Asthma & Autonomics

Question 1

What is the non-specific adrenergic agonist?

Answer 1

Epinepherine- when it binds to beta 2 receptors in the lung, it causes bronchodilation

Question 2

What is the short acting “rescue” beta agonist?

Answer 2

Albuterol

Question 3

What are the LABAs?

Answer 3

Salmeterol & Formoterol

Question 4

Take out a sheet of paper and write down the classical and alternative pathways of beta 2 agonism

Answer 4

Do it!!

Question 5

What are 3 other positive effects of beta 2 agonists?

Answer 5

1. Decrease degran
2. Decreased perm
3. Increased escalator

Question 6

What is the MOA of Ipratropium?

Answer 6

ACh antagonist. Decreases the parasympathetics of the lung leading to less bronchial smooth muscle contraction –> bronchodilation

Question 7

What is an additional positive effect of ipratropium?

Answer 7

Decreased mucus production

Question 8

ADE of ipratropium?

Answer 8

EYES!!! Pupillary dilation and cycloplegia

Question 9

What is Theophylline’s MOA for treating asthma? 3 ways? Theophylline is like caffeine!

Answer 9

1. Increase cAMP
2. Decrease PDE
3. Decrease adenosine
4. Increase HDAC2

Question 10

Additional actions of Theophylline? (Hint: it decreases one thing and increases 5 things)

Answer 10

Decreases mast cell degranulation
Increases CNS activity, gastric secretions, musculoskeletal strength (makes you stronger, smarter, poopier).. Also increases HR and inotropy (like caffeine!)

Question 11

ADE of theophylline?

Answer 11

SEIZURES at high doses!!!!! Narrow theraputic window!!! Also interacts with Zileuton!

Question 12

Cromolyn sodium MOA? (Decreases 2 things)

Answer 12

1. Decreased degranulation

2. Decreased nerves in airway -> decreased cough

Question 13

Cromolyn sodium treatment?

Answer 13

prophylactic for asthma attacks (due to allergies or exercise)

Question 14

ADE of cromolyn sodium?

Answer 14

Bad taste!

Question 15

What are the listed corticosteroids and what is the MOA?

Answer 15

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

Question 16

ADE of corticosteroids?

Answer 16

1. Cushingoid Syndrome: moon face and buffalo hump
2. Inhaled: Candidiasis, horseness, dry mouth, osteoperosis in women, growth retardation in kids
3. Prolonged use: Glucose intolerance, increased BP, weight gain, cataracts, immunosuppression

Question 17

Montelukast MOA?

Answer 17

Leukotrine receptor blocker (LRB). Mainly LTD4 and LTC4

Question 18

Blocking LT receptors leads to what three things that are good to treat asthma/COPD?

Answer 18

1. Decrease inflammation
2. Decrease mucus production
3. Decrease bronchoconstriction

Question 19

ADE of Montelukast?

Answer 19

Viral infections: laryngitis, pharyngitis, otitis, sinusitis. Also suicidal ideology

Question 20

MOA of Zileuton?

Answer 20

Leukotrine synthesis inhibitor

Question 21

With Zileuton, you’re gonna get the same 3 outcomes as Montelukast, but you’re gonna get a couple more. What are they? Why?

Answer 21

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.

Question 22

ADE of Zileuton?

Answer 22

1. Decreases liver enzymes
2. Interacts with theophylline (CYP1A2)
   Recall that theophylline ADE included bad heart probs

Question 23

Omalizumab MOA?

Answer 23

IgE antibody

Question 24

Omalizumab ADE?

Answer 24

Anaphylactic shock