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Pharm Exam 6 > Asthma COPD > Flashcards

Asthma COPD Flashcards

1
Q

Two phases of asthmatic response

A

Early phase: acute bronchoconstriction

Late phase: influx of inflammatory cells, second wave of mediator release

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2
Q

Targets of asthma meds:

A

Bronchiolar SMC
Inflammation
Mediators (histamine, leukotrienes, prostaglandins, IgE, cytokines)

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3
Q

Targets of COPD meds:

A

Pulmonary infection prevention
Hypoxemia (O2)
Bronchiolar SM
Inflammation (contradictory)

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4
Q

MDI

A

drug is suspended in compressed gas propellant

must be coordinated

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5
Q

“Spacer”

A

used to allow sequential action and inhalation

Decrease amount of drug that goes in just oropharynx

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6
Q

DPI

A

Dry powder inhaler
Requires proper use of inhalation
Not good for children, elderly, or those in acute attack

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7
Q

Bronchodilators aka

A

B-2 agonists

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8
Q

What are 2 mechanisms of B-2 agonists?

A

(1) Stimulate B-2 receptor on bronchiole SM, elevate cAMP reduce SM tone = dilation
(2) Anti-inflammatory - inhibit release of histamine

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9
Q

What is the first line agent used PRN for acute attacks?

A

Albuterol

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10
Q

What agent is used for prevention of exercise induced asthma?

A

Albuterol

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11
Q

Short acting B-agonist

A

Albuterol

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12
Q

Long-acting B-agonist

A

Salmeterol

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13
Q

Has a long lipophilic tail that anchors to the drug membrane

A

Salmeterol

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14
Q

Which B-2 agent should not be used for acute attacks?

A

Salmeterol

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15
Q

Requires asthma prophylaxis schedule and administration with glucocorticoids?

A

Salmeterol

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16
Q

Long lasting oral B-2 agonist

A

Albuterol oral

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17
Q

Which B-2 agonist can be used in children

A

Oral albuterol

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18
Q

What are adverse effects of B-2 agonists at high doses?

A

Reflex tachycardia

Palpitation tremor

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19
Q

When used alone which B-2 agonists are associated with increase risk of severe asthma attack and asthma related death by exacerbating inflammation?

A

Salmeterol

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20
Q

Which agents must be used in combination and not be used longterm?

A

B-2 agonists

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21
Q

Theophylline mechanism of action

A

Non-specific inhibitor of phosphodiesterases that degrade cAMP (similar to b-agonist)

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22
Q

PDE3 inhibition

A

Bronchodilation

23
Q

PDE4 inhibition

A

anti-inflammatory action

24
Q

Which agent antagonizes adenosine receptors on bronchioles?

A

Theophylline

25
Q

What agent is used if patient is noncompliant or monteleukast is ineffective?

A

Theophylline

26
Q

Which is an alternative to LABAs?

A

Theophylline

27
Q

Which agent has large variability in CYP metabolism and can lead to variation in blood levels?

A

Theophylline

28
Q

Which has high dose effects of nausea, nervousness, anxiety, headache and insomnia?

A

Theophylline

29
Q

Which at toxic levels creates dysarrthmias?

A

Theophylline

30
Q

Anticholinergic agent

A

Ipratropium

31
Q

Which agent is “Atropine like”?

A

Ipratropium

32
Q

Which agent forms a quaternary amine?

A

Ipratropium

33
Q

Mechanism of Ipratropium

A

Blocks muscarinic M3 receptors of bronchoconstriction

34
Q

Which has been approved for symptomatic COPD and better than B-agonists?

A

Ipratropium

35
Q

Which causes pharyngeal irritation and dry mouth?

A

Ipratropium

36
Q

Which is often given with B agonists (albuterol)?

A

Ipratropium

37
Q

Which inhaled corticosteroid is first line for CHRONIC asthma?

A

Fluticasone

38
Q

Which drug improves lung function and prevents irreversible airway changes?

A

Fluticasone

39
Q

Which B-agonist and inhaled corticosteroid are combined to treat asthma?

A

Salmeterol+Fluticasone

40
Q

When is oral/parenteral prednisone used?

A

During severe asthma attacks and acute exacerbations that are not relieved by B-agonists

41
Q

What is the MOA of Fluticasone

A

No effect on brochoconstriction
Bind to GC receptors and inhibit release and synthesis of inflammatory mediators (anti-inflammatory)
decrease airway mucus production increase responsiveness to B-2

42
Q

What is the adverse reaction of inhaled corticosteroids?

A

Oral thrush

Dysphonia

43
Q

Mechanism of action of Cromolyn

A

Mast cell stabilizer, preventing the release of histamine (anti-inflammatory)
Decreases bronchial hyper-reactivity

44
Q

Use of cromolyn

A

asthma prophylaxis
allergic asthma
exercise induced asthma
reduce frequency and intensity of attacks

45
Q

Leukotriene modifiers

A

Monteleukast

Zileuton

46
Q

Monteleukast MOA

A

Act on leukotriene receptor

Antagonist

47
Q

Which leukotriene acts on leukotriene synthesis (5-lipoxygenase) as an inhibitor?

A

Zileuton

48
Q

Which asthma agents are used for aspirin sensitive asthma?

A

Leukotriene modulators (monteleukast and zileuton)

49
Q

Which leukotriene modifier is associated with hepatotoxicity and dyspepsia?

A

Zileuton (enzyme)

50
Q

Which leukotriene should not be combined with theophylline and warfarin?

A

Zileuton (enzyme)

51
Q

Which asthma anti-inflammatory acts on IgE?

A

Omalizumab

52
Q

Omalizumab MOA

A

Decrease amount of IgE that can bind to mast cells, allergens unable to trigger histamine release from mast cells

53
Q

Use of Omalizumab

A

Allergy related asthma

54
Q

Which anti-inflammatory is administered subcutaneously?

A

Omalizumab

Pharm Exam 6 (8 decks)

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