Asthma Pharmacology

Question 1

side effects of beta-agonists

Answer 1

(1) skeletal muscle tremors
(2) tachycardia
(3) palpitations
(4) hypokalemia
(5) hyperglycemia

Question 2

time to onset for SABA

Answer 2

3-5 minutes

Question 3

side effects of ICS

Answer 3

oral thrush
dysphonia
cough
hoarse throat
increased risk of pneumonia

Question 4

Beclomethasone = ?

Answer 4

QVAR

Question 5

Ciclesonide = ?

Answer 5

Alvesco

Question 6

Budesonide = ?

Answer 6

Pulmicort

Question 7

Flunisolide = ?

Answer 7

Aerospan

Question 8

Fluticasone = ?

Answer 8

Flovent, Arnuity, ArmonAir

Question 9

Mometasone = ?

Answer 9

Asmanex

Question 10

Side effects of leukotriene modifiers

Answer 10

(1) neuropsychiatric events
(2) increase in LFTs
(3) sinusitis
(4) Churg-Strauss syndrome (rare)

Question 11

contraindications to leukotriene modifier therapy

Answer 11

hepatic impairment (except montelukast)

Question 12

cromolyn drug class

Answer 12

mast cell stabilizer

Question 13

side effects of mast cell stabilizers

Answer 13

(1) cough
(2) unpleasant tasta
(3) cardiac arrhythmias (rare)

precaution: anaphylaxis

Question 14

side effects of methylxanthines

Answer 14

(1) insomnia
(2) GI upset
(3) tremor
(4) nervousness
(5) hyperactivity in children

Question 15

Use caution with methylxanthine treatment in patients with ________ disease.

Answer 15

cardiovascular

Question 16

Major drug interactions occur with all CYP _____ substrates and theophylline.

Answer 16

1A2

Question 17

Minor drug interactions occur with all CYP ____ and ____ substrates and theophylline.

Answer 17

3A4, 2E1

Question 18

target serum concentration of theophylline

Answer 18

5-15 mcg/mL

Question 19

signs of theophylline toxicity

Answer 19

(1) N/V
(2) tachyarrhthmias
(3) headache
(4) seizures

Question 20

Omalizumab = ?

Answer 20

Xolair

Question 21

Omalizumab is anti-____, while Mepolizumab and Reslizumab are anti-____.

Answer 21

IgE, IL-5

Question 22

Reslizumab = ?

Answer 22

Cinquair

Question 23

Mepolizumab = ?

Answer 23

Nucala

Question 24

Which two monoclonal antibodies for asthma treatment are injected subcutaneously, and which one is IV?

Answer 24

subQ: Xolair, Nucala
IV: Cinquair

Question 25

side effects of mabs

Answer 25

(1) injection site reaction (2) arthralgia (3) dizziness (4) fatigue (5) CV events (Xolair) (6) herpes zoster infection (mepolizumab)

Question 26

Which mab carries a precaution (not a warning) for anaphylaxis?

Answer 26

mepolizumab (Nucala) Xolair and Cinquair carry warnings for anaphylaxis.

Question 27

side effects of anti-muscarinics

Answer 27

(1) dry mouth (2) dizziness (3) blurred vision (4) urinary retention (5) upper respiratory tract infection

Question 28

precautions with anti-muscarinics

Answer 28

myasthenia gravis urinary retention BPH narrow angle glaucoma

Question 29

Ipratropium = ?

Answer 29

Atrovent

Question 30

Ipratropium + albuterol = ?

Answer 30

Combivent

Question 31

LAMA examples

Answer 31

Tiotropium (Spiriva) Umeclidinium (Incruse) Aclidinium (Tudorza) Glycopyrrolate (Seebri)

Question 32

PDE4 mechanism of action

Answer 32

inhibition of PDE4 leads to increased intracellular cAMP, which

Question 33

Give an example of a PDE4 inhibitor.

Answer 33

Roflumilast (Daliresp)

Question 34

side effects of roflumilast

Answer 34

``` diarrhea weight loss decreased appetite insomnia depression ```

Question 35

With PDE4 inhibitors, drug-drug interactions can occur with CYP ____ and ____.

Answer 35

3A4, 1A2