Asthma & COPD

Question 1

definitions of asthma?

Answer 1

1. chronic inflammation of the airways
2. recurrent episodes of wheezing, breathlessness, chest tightness, coughing
3. variable airway obstruction that is often completely reversible

Question 2

Define COPD

Answer 2

1. persistent airway limitation
2. progressive (not fully reversible)
3. enhanced chronic inflammatory response in the airways and the lungs to noxious particles and gases

Question 3

what are the 4 major bronchodilators?

Answer 3

1. inhaled short-acting beta 2 agonist

2. inhaled long-acting beta 2 agonist

Question 4

what is the hallmark of asthma?

Answer 4

hyper reactive airway

Question 5

what T lymphocytes are involved in asthma?

Answer 5

TH2 with excess eosinophil (normal neutrophils)

Question 6

what T lymphocytes are involved in COPD?

Answer 6

TH1 with excess neutrophils (normal eosinophil)

Question 7

what are the 4 types of bronchodilators for asthma?

Answer 7

1. inhaled short-acting beta 2 agonist
2. inhaled long-acting beta 2 agonist
3. inhaled anticholinergic
4. theophylline

Question 8

what are the 4 types of anti inflammatory agents for asthma?

Answer 8

1. inhaled corticosteroids
2. antileukotrienes
3. cromones
4. anti-immunoglobulin E

Question 9

what are the 2 asthma drugs that are inhaled short acting beta 2 agonist?

Answer 9

1. albuterol

2. terbutaline

Question 10

what are the 2 asthma drugs that are inhaled long-acting beta 2 agonists?

Answer 10

1. salmeterol

2. formoterol

Question 11

what are the 2 inhaled anticholinergic?

Answer 11

1. iprotropium

2. tiotropium

Question 12

slow-release theophylline and aminophylline

Answer 12

theophylline

Question 13

what are the inhaled corticosteroids?

Answer 13

1. budesonide
2. fluticasone
3. beclomethasone
4. mometasone

Question 14

names of antileukotrienes?

Answer 14

1. montelukast
2. zafirlukast
3. zileuton

Question 15

when prescribing long acting beta 2 for asthma, what do you also need to give?

Answer 15

inhaled corticosteroids

Question 16

what are the names of cromones?

Answer 16

sodium cromglycate and nedocromil

Question 17

what is the name of the anti-immunoglobulin E?

Answer 17

omalizumab

Question 18

what is the R isomer of albuterol?

Answer 18

levalbuterol

Question 19

what is methylxanthines?

Answer 19

weak bronchodilator –> theophylline, theobromine, and caffein

Question 20

what are the mech of methylxanthines (theophylline)?

Answer 20

non selective phosphodiesterase inhibitors (PDE) bronchodilation

Question 21

what is the selective PDE4 inhibitor?

Answer 21

roflumilast

Question 22

characteristics of Roflumilast (PDE4 inhibitor)?

Answer 22

 More of an anti-inflammatory agent
◦ Prevents neutrophil migration by inhibiting PDE4 isoforms
 Improvement in lung function is secondary to antiinflammatory
action rather than bronchodilation (very
weak)
 Clinical use approved in COPD.

Question 23

what are the major side effects of methylxanthine (theophylline)

Answer 23

1. cardiac arrythmia
2. seizure
3. anorexia, nausea, headahce, insomnia, GERD

Question 24

what is the cornerstone treatment for persistent asthma?

Answer 24

corticosteroid

Question 25

why is corticosteroid beneficial to combine with beta 2 agonist?

Answer 25

1. corticosteroid increase transcription of beta 2 receptor gene
2. beta 2 agonist increase translocation of glucocorticoid receptor from cytoplasm to the nucleus

Question 26

what is the pro-drug that has on site activation by esterase?

Answer 26

ciclesonide

Question 27

what is the drug of choice for aspirin induced asthma?

Answer 27

leukotriene inhibitors

Question 28

does leukotriene have a role in COPD?

Answer 28

no, no role in COPD

Question 29

what drug prevent mast cell degranulation and mediator release form macrophage and eosinophil?

Answer 29

sodium cromoglycate and nedocromil sodium