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Pharmacology III > Asthma & COPD > Flashcards

Asthma & COPD Flashcards

1
Q

SABAs… (2)

A

Albuterol

Levalbuterol

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2
Q

LABA (1)

A

Salmeterol

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3
Q

Leukotriene inhibitors

A

montelukast/zafirlukast

Zileuton

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4
Q

Inhaled CS (5)

A 
Fluticasone
Flunisolide
Beclomethasone
Budesonide
Triamcinolone
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5
Q

a LABA should always be combined with…

A

inhaled CS

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6
Q

3 features of asthma…

A

reversible obstruction

airway inflammation

Increased airway responsiveness

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7
Q

What substances released from inflammatory cells cause bronchoconstriction and edema?

A

Leukotrienes

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8
Q

What substances released from inflammatory cells cause bronchoconstriction, sustained airway hyperreactivity, edema, chemotaxis of eosinophils?

A

platelet-activitating factor

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9
Q

Prostaglandins cause…

A

inflammation

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10
Q

These chemicals attract and activate eosinophils and stimulate IgE production in B-lymphocytes

A

Interleukins

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11
Q

What is the only drug that is used PRN to treat acute asthma attack/exacerbation

A

SABA

albuterol/levalbuterol

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12
Q

These drugs for asthma decrease the likelihood of bronchospasm and prevent attacks

A

LABA (salmeterol)

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13
Q

These are used to produce bronchodilation in COPD

A

cholinergic antagonists

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14
Q

Which three asthma drug classes can reduce inflammation

A

CS, Leukotriene inhibitors, Monoclonal Ab

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15
Q

This decreases the release of histamine from mast cells…

A

cromolyn

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16
Q

This is a CNS stimulant that can produce long-lasting bronchodilation

A

theophyline

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17
Q

What happens to cilia and goblet cells in COPD?

A

immobilized cilia

excess mucous production

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18
Q

Generally, COPD is treated with _______ or _______

A

LABA or inhaled anticholinergics

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19
Q

what two drugs can be used for acute COPD exacerbations?

A

ipratropium

albuterol

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20
Q

Mechanism for beta 2 agonists…

A

activate adenylate cyclase

increase cAMP

relax SM, bronchioles, stabilize mast cells

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21
Q

What class of drugs are the most effective bronchodilators?

A

beta-2 agonists

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22
Q

Where are beta 1 located?

A

heart

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23
Q

onset and duration of action for albuterol/levalbuterol…

A

fast onset

4-8 hours

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24
Q

onset and duration of action for salmeterol?

A

onset 20 minutes

duration 12 hours

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25
Q

In addition to a LABA and ICS, what should always be prescribed to asthma patients?

A

SABA

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26
Q

4 common beta 2 agonist S/Es?

A

tachy
nervousness
dizziness
tremor

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27
Q

What is responsible for tolerance to beta 2 agonists?

A

chronic use = receptor downregulation

28
Q

Tolerance to beta 2 agonists occurs more/less in the lungs than other tissues

A

less

29
Q

Tolerance to beta 2 agonists has more an effect on _______

A

side effects

30
Q

2 muscarinic antagonists…

A

ipratropium

tiotropium

31
Q

Use of ipratropium/tiotropium

A

COPD

32
Q

When could you consider ipratropium/tiotropium (M antagonists) in asthma patients?

A

if B2 agonist alone isn’t sufficient

33
Q

What are the advantages of Tiotropium?

A

longer duration of action

QD admin

34
Q

Combivent is a rescue inhaler that contains…

A

albuterol + ipratropium

35
Q

Mechanism for Theophylline

A

Blocks adenosine receptor

AND

PDE inhibitor –> increased cAMP + epi mimetic

36
Q

When should theophylline be considered? Why?

A

insufficient beta 2 agonist response

low therapeutic index (easy to OD)

37
Q

route of admin for theophylline?

A

PO

38
Q

Is it safe to switch between brands of theophylline once a dose has been established?

A

no

39
Q

What 4 things increase the clearance of theophylline in the liver?

A

Phenytoin, TOBB, rifampin, OCs

40
Q

What two drugs decrease the clearance of theophylline?

A

cimetidine, erythromycin (P450 inhibitor)

41
Q

Major, serious side effect of theophylline?

A

arrhythmia

42
Q

mild SE of theophylline

A

nervousness, insomnia

43
Q

_______ improve sxs and decrease the requirement for _______ in asthma patients w. in 1 week.

A

ICS

Beta agonists

44
Q

When should PO CS be considered?

A

short course for exacerbation

taper to ICS

45
Q

Does short term use of PO CS carry risk of serious SEs?

A

no

46
Q

These drug has the following effects:

  • decrease inflammatory cell number
  • decrease cytokines and cytokine mediators
  • decrease capillary permeability
  • decrease mucus secretion
  • increase beta 2 receptors on airway smooth muscle
A

CS

47
Q

3 major side effects of ICS?

A

OP Candidiasis

Hoarseness

Decreased bone Density

48
Q

What can be used to limit the SEs of ICS?

A

spacer

49
Q

Two PO steroids used for asthma/COPD?

A

methylprednisolone, prednisone

50
Q

4 major SEs of chronic systemic CS therapy?

A

osteoporosis, thin skin, hyperglycemia, truncal obesity

51
Q

Short term SEs of systemic CS?

A

hyperactivity, insomnia, restlessness

52
Q

Which drug class will decrease the asthmatic response to exercise or cold air, and decreases the need for steroids?

A

leukotriene inhibitors

53
Q

Which leukotriene inhibitors block the receptor?

A

Zafirlukast + Montelukast

54
Q

Which leukotriene inhibitor blocks 5-LOX, and therefore decreases synthesis?

A

Zileuton

55
Q

Which drug may decrease asthmatic reaction to ASA?

A

Zileuton (blocks 5-lox)

56
Q

4 SEs of leukotriene inhibitors?

A

increased URI
ST
Sleepiness
Psych sxs

57
Q

Mechanism for Omalizumab?

A

Ab targeted to IgE

Prevents binding/activation of mast-cells/basophils

58
Q

Omalizumab should be considered for what reason?

A

decrease CS need

Reduce exacerbation

adjunct to therapy

59
Q

Route for omalizumab

A

SC Injection q 2–4 weeks

60
Q

Mechanism for Benralizumab, mepolizumab, reslizumab…

A

Ab targeting IL-5… reduces eosinophil function

61
Q

Indication for Benralizumab, mepolizumab, reslizumab

A

severe, eosinophilic asthma

decreases CS need

62
Q

route for Benralizumab, mepolizumab, reslizumab

A

SC injection q 4 weeks

63
Q

this drug inhibits the release of histamine from mast cells…

A

cromolyn

64
Q

Describe the dosing for cromolyn…

A

several times daily, chronically

65
Q

Cromolyn is effective as a _____ agent for asthma…

A

prophylactic

Pharmacology III (15 decks)

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