asthma/COPD drugs

Question 1

name 2 SABAs

Answer 1

albuterol and terbutaline

Question 2

name 2 LABAs and the steroids that go with them

Answer 2

salmeterol/fluticasone

formoterol/budesonide

Question 3

what are 3 CV side effects of beta agonists

Answer 3

• decreased BP
• heart stimulation
• hypokalemia: QT prolongation

Question 4

what two drugs are used in COPD but not asthma? what are their specific actions?

Answer 4

• ipratropium: M2/3 muscarinic antagonist

- tiotropium: M1/3 muscarinic antagonist

Question 5

what muscarinic antagonist is used in COPD/asthma and what receptor types does it block?

Answer 5

atropine: M2/3

Question 6

what are aminophylline and theophylline and what are their actions?

Answer 6

phosphodiesterase-5 inhibitors

• prevent breakdown of cAMP
• also block adenosine receptors: strengthen diaphragm and blocks histamine release by mast cells

Question 7

what 3 actions does cromolyn sodium have?

Answer 7

1. inhibits degranulation of mast cells
2. inhibits eosinophils
3. inhibits cough by acting on airway nerves

Question 8

what are some main side effects of glucocorticoid use?

Answer 8

• oral candidiasis
• weight gain
• increase BP
• glucose intolerance
• decreased bone density or growth rate
• Cushingoid syndrome

Question 9

what are the beneficial effects of glucocorticoids in COPD/asthma?

Answer 9

-upregulate beta2 receptors
anti-inflammatory:
-reduced mucus secretion
-reduce bronchial activity

Question 10

what are the beneficial effects of leukotriene inhibitors?

Answer 10

reduced bronchial hyperreactivity, bronchoconstriction and mucus secretion

Question 11

what are the leukotriene inhibitors and their specific action

Answer 11

monteleukast: LTD4 receptor antagonist
zafirlukast: LTD4 receptor antagonist
zileuton: leukotriene synthesis inhibitor

Question 12

what is the major side effect for zafirlukast and zileuton?

Answer 12

increased hepatic enzymes

Question 13

what is the action of omalizumab? when is it used? what type of side effects does it have?

Answer 13

• anti-IgE monoclonal antibody
• asthma uncontrolled with glucocorticoids
• CV complications: MI, CAD, arrhythmias

Question 14

what are 3 unspecific beta agonists and their specificities

Answer 14

epinephrine: beta1/2 and alpha
ephedrine: beta1/2 and some alpha
isoproteronol: beta 1 and 2 equally

Question 15

what is the first treatment option for COPD

Answer 15

smoking cessation

Question 16

what 4 types of drugs are contraindicated in obstructive disease?

Answer 16

1. sedatives
2. beta blockers
3. aspirin/cyclooxygenase inhibitors
4. ACEIs