severe persistent asthma?

A

Beta 2 agonist, LABA, ICS high dose and oral corticosteroid.

Respiratory Medicine (27 decks)

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