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Pharm Test 3 > Asthma + COPD > Flashcards

Asthma + COPD Flashcards

1
Q

Systemic corticosteroids

A

Methylprednisolone

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2
Q

Aerosol corticosteriods

A

Fluticason

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3
Q

B2 adrenergic Ags

A 
SABA = albuterol
LABA = Salmeterol
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4
Q

Muscarinic blockers

A
  • ipratropium bromide

* tiotropium

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5
Q

Phosphodiesterase blocker

A

Theophylline

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6
Q

Leukotriene pathway blocker

A

Montelukast

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7
Q

IgE inhbitors

A

Omalizumab

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8
Q

Asthma airway resistance

A

Reversible!

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9
Q

Hallmark of asthma

A

Early rxn = mast cell + t lymp

Late rxn = Neutrophil/eosinophil release in late rxn,

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10
Q

Maintenance therapy Rx

goal

A
  • Prevent attack

* Affect airway responsiveness/reactivity

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11
Q

Quick relief Meds

Goals

A

Relieve bronchospasm in attack

*affect airway resistance

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12
Q

Topical delivery of aerosolized Rx

T.I. Effect?

A

UPs T.I.

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13
Q

Methylxanthines target

A

Cholinergic

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14
Q

ICS

A
  • target + suppress inflammatory
  • NOT cure
  • anti-inflammatory (hours) –> maximal benefit (weeks)
  • can add long acting B2 agonist
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15
Q

Topical activity of ICS UPed by

A

17a sub

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16
Q

Effect corticosteriods on Airway cells

A

*DOWN cytokines
No effect on mediater release
*UP B2 receptors

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17
Q

ICS

S.E

A
  • oropharyngeal candidiasis/dysphonia
  • Hypothalamic pituitary axis (HIGH dose/systemic)
  • COPD = only if FEV1 <50%
18
Q

B2 Ags

Effects

A
  • relax airway

* inhibit release of mast cell mediators (less microvascular leakage)

19
Q

Rescue tx

A

SABA

20
Q

LABA used

A

Maintenance

ONLY w/ ICS

LABAs alnoe w/ COPD

21
Q

Most asthma controlled w/

A

ICS + b2 ag

22
Q

Albuterol

Time

A
  • Short acting 3-5 min
  • Peak 30-60 mins
  • Duration 3-6 hours
23
Q

Salmeterol

Time

A

Long-acting

>12 hrs

24
Q

B2 ags

S.E.

A

*uncommon w/ short-acting b2

Tremor/tac/hypokalemia

25
Q

Muscarinic cholinergic antagonists

Effects

A

Block Ach from vagus to M3

  • down mucus
  • down secretion
  • NO anti-inflammatory
  • Limited unless B2 ag intolerant (Can do 2 together)

*COPD effective in some

26
Q

Ipatroprium vs Tiotropium

Time

A

Ipratropium = Short acting

Tiotropium = long acting

27
Q

Antichol

Why effective in COPD?

A

Vagal tone the only thing left to control

28
Q

Natural trippy atropine version

A

Datura stramonium

29
Q

Antichol

Adverse effects

A
  • Few systemic = poorly absorbed
  • NO prostatic hyperplasia
  • Dry mouth
30
Q

Methylxanthine Rx = Theophylline

Effects

A
  • Block cAMP phosphodiesterase = UP cAMP
  • oral
  • COPD = up diagragm muscle contractility, up ventilatory function
31
Q

Methylxanthine Rx = theophylline

A
  • narrow T.I. = monitor plasma
  • cardio = tac, vasodilation, arrythmia
  • CNS = nervousness
  • GI = N/V
32
Q

Leukotriene pathway inhbitor

A
  • GOOD in aspirin sensitive
  • inhibit bronchoconstriction
  • add-on
  • NO COPD
33
Q

Anti-IgE

Mech

A

Binds Fc IgE, can’t bind to mast cell

No allergen induced activation of mast cells

34
Q

New drugs

A

IL=5
Mepolizumab
Reslizumab

35
Q

COPD = LABAs superior to anticholinergics?

A

Don’t know

They help improve lung function and quality of life

36
Q

Deposition of inhaled Rx

A

80-90% swallowed

Blood stream –> systemic effects + inactive metabolites

37
Q

Cortiocosteroids inhibit inflammation how?

A
  • Stop gene transcription

* Stop acetylation of DNA so strand doesn’t open

38
Q

Systemic glucocorticoid use

A

Asthma exacerbation
SHORT TERM
Methylprendisolone 3-10 days

Withdraw over 2 weeks

Status Asthmaticus? IV

39
Q

B2 agonists

Mech

A

Through cAMP/PKA –> down Ca2+ influx into bronchial smooth muscle

40
Q

Montelukast blocks

A

Leukotriene receptor (CysLT1) = block:

  • plasma exudation
  • Mucus secretion
  • Bronchoconstriction
  • Eosinophil recruitment
41
Q

Omalizumab

Mech

A
  • anti-IgE antibody
  • binds Fc portion IgE, prevents Fc receptor binding to mast cells

*use less steroid + prevent allergic reactions

Pharm Test 3 (11 decks)

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