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Vanessa respiration ppnp > asthma pharmacology > Flashcards

asthma pharmacology Flashcards

1
Q

what is the first line drug for acute asthma ?

A

SABA

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2
Q

what is the easy memorize slang of beta 2 adrenoreceptor agonist ?

A

OL

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3
Q

what are the names of beta 2 adrenoreceptor agonist?

A

SABA - sabutamol

LABA - salmeterol and formeterol (long and fast)

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4
Q

what is the mechanism for beta 2 adrenoreceptor agonist ?

A

relaxation of smooth muscle
bronchodilation and opening of airways
imitate the action of adrenaline triggering sympathetic response

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5
Q

what are the extra notes to take for LABA ?

A

it downregulate the beta 2 receptor

MUST always take with corticosteroid

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6
Q

what are the adverse effect of beta2 adrenoreceptor agonist ?

A 
tremors (most common) 
muscle cramps 
peripheral vasodilation (flushing, palpitations,tachycardia)
hypokalemia 
hypertension
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7
Q

what is the route of beta 2 adrenoreceptor agonist ?

A

usually by inhalation but oral when cannot use inhaler
IV in emergency

for epinephrine : IV/ SC in emergency

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8
Q

what is the second line of drugs for acute asthma?

A

SAMA, add on if beta 2 agonist is not producing not enough bronchodilation or can completely replace it too if they cannot use beta 2

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9
Q

what is the easy name for muscurinic receptor antagonist ?

A

tropium

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10
Q

what are the medication names of muscarinic receptor agonist ?

A

SAMA ipratropium

LAMA tiotropium

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11
Q

what is the mechenism of muscarinic receptor antagonist ?

A

inhibit ACH from causing vasoconstriction

inhibit m3 mediated bronchoconstriction

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12
Q

what are the adverse effect of muscurinic receptor antagonist ?

A

unpleasant taste
parasympathetic effect like dry mouth and urinary retention (esp in elderly)

not well absorbed there fore little sideeffects

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13
Q

what are the second class of bronchodilation medication for asthma?

A

methylxanthines

and leukotriene receptor antagonist , cyslt receptor antagonist (also anti inflammatory)

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14
Q

what is the easy name for methylxanthines ?

A

phylline

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15
Q

what are the uses of methylxanthines (phyllines) ?

A

as a add on bronchodilator

less effective than beta 2 agonist

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16
Q

what is the mechanism of methylxanthines ? (phylline)

A
  1. inhibit phosphodiesterase (PDE) for cyclic AMP to accumulate and cause bronchodilation
  2. block adenosine receptor , block bronchodilation)
  3. increase adrenaline release

has some anti inflammatory effects

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17
Q

what are the adverse effect of methylxanthines ? (phylline)

A
  1. narrow theraputic window
  2. many drug drug interactions
  3. gi discomfort
  4. CNS nervousness, tremor anxiety
  5. cns arrhythmia
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18
Q

what is the easy name for leukotrine receptor antagonist (cyslt reecptor antagonist)

A

KAST

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19
Q

what are the uses for leukotrine receptor antagonist (cyslt reecptor antagonist)?

A 
add on for mild to moderate asthma 
weak bronchodilator 
mild asthma 
aspirin sensitive asthma 
exercise induced asthma
20
Q

what is the mechenism for leukotrine receptor antagonist (cyslt reecptor antagonist)?

A

prevent the formation of LTE which causes asthma

  • decreases frequency of acute asthma
  • reduce the need for beta 2 agonist
  • decrease peripheral eosinophil level
21
Q

what is the adverse effect for leukotrine receptor antagonist (cyslt reecptor antagonist)?

A

upper respiratory infection

22
Q

what are the anti inflammatory medication used for?

A

preventer

23
Q

what is the first line drug for anti inflammatory?

A

glucocorticoid , corticosteroid

24
Q

what are the medication for glucocorticoid and corticosteroid?

A

budesonide
flutasone (can cause the body to stop producing corticosteroid)
ciclesonide (soft steroid,requires esterase actication and only work in the lungs )

25
Q

what are the mechenism of glucocorticoids ?

A

prevent asthma and nocturnal asthma

  1. inhibit many inflammation associated molecules
  2. anti inflammatory mediators are often upregulated
  3. activate beta 2 receptors
26
Q

what are the adverse effect of glucocorticoids?

A

rare due to limited systemic absorption

  1. oropharyngeal irritation
  2. dysphonia (enfeebled voice due to msucle wasting)
  3. cough
  4. adrenosupression
  5. easy bruising
  6. cataracts
  7. osteoporosis
27
Q

what is the route for glucocorticoid ?

A

via inhalation
due to higher bidning affinity

can be administered IV in acute asthma attack but must be early as onset of action is slow

28
Q

what are some extra notes of glucocorticoids ?

A
  1. do not relax the smooth muscles
  2. it ddecreases the airway hyper responsiveness in 4-6 weeks od using the drug
  3. decrease frequency of asthma attacks
  4. reduce the need for beta 2 agonist
  5. reduce the death from asthma
  6. improve lung fucntion
29
Q

what is the second line of drug for anti inflammatory ?

A

leukotrience pathway inhibitors

  1. 5 lox inhibitor (zileuton)
  2. montelukast ( cyst receptor antagonist), also a weak bronchodilator
30
Q

what are the uses of the anti inflammaotry drug leukotrine pathway inhibitor ?

A 
second line ADD on if ICS is not enough 
or 
can be replaced in children 
or 
if asthma is mild can be replaced

for chronic treatment of asthma
aspirin induced asthma
exercise induced asthma

31
Q

what is the mechanism of leukotrine pathway inihbitor? (anti inflammatory)

A
  1. inhibit bronchoconstriction
  2. decrease frequency of asthma attack
  3. decrease need for ICS and beta agonsit
  4. decrease peripheral eosinophil level
32
Q

what are the adverse effect of leukotrine pathway inhibitors (anti imflammatory)?

A

churg straus syndrome (rapid withdrawal of glucocorticosteroid)
suicidal thinking

33
Q

what is the route for leukotrine pathway inhibitors ?

A

oral only

34
Q

what medication is good for allergic asthma ?

A

mast cell stabilizer (cromoglicic acid)
taken before allergic and exercise induced bronchospasm it decreases the need for beta agonist and need for bronchodilator therapy
less effective than glucocorticoid
response varies in patients

35
Q

what is the mechanism of mast cell stabilizer?

A
  1. prevent lge mediated allergic granulation events
  2. decrease release of histamine
  3. decrease seecretion of inflammatory mediators
  4. increase secretion of annexin A1 , anti inflammatory
36
Q

what are the adverse effect of mast cell stabalizer?

A

throat and nasal irritation
mouth dryness
cough
unplesant tase

37
Q

what is the route of mast cell stabalizer

A

only inhalation

38
Q

what is the antibody medication used for allergic asthma/

A

anti -lgE monoclonal antibody
for severe allergic asthma with an elevated LgE level
(s/C route, every 2-4 weeks )

39
Q

what is the mechenism for anti LgE ?

A
  • decreases the level of LgE in serum

- decreases mast cell degranulation

40
Q

what are the adverse effect of anti- lgE medication

A

small increase risk of heart attack
blood clots
body can make antibody against this
expensive

41
Q

what is the antibody medication for eosinphilic asthma ?

A

anit iL 5 (reslizumab)

anti iL 4 for mixed asthma (dupilumaab)

42
Q

what is the use for antiiL 5 drug ?

A

only for eosinophilic asthma for people above 18

L5 specific

43
Q

what are the adverse effect of anti iL 5 ?

A

oropharyngeal pain

potential for anaphylaxis

44
Q

what is the route for IL5 ?

A

IV once ever 4 weeks, expensive

45
Q

for severe acute asthma (emergency) what drug should be used?

A

magnesium sulfate
(relaxes smooth muscle of the airway
moderate release of acetylcholine and histamine
anti inflammatory effect)

Vanessa respiration ppnp (6 decks)

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