Asthma/COPD Drugs Flashcards
what is the important parasympathetic receptors in the lungs?
M3
what is the important sympathetic receptors in the lungs?
B2
what does a B2 agonist cause in airway smooth muscle?
relaxation
what does an M3 antagonist cause in airway smooth muscle?
relaxation
what class of autonomic drugs is used for rescue therapy?
short acting beta agonists
name the two short acting beta agonist drugs for respiratory ?
albuterol and epinephrine
what is the issue associated with over use of albuterol?
can lead to desensitization of the B2 receptors in the lungs
name the three short acting beta agonists for asthma/COPD
Salmeterol
Formoterol
Indacaterol
what is the issue with beta agonists that leads to many of its toxicities?
it is not specific in binding and can bind other beta receptors like B1 receptors
due to beta agonists lack of specificity…what are common toxicities?
tachycardia
a fib
angina
hypertension
since beta agonists for respiratory diseases is inhaled…how much is systemically available? why is this?
actually about 95% because a lot of the drug is swallowed instead of inhaled
which two beta agonist have the highest risk of cardiac toxicities?
epinephrine and indacaterol
name the short acting M3 antagonist for respiratory disease
ipratropium
name the four long acting M3 antagonists for respiratoyr disease
tiotrpium
aclidinium
umeclidinium
glycopyrronium
name the five common toxicities with M3 antagonists
xerostomia dry nasal membranes constipation urinary retention tachycardia
describe the two mechanisms of corticosteroids
inhibit inflammatory protein production
induce anti inflammatory protein production
what is the main protein that corticosteroids induces for anti inflammation?
lipocortin
how is lipocortin antiinflammatory?
it blocks phospholipase A and prevents arachidonic acid from being turned into cyclooxygenase or leukotrienes
why are long acting beta agonists not used alone in treatment of asthma?
associated with premature death
what two drugs is Advair a combo of?
fluticasone and salmeterol
what two drugs is Symbicort a combo of?
Budesonide and formoterol
what two drugs is Dulera a combo of?
Mometasone and Formoterol
what is a side effect of inhaled corticosteroids?
immunosupression…so more oral and lung infections
what two cells are in charge of production of leukotrienes? what is the role of leukotrienes in asthma?
mast cells and eosinophils
smooth muscle contraction
name the three leukotriene inhibitors
Zileuton
Montelukast
Zafirlukast
which leukotriene inhibitors target the leukotriene receptor on smooth muscle?
Montelukast and Zafirlukast
which leukotriene inhibitor targets lipoxygenases or the molecules that make leukotrienes?
Zileuton
name the drug that targets the IgE antibodies? what asthma can it treat?
Omalizumab
allergic
name the drug that targets IL-5? what asthma can it treat?
Mepolizumab
any eosinophilic asthma
name the drug that targets the IL-4Receptor? what asthma can it treat?
Dupilumab…asthma add on
name the PDE4 inhibitor
Roflumilast
what is the role of PDE4? why is it a target in asthma treatment?
PDE4 decreases the amounts of cAMP in the smooth muscle cells of the airway…cAMP is usually a bronchodilating chemical so by inhibiting PDE4 you get more cAMP available to bronchodilate
what is the mechanism of theophylline?
inhibits adenosine and PDE4 in smooth muscle cells
adenosine plays what role in smooth muscle cells of the airway?
it leads to smooth muscle contraction
is theophylline classified as solely a bronchodilator or an anti inflammatory too?
it has effects on both bronchodilation and anti inflammation
name two important toxicities of theophylline
seizures and arrhythmias
what is the mechanism of cromolyn?
it inhibits mast cell degranulation
what is the name of the drug that stabilizes mast cells?
cromolyn
what is step 1 asthma treatment called? what drug to give?
intermittent asthma…give rescue albuterol
what drugs are indicated in step 2 of asthma treatment?
low dose inhaled corticosteroid
what drugs are indicated in step 3-5 of asthma treatment?
low to high dose of inhaled corticosteroids with a LABA
what drugs are indicated in step 6 of asthma treatment?
high dose inhaled corticosteroid
LABA
and oral systemic corticosteroid
what class of drugs is usually used in COPD?
anticholinergic drugs…M3 antagonist