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Respiratory Week 3 > Asthma/COPD Drugs > Flashcards

Asthma/COPD Drugs Flashcards

1
Q

what is the important parasympathetic receptors in the lungs?

A

M3

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2
Q

what is the important sympathetic receptors in the lungs?

A

B2

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3
Q

what does a B2 agonist cause in airway smooth muscle?

A

relaxation

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4
Q

what does an M3 antagonist cause in airway smooth muscle?

A

relaxation

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5
Q

what class of autonomic drugs is used for rescue therapy?

A

short acting beta agonists

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6
Q

name the two short acting beta agonist drugs for respiratory ?

A

albuterol and epinephrine

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7
Q

what is the issue associated with over use of albuterol?

A

can lead to desensitization of the B2 receptors in the lungs

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8
Q

name the three short acting beta agonists for asthma/COPD

A

Salmeterol
Formoterol
Indacaterol

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9
Q

what is the issue with beta agonists that leads to many of its toxicities?

A

it is not specific in binding and can bind other beta receptors like B1 receptors

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10
Q

due to beta agonists lack of specificity…what are common toxicities?

A

tachycardia
a fib
angina
hypertension

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11
Q

since beta agonists for respiratory diseases is inhaled…how much is systemically available? why is this?

A

actually about 95% because a lot of the drug is swallowed instead of inhaled

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12
Q

which two beta agonist have the highest risk of cardiac toxicities?

A

epinephrine and indacaterol

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13
Q

name the short acting M3 antagonist for respiratory disease

A

ipratropium

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14
Q

name the four long acting M3 antagonists for respiratoyr disease

A

tiotrpium
aclidinium
umeclidinium
glycopyrronium

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15
Q

name the five common toxicities with M3 antagonists

A 
xerostomia
dry nasal membranes
constipation
urinary retention
tachycardia
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16
Q

describe the two mechanisms of corticosteroids

A

inhibit inflammatory protein production

induce anti inflammatory protein production

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17
Q

what is the main protein that corticosteroids induces for anti inflammation?

A

lipocortin

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18
Q

how is lipocortin antiinflammatory?

A

it blocks phospholipase A and prevents arachidonic acid from being turned into cyclooxygenase or leukotrienes

19
Q

why are long acting beta agonists not used alone in treatment of asthma?

A

associated with premature death

20
Q

what two drugs is Advair a combo of?

A

fluticasone and salmeterol

21
Q

what two drugs is Symbicort a combo of?

A

Budesonide and formoterol

22
Q

what two drugs is Dulera a combo of?

A

Mometasone and Formoterol

23
Q

what is a side effect of inhaled corticosteroids?

A

immunosupression…so more oral and lung infections

24
Q

what two cells are in charge of production of leukotrienes? what is the role of leukotrienes in asthma?

A

mast cells and eosinophils

smooth muscle contraction

25
Q

name the three leukotriene inhibitors

A

Zileuton
Montelukast
Zafirlukast

26
Q

which leukotriene inhibitors target the leukotriene receptor on smooth muscle?

A

Montelukast and Zafirlukast

27
Q

which leukotriene inhibitor targets lipoxygenases or the molecules that make leukotrienes?

A

Zileuton

28
Q

name the drug that targets the IgE antibodies? what asthma can it treat?

A

Omalizumab

allergic

29
Q

name the drug that targets IL-5? what asthma can it treat?

A

Mepolizumab

any eosinophilic asthma

30
Q

name the drug that targets the IL-4Receptor? what asthma can it treat?

A

Dupilumab…asthma add on

31
Q

name the PDE4 inhibitor

A

Roflumilast

32
Q

what is the role of PDE4? why is it a target in asthma treatment?

A

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

33
Q

what is the mechanism of theophylline?

A

inhibits adenosine and PDE4 in smooth muscle cells

34
Q

adenosine plays what role in smooth muscle cells of the airway?

A

it leads to smooth muscle contraction

35
Q

is theophylline classified as solely a bronchodilator or an anti inflammatory too?

A

it has effects on both bronchodilation and anti inflammation

36
Q

name two important toxicities of theophylline

A

seizures and arrhythmias

37
Q

what is the mechanism of cromolyn?

A

it inhibits mast cell degranulation

38
Q

what is the name of the drug that stabilizes mast cells?

A

cromolyn

39
Q

what is step 1 asthma treatment called? what drug to give?

A

intermittent asthma…give rescue albuterol

40
Q

what drugs are indicated in step 2 of asthma treatment?

A

low dose inhaled corticosteroid

41
Q

what drugs are indicated in step 3-5 of asthma treatment?

A

low to high dose of inhaled corticosteroids with a LABA

42
Q

what drugs are indicated in step 6 of asthma treatment?

A

high dose inhaled corticosteroid
LABA
and oral systemic corticosteroid

43
Q

what class of drugs is usually used in COPD?

A

anticholinergic drugs…M3 antagonist

Respiratory Week 3 (14 decks)

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