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PharmQ1Questions > AsthmaCOPD > Flashcards

AsthmaCOPD Flashcards

1
Q

Which drugs can be risk factors for asthma?

A

Beta Blocker, Ca antagonists, NSAIDS

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2
Q

What are the 2 phases of an asthma attack?

A

Immediate (mainly bronchospasm) Late-phase ( bronchospasm, vasodilation, edema and mucus)

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3
Q

What are long term control medications in asthma?

A

ICS, LABA, leukotriene modifiers, methylxanthines, cromolyn, Anti IgE

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4
Q

What are the quick relief medications in asthma?

A

SABA, anticholinergics, systemic corticosteroids

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5
Q

What is a major advantage of inhaled therapy?

A

Delivery of drugs directly to the airways, deliver higher drug concentrations locally. And minimize systemic side effects

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6
Q

What is the MOA for ICS?

A

Depress the inflammatory response + edema in the reps tract and diminishes bronchial hyper-responsiveness?

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7
Q

What is the most effective long-term controlled therapy for persistent asthma?

A

ICS, have to be used REGULARLY to be effective

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8
Q

What are local and systemic ADR of ICS?

A

Local: thrush, dysphonia, reflex cough. Systemic: hypothalamic- pituitary adrenal suppression, impaired growth in kids, and dermal thinning

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9
Q

What are the ICS?

A

Fluticasone, budesonide, beclomethasone, flunisolide, triamcinolone, mometasone, ciclesonide

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10
Q

What are the ICS/ LABA combo drugs?

A

Fluticasone+ salmeterol ( advair). Flucticason+ vilanterol, Budesonide+ fomoterol, mometasone+ fomoterol

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11
Q

Are LABAs a substitute for anti-inflammatory therapy?

A

no

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12
Q

Are LABAs used for monotherapy?

A

NO

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13
Q

What is the LABA black box warning?

A

May increase the chance of severe asthma episodes and death

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14
Q

What are some LABAs?

A

Salmeterol, formoterol, arformoterol tartrate, and formoterol fumarate

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15
Q

What drugs should be avoided d/t interactions that cause prolonged QT, palpitations, and tachycardia?

A

Ketoconazole, ritonavir, atazanavir, clarithromycin, indinavir, intraconazole, netazodone, nelfinavir, saqunavir, and telithromycin

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16
Q

What are 3 leukotriene receptor antagonists?

A

Montelukast ( singular), zarfirlukast, and zileuton

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17
Q

What is the MOA of the leukotriene recpetor antagonists?

A

Competitively antagonize leuk.. receptors D4 and E3 in the bronchiolar muscle, antagonizing endogenous leukotrienes causing bronchodilation

18
Q

Which leuk., receptor antagonists interact with warfin?

A

Zarfirlukast and zileutin

19
Q

What are the methylxanthines and their MOA?

A

Theophylline, aminophylline. Increase CAMP in bronchial smooth muscle ñ bronchodilate

20
Q

Can the methylxanthines be used as a monotherapy?

A

YES

21
Q

Why are the methlyxanthines used infrequently?

A

They have a narrow therapeutic window and a lot of drug interactions- there are safer alternatives

22
Q

What are the 2 major categories and examples of interactions with methylxanthines?

A

1)drug-disease: viral illness, CHF, cirrhosis, and smoking. 2) drug-drug: cimetidine, ,macrolides, quinolones, CYP1A2/3A4 substrates

23
Q

What type of drug is indicated for pts

A

Mast cell stabilizers

24
Q

What is the MOA for mast cell stabilizers?

A

Stabilize mast cells preventing the release of inflammatory mediators. Must be used regularly for weeks for effect

25
Q

What is the immunodilator and what is its black box warning?

A

Omalizumab. Anaphylaxis

26
Q

How often is omalizumab administered?

A

Once every 2-4wks SUB Q

27
Q

What is the MOA for systemic corticosteroids?

A

Decrease inflammation by suppression of migration of leukocytes and reversal of increased capillary permeability

28
Q

What category is Albuterol

A

SABA- quick relief bronchdilator

29
Q

What do the beta 2s do?

A

Increase CAMP- bronchodilation

30
Q

Do Beta 2s treat or control asthma?

A

No- they only treat symptoms in acute exacerbations

31
Q

A pt needs to have their plan re-evaluated if they have more than how many courses of systemic corticosteroids yearly?

A

3

32
Q

Increased SABA use to how many times weekly indicated inadequate control and a need to step up treatment?

A

> 2 times weekly

33
Q

What is the approach to initial management of asthma?

A

Quick relief- SABA, 2-4 puffs PRN, up to 3treatments per 20 min intervals or a single nebulizer tx. Step 1: mild intermittent- symptoms 1day/wk BUT 2 nights a month, preferred tx is low dose ICS, prn SABA
Step 3: moderate persistent: symptoms daily, >1 night a week, low dose ICS+ LABA and prn SABA
Step 4: severe persistent : continuous symptoms, medium or high dose ICS+LABA and prn SABA and oral steroid if needed

34
Q

What are some risk factors for death by asthma?

A

2 or more hospitalizations or >3 ED visits in the past year. hospitalized or ED in the past month
uses >2 canisters of SABA/month

35
Q

What is the foundation of therapy for COPD?

A

Anticholinergics + B2 agonist. Combo albuterol and ipratropium

36
Q

What are the antocholinergics and are they indicated for chronic therapy?

A

Ipratroprium, tiotroprium. NO- relief of ACUTE bronchospasms

37
Q

What is the MOA for the anticholinergics?

A

Muscarinic antagonist block muscarinic receptors, which respond to the parasympathetic bronchoconstriction tone

38
Q

What are the antichol./ LABA combos?

A

Indacaterol + glycopyrronium. Tiotropium + olodaterol

39
Q

When are antibiotics indicated for COPD?

A

When at least 2 of the following symptoms are present: Increased dyspnea
Increased sputum volume
Increased sputum purulence

40
Q

Which organisms are most common pathogens treated in COPD?

A

Strep pneumo, H influenzae, and moraxella catarrhalis

41
Q

Which antibiotics are used most often in Mild to moderate COPD and Severe COPD

A

Mild to mod: doxycycline, sulfamethoxazole/ trimethoprim, amoxicillin clavulante, macrolides, and fluoroquinolones Severe: antipseudomonal PNC, 3rd generation cephs, and fluoroquinolones.

PharmQ1Questions (13 decks)

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