Asthma & Autonomics Flashcards
What is the non-specific adrenergic agonist?
Epinepherine- when it binds to beta 2 receptors in the lung, it causes bronchodilation
What is the short acting “rescue” beta agonist?
Albuterol
What are the LABAs?
Salmeterol & Formoterol
Take out a sheet of paper and write down the classical and alternative pathways of beta 2 agonism
Do it!!
What are 3 other positive effects of beta 2 agonists?
- Decrease degran
- Decreased perm
- Increased escalator
What is the MOA of Ipratropium?
ACh antagonist. Decreases the parasympathetics of the lung leading to less bronchial smooth muscle contraction –> bronchodilation
What is an additional positive effect of ipratropium?
Decreased mucus production
ADE of ipratropium?
EYES!!! Pupillary dilation and cycloplegia
What is Theophylline’s MOA for treating asthma? 3 ways? Theophylline is like caffeine!
- Increase cAMP
- Decrease PDE
- Decrease adenosine
- Increase HDAC2
Additional actions of Theophylline? (Hint: it decreases one thing and increases 5 things)
Decreases mast cell degranulation
Increases CNS activity, gastric secretions, musculoskeletal strength (makes you stronger, smarter, poopier).. Also increases HR and inotropy (like caffeine!)
ADE of theophylline?
SEIZURES at high doses!!!!! Narrow theraputic window!!! Also interacts with Zileuton!
Cromolyn sodium MOA? (Decreases 2 things)
- Decreased degranulation
2. Decreased nerves in airway -> decreased cough
Cromolyn sodium treatment?
prophylactic for asthma attacks (due to allergies or exercise)
ADE of cromolyn sodium?
Bad taste!
What are the listed corticosteroids and what is the MOA?
Beclomethasone & Prednisolone MOA: 1. Decrease inflammatory cytokines 2. Decrease mucus secretion 3. Decrease bronchial hyperactivity 4. Increase LABA activity Look at notes for the long, drawn out, pointless complete MOA's
ADE of corticosteroids?
- Cushingoid Syndrome: moon face and buffalo hump
- Inhaled: Candidiasis, horseness, dry mouth, osteoperosis in women, growth retardation in kids
- Prolonged use: Glucose intolerance, increased BP, weight gain, cataracts, immunosuppression
Montelukast MOA?
Leukotrine receptor blocker (LRB). Mainly LTD4 and LTC4
Blocking LT receptors leads to what three things that are good to treat asthma/COPD?
- Decrease inflammation
- Decrease mucus production
- Decrease bronchoconstriction
ADE of Montelukast?
Viral infections: laryngitis, pharyngitis, otitis, sinusitis. Also suicidal ideology
MOA of Zileuton?
Leukotrine synthesis inhibitor
With Zileuton, you’re gonna get the same 3 outcomes as Montelukast, but you’re gonna get a couple more. What are they? Why?
With Zileuton you also get decreased PMN migration and decreased vessel permeability. This is because you are blocking synthesis of all LT’s including LTB4 with controls the aforementioned things.
ADE of Zileuton?
- Decreases liver enzymes
- Interacts with theophylline (CYP1A2)
Recall that theophylline ADE included bad heart probs
Omalizumab MOA?
IgE antibody
Omalizumab ADE?
Anaphylactic shock
