B. 11+12 asthma, COPD, expectorants

Question 1

B2 receptor agonist mechanism for bronchodilation

Answer 1

Gs–> Increase cAMP –> SM relaxation

Question 2

what are Albuterol, terbutaline and metaproterenol?

Answer 2

SABA- short acting B2 agonists

Question 3

major difference between SABA and LABA

Answer 3

SABA in acute asthma attack, LABA prophylaxis

Question 4

side effects of SABA & LABA

Answer 4

tremor, arrhythmia, tachycardia

Question 5

what are Salmetarol and formoterol?

Answer 5

LABA- long acting B2 agonists

Question 6

what group do these belong to: ipratropium, tiotropium and aclidinium ?

Answer 6

muscarinic antagonists

Question 7

mechanism of muscarinic antagonists in asthma and COPD

Answer 7

competitive inhibitor of M3 R (Gq)–> prevent bronchoconstriction

Question 8

side effects of muscarinic antagnosits- M3

Answer 8

dry mouth, cough

Question 9

what group do these belong to: theophylline, aminophylline, roflumilast ?

Answer 9

methylxanthines

Question 10

what do methylxanthines do? (theophylline)

Answer 10

1. Phosphodiesterase inhibition–> increase cAMP–> bronchodilation
2. adenosine receptor antagonist –> CNS effects

Question 11

how is theophylline given?

Answer 11

oral

Question 12

how is aminophylline given ?

Answer 12

IV

Question 13

side effects if theophylline

Answer 13

GI distress, insomnia, tremor, anorexia, seizures, arrhythmias, CNS effects

Question 14

what is the most effective anti-inflammatory agent used in asthma therapy?

Answer 14

corticosteroids

Question 15

effects of corticosteroids

Answer 15

1. inhibit Pospholipase A2–>↓ COX activity ↓ inflammatory mediators
2. number of inflammatory cells ↓ eosinophils in the airway and sputum ↓
3. number of activated T lymphocytes and mast cells in the airway mucosa ↓

Question 16

what type are- beclomethasone, budesonide, dexamethasone

Answer 16

inhaled glucocorticoids

Question 17

what type is prednisone

Answer 17

systemic glucocorticoid

Question 18

what type are- prednisolone, hydrocortisone

Answer 18

IV Glucocorticoids

Question 19

side effect of budesonide

Answer 19

oropharyngeal candidiasis

Question 20

IV glucocorticoids are used for..

Answer 20

Status asthmaticus

Question 21

what is Montelukast?

Answer 21

LTD4 receptor antagonist

Question 22

what are leukotrienes antagonists ?

Answer 22

interfere with the synthesis of leukotrienes –> reduce inflammation+ decrease bronchoconstriction
(e.g- montelukast)

Question 23

what is Zileuton?

Answer 23

selective inhibitor of LOX (lipoxygenase enzyme)

Question 24

when do you give leukotrienes antagonists?

Answer 24

asthma prophylaxis

Question 25

side effect of zileuton

Answer 25

elevated liver enzymes

Question 26

mast cell stabillizer?

Answer 26

Cromolyn sodium ( Na- chromoglycate)

Question 27

how is Cromolyn sodium given ?

Answer 27

Aerosol

Question 28

what is Omalizumab ?

Answer 28

Anti IgE antibody, attches to antibodies on mast cells preventing inflammatory response

Question 29

when will Omalizumab given?

Answer 29

when asthma is unresponsive to other drugs

Question 30

prenoxidazine

Answer 30

peripheral acting antitussive agent

Question 31

codeine

Answer 31

centrally acting antitussive agent | opioid derivative

Question 32

side effects of codeine, dihydrocodeine

Answer 32

morphine effects- respiratory depression, constipation, dry mouth, nausea, vomiting

Question 33

centrally acting, non-opioid antitussive agents

Answer 33

1. dextromethorphan 2. butamirate 3. pentoxyverine

Question 34

what are antitussive?

Answer 34

cough suppressing agents, supress cough reflex

Question 35

what are muco-active drugs?

Answer 35

mucoactive= expectorants--> promote sputum excretion

Question 36

name the types of expectorants

Answer 36

1. secretolytics 2. mucolytics 3. secretomotorics

Question 37

what do secretolytics do?

Answer 37

increase secretion of mucus, make it less viscous so no irritation of sensory receptors

Question 38

indication for secretolytics ( ipecacuanha, guaifenesine, ottars)

Answer 38

respiratory disease with increased mucos secretion

Question 39

what are mucolytics?

Answer 39

agents the liquefy and loosen mucos secretion

Question 40

name 2 mucolytics

Answer 40

acetylcysteine (ACC) bromhexine carbocystein dornase alpha

Question 41

what does acetylcysteine do?

Answer 41

reduce disulfide bonds in the mucus matrix--> decrease mucos viscosity

Question 42

what does bromhexine do?

Answer 42

its an active metabolite, cleaves the mucopolysaccarides of the mucos and makes it more liquid and easy to come out 🤧 (more serous)