Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Pharmacology II > Asthma/COPD > Flashcards

Asthma/COPD Flashcards

1
Q

What is asthma?

A

Disease of inflammation due to allergen exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What causes the reduced airway in asthma?

A

Smoot muscle thickening causing bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the inflammatory mediators of asthma?

A 
EOSINOPHILS
neutrophils
mast cells
CD4 cells
IL-5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the symptoms of asthma?

A

Episodic shortness of breath
Wheeze
Cough
Chest tightness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens to the lungs in asthma after treatment?

A

reversible lung function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is COPD?

A

disease of inflammation due to irritation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes the reduced airway in COPD?

A

Cellular damage by external irritants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the inflammatory mediators of COPD?

A

NEUTROPHILS
macrophages
CD8 cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the symptoms of COPD?

A

Chronic cough
sputum production
DOE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens to the lungs in COPD after treatment?

A

irreversible lung function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the pathophysiology of asthma?

A

Airway inflammation
Airflow obstruction
Bronchial hyperresponsiveness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the early response of asthma and what do we treat it with?

A

Mast cell degranulation causes release of mediators which causes smooth muscle contractions and vascular leakage

Treat with bronchodilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the late response of asthma and what do we treat it with?

A

3-6 hours after allergen exposure there is more sustained bronchoconstriction mediated by cytokines

Treat with inhaled corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the pathophysiology of COPD?

A

Airway inflammation
Structural changes/”remodeling”
Mucociliary dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What happens to the lungs in COPD?

A

fibrosis and scarring
Alveolar damage
Mucus hypersecretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the treatment approaches for asthma?

A 
Short-acting beta-2 agonist
Long-Acting beta-2 agonist
Inhaled or oral corticosteroid
Mast cell stabilizers
Leukotriene Antagonists
Methylxanthine derivatives
Immunotherapy
Long-acting antimuscarinics (LAMA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the treatment approaches for COPD?

A 
Smoking Cessation
Short-acting beta-2 agonists
Long-acting beta-2 agonists
Short acting antimuscarinics (SAMA)
Long acting antimuscarinics (LAMA)
Inhaled or oral corticosteroids
Methylxanthine derivatives
Phosphodiesterase 4 (PDE-4) inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the common delivery system of asthma and COPD treatments?

A

Aerosolized systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why are aerosolized delivery systems prefered?

A

They deliver small particle sizes of the drug directly to the lung in high concentrations which will reduce the risk of systemic exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the drawbacks of using aerosolized delivery systems?

A

Requires proper technique for effective treatment

Expensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the different aerosolized delivery systems?

A

Metered Dose inhaler (MDI)
Dry powder inhaler (DPI)
Soft mist inhaler
Nebulizer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the advantages to using a metered dose inhaler?

A

Small, compact, portable
Easy to use
Can be used with spacer
No drug prep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the disadvantages to using a metered dose inhaler?

A

Needs proper technique/coordination of breath
Contains propellants
Expensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the advantages of using a dry powder inhaler?

A

Small, compact, portable
Easy to use
Usually cheaper than an MDI
No coordination needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the disadvantages of using dry powder inhaler?
Patient must prep the dose Requires fast, deep inhalation Moisture sensitive NOT IDEAL FOR COPD patients
26
What are the different types of dry powder inhalers?
``` Diskus Handihaler Twisthaler Ellipta Pressair Flexhaler Aerolizer ```
27
What are the advantages of using a soft mist inhaler?
Compact, portable Multi-dose device High lung deposition Does not contain propellants
28
What are the disadvantages of using a soft mist inhaler?
Complicated process for the first dose Slow moving mist Cannot use a spacer Expensive
29
What are the advantages of using a nebulizer?
Minimal technique required | Patient is not required to hold breath
30
What are the disadvantages of using a nebulizer?
``` Expensive Requires dose prep Bulky Administration time is 5-15 minutes Needs a power source Cleaning needed ```
31
What are the bronchodilators?
``` SABA LABA Muscarinic antagonists Methylxanthine derivatives PDE-4 inhibitors ```
32
What do we want the medications to do in order to prevent bronchoconstriction and increase bronchodilation?
Bronchoconstriction = inhibit ACh and adenosine Bronchodilation = increase cAMP levels or prevent cAMP from being broken down
33
What is the MOA of SABAs and LABAs?
Stimulates adenylyl cyclase at beta 2 receptor to increase cAMP in bronchial smooth muscle --> BRONCHODILATION
34
What are SABAs the drug of choice for?
Acute asthma attacks and exercise induced asthma
35
What is the onset and duration of SABAs?
``` Onset = 5 min. Duration = 3-4 hours ```
36
What is the administration of SABAs?
inhalation
37
What are the ADRs of SABAs and LABAs?
Mouth irritation Cough ``` At high doses: Skeletal muscle tremor Tachycardia/Palpitations Arrhythmias Tolerance with excessive use ```
38
What is the onset and duration of LABAs?
``` Onset = 30 min. Duration = 12-24 hours ```
39
What are LABAs used for?
CANNOT BE USED in MONOTHERAPY for asthma THEY MUST BE USED WITH A CORTICOSTEROID for asthma treatment Not for rescue therapy Can be used in monotherapy for COPD
40
What is the MOA of antimuscarinic agents?
Competitively block muscarinic receptors and the effects of ACh in the airway which prevents vasoconstriction mediated by vagal discharge
41
What effects do antimuscarinic agents have and what are they typically used to treat?
no effects on chronic inflammation mostly used in COPD
42
What are the ADRs of antimuscarinic agents?
minimally absorbed and generally well tolerated ``` Potential for: Dry mouth/eyes Bitter, metallic taste Constipation Urinary retention ```
43
What is the MOA of Methylxanthine derivatives?
1. Nonselevtively inhibits PDE to increase cAMP causing BRONCHODILATION 2. Blocks adenosine receptors in CNS
44
What is the duration of action for methylxanthine derivatives?
12 hours
45
What are methylxanthine derivatives used for?
PO in IR and SR forms Requires high concentrations to be efffective Considered Narrow Therapeutic index drug so they are not used very often to treat asthma/COPD
46
What is Theophylline metabolized by and what are it's DDIs?
CYP450 1A2 Febuxostat Bupropion Cabamazepine Macrolide antibiotics
47
What is the clearance of theophylline mediated by?
Age Smoking status Other drugs Younger patients clear drug faster Smokers clear the drug faster
48
What monitoring is required with theophylline use?
Therapeutic monitoring for range between 10-20 mcg/mL
49
What are the ADRs of theophylline?
GI DISTRESS (enhanced gastric acid secretion) Tremor Insomnia In overdose = severe nausea and vomitting, hypotension, agitation, arrythmias, cardiac arrest, and seizures
50
What is the MOA of PDE-4 inhibitors?
Selectively inhibits PDE-4 to increase cAMP causing Bronchodilation
51
What are PDE-4 inhibitors used for?
Severe or very severe COPD Should be given in combo with at least 1 other long acting bronchodilator for COPD
52
What DDI's are there with Roflumilast?
CYP450 3A4 Rifampin Phenobarbital Phenytoin Carbamazepine
53
What are the ADRs of Roflumilast?
``` Diarrhea/N/V Abdominal pain headache Dyspepsia Psychiatric events Weight loss ```
54
What is the MOA of corticosteroids?
Binds to glucocorticoid receptors to: Inhibit inflammatory cell migration and activation Inhibit cytokine and mediator release UPregulate beta 2 receptors Inhibit IgE synthesis
55
What are corticosteroids used for?
Persistent asthma
56
Which corticosteroid is safest to use in pregnancy?
Budesonide
57
What are the ADRs of inhaled corticosteroids?
Thrush = counsel patients to wash mouth after each use Dysphonia Sore throat Cough
58
What are the ADRs of oral corticosteroids?
``` Adrenal suppression Cushing syndrome Growth retardation Osteoporosis Glucose intolerance Infection risk Mood changes Weight gain Edema ```
59
What are leukotrienes?
Inflammatory mediators derived from arachadonic acids
60
What do leukotrienes do?
Produce bronchoconstriction Recruit eosinophils Vascular and mucus secretions
61
What is the MOA of Lipoxygenase inhibitors?
Inhibits actions of 5-lipoxygenase to inhibit the synthesis of leukotrienes
62
What are the ADRs of lipoxygenase inhibitors?
``` Headache Insomnia Somnolence GI upset HEPATOTOXICITY = do not use if LFTs are greater than 3X the upper limit of normal; do not give to female patients older than 65 and patients with preexisting LFT elevations ```
63
What is the MOA of leukotriene receptor antagonists?
competitively blocks actions of leukotrienes at the LTD4 receptor
64
What are leukotriene receptor antagonists used for?
Asthma Allergic symptoms Exercise-induced bronchospasm Urticaria Adjunctive treatment
65
Which leukotriene receptor antagonist has a DDI with warfarin?
Zafirlukast increased risk of bleed
66
What are the ADRs of leukotriene receptor antagonists?
Headache | Hepatotoxicity = Zafirlukast
67
Which leukotriene receptor antagonist has a BBW for neuropsychiatric events and what events are they?
Montolukast ``` Abnormal dreams Hostility Aggression Suicidality Agitation Hallucinations ```
68
What is the MOA of Mast cell stabilizers?
Block influx of Ca to prevent mast cell degranulation which stablizes the mast cell and prevents release of inflammatory mediators NO direct bronchodilating, antihistaminic or anti-inflammatory effects
69
What are mast cell stabilizers used to treat?
mild asthma Not used often in practice
70
What are the ADRs of mast cell stabilizers?
``` Mild throat irritation Cough Abnormal taste in mouth Requires multiple daily doses takes 2-6 weeks to take full effect ```
71
What is the MOA of Omalizumab?
Inhibits binding of IgE to surface of mast cells and basophils which inhibits release of inflammatory medaitors
72
What is Omalizumab used to treat?
Allergic asthma not relieved with corticosteroid treatment = patient must have allergy testing done prior to use
73
What is the dose of Omalizumab based on?
IgE levels and body weight
74
What are the ADRs of Omalizumab?
``` Don't use in patients under the age of 12 Takes 12 weeks to work Injection site reactions Anaphylaxis 1.5-2 hours after dose Arthralgia Headache Pharyngitis Sinusitis Malignancies ```
75
What is the MOA of IL-5 antagonists?
Humanized interleukin-5 monoclonal antibody antagonist to reduce the amount of circulating eosinophils
76
What are IL-5 antagonists used to treat?
Used for maintenance of severe asthma for patient who continues to have exacerbation despite adequate therapy CAN ONLY BE USED in patients who are 18 or older that have eosinophil
77
What are the ADRs of IL-5 antagonists?
``` Not recommended for monotherapy Injection site reactions Headache Hypersensitivity reactions Malignancy Muscle and face pain ```

Clinical Pharmacology II (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions