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Respiratory Pathophys > Asthma and COPD pharmacotherapy > Flashcards

Asthma and COPD pharmacotherapy Flashcards

1
Q

What are the two main therapeutic interventions?

A

bronchodilators and inflammatory agents

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2
Q

Beta2 receptor stimulation causes…

A

relaxation of bronchial smooth muscle
inhibition of inflammatory mediator release
stimulation of mucocilliary clerance

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3
Q

Potential adverse effects of non-selective bronchodilators?

A

Beta 1 and alpha agonist activity can cause myocardial stress by increasing HR and vasoconstriction.

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4
Q

Whats the MOA of selective Beta 2 agonists?

A

causes smooth muscle relaxation via B2 agonism, leads to increase adenyl cyclase, leads to increased CAMP leads to antagonism of bronchoconstriction

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5
Q

What are the three short acting beta 2 agonists?

A

Albuterol, levalbuterol, pirbuterol

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6
Q

What are the long acting beta 2 agonists?

A

salmeterol, formeterol, arfomotrol, albuterol ER, indacaterol, vilanterol

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7
Q

can asthmatics use long acting beta2 agonists as monotherapy?

A

no!!! but CAN be used as monotherapy for COPD!

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8
Q

Whats the mechanism of action for anticholinergics?

A

inhibit muscarining cholinergic receptors and reduce intrinsic vagal tone of the airway

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9
Q

What is an example of short acting anticholinergic?

A

Ipratropium

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10
Q

What are side effects of anticholinergics?

A

dry mouth for ipratropium, pharyngitis/sinusitis/cough/diarrhea for others

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11
Q

What are the long acting anticholinergics?

A

tiotropium, aclidinium

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12
Q

Which drugs selectively and competitively inhibit the Cys LT1 receptor?

A

Montelukast and Zafirlukast

leukotriene receptor antagonists

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13
Q

What is the MOA for Zileuton?

A

5-Lipox inhibitor:

inhibits production of leukotrienes from arachidonic acid, ltb4 and cysteiyl leukotrienes

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14
Q

Are the antileukotriene agents short or long acting?

A

long!

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15
Q

What type of toxicity should we watch for in zafirlukast and zileuton?

A

hepatitis! elevated LFTs

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16
Q

What’s the corticosteroid MOA?

A

inhibit leukocyte recruitment to airway
inhibit enzyme PLA2 so decrease production of prostaglandins and leukotrienes
decrease inflammation by stabilizing lysosomes in neutrophils (prevent degran)
upreg of antiinflamm genes
decrease stabilityh of some mRNA

17
Q

What is the main difference between all of the inhaled corticosteroids?

A

DOSAGE!! same efficacy just different number of puffs per day

18
Q

what are side effects of corticosteroids?

A

COUGH, dysphonia, oral thrush (just rinse after using!), high dose adrenal suppression, low dose decrease growth velocity in children

19
Q

What’s the methylxanthine MOA?

A

nonselective inhibition of phoshpodiesterase (inc cAMP, smooth muscle relax)
direct/indirect effects on calcium
mild anti-inflamm

20
Q

Which class of drugs has the most narrow Therapeutic index?

A

methylxantines!

21
Q

what’s the drug class of Roflumilast?

A

PDE-4 inhib

accum cAMP

22
Q

What is Roflumilast used for?

A

ONLY COPD! (late stage)

23
Q

what’s the difference between PDE-4 inhibitors and methylxanthines?

A

PDE-4 inhib is a selective phosphodiesterase inhibit AND it is available as a tablet

24
Q

What drug is a mast cell stabilizer?

A

Cromolyn

25
Q

what are the adverse reactions from the immunomodulator, omalizumab?

A

potential for anaphylaxis!

potential for malignant neoplasms!

26
Q

Which combination product is indicated SOLELY for asthma?

A

mometasone + formoterol, via MDI

27
Q

What combination products are ONLY for COPD?

A

Ipratropium + Albuterol, via MDI, quick

Fluticasone + vilanterol, via DPI, controller

28
Q

What medications would increase theophylline concentrations?

A

Cimetidine
macrolides: erythromycin, clarith, troeland
quinolones: cipro, enox, perflox
Ticlopidine

29
Q

What medications would DECREASE theophylline levels?

A

phenobarbital/phenytoin/carbamez
Rifampin
SMOKING

Respiratory Pathophys (12 decks)

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