B / 21 : Selective B2 Stimulants And Other Bronchodilators

Question 1

3 examples of COPD

Answer 1

• Emphysema
• Chronic bronchitis
• Small airway disease

Question 2

What is emphysema?

Answer 2

Destruction and enlargement of lung alveoli

Question 3

Effect of B2 agonists in the bronchial tree

Answer 3

Bronchodilation and increased ciliary activity

Question 4

B2 agonists (5)

Answer 4

• Salbutamol
• Terbutaline
• Fenoterol
• Salmeterol
• Formoterol

FFSST

Question 5

Salbutamol, Terbutaline, Fenoterol
- MOA
- Effect
- Indication
- SE
- ROA
- Extra

Answer 5

• Short acting B2 agonists
• Bronchodilation via Gs activation
• For asthma, COPD
• Tachycardia, tremor
• Aerosol inhalation, nebulizer, parenteral
• Onset : 5min, duration : less than 4 hours

Question 6

What is an extra indication of terbutaline?

Answer 6

Prevents premature labor via uterus relaxation

Question 7

Salmeterol, formoterol
- MOA
- Effect
- Indication
- SE
- ROA
- Extra

Answer 7

• Long acting B2 agonists
• Bronchodilation through Gs activation
• Controller in moderate asthma
• Aerosol, nebulizer, parenteral, oral
• 12-24 hour duration, always used with corticosteroids

Question 8

Why are long acting B2 agonists combined with corticosteroids?

Answer 8

Reduces dosage and SE of drugs

Question 9

How can muscarinic ANTagonists helps in bronchodilation?

Answer 9

Inhibitors of M3 receptors (Gq) prevent bronchoconstriction mediated by vagal stimulation

Question 10

Ipratropium
- MOA
- Effect
- Indication
- ROA

Answer 10

• Non-selective muscarinic antagonist
• Bronchodilation
• Asthma, COPD, chronic bronchitis
• Inhaled from a spray

Question 11

Tiotropium
- MOA
- Effect
- Indication
- SE
- ROA
- Extra

Answer 11

• M3 antagonist
• Bronchodilation
• Asthma, COPD, chronic bronchitis
• Dry mouth, cough
• Inhaled from a spray
• Longer duration than ipratropium (24h vs 4-6h)

Question 12

What are methylxanthines?

Answer 12

Purine derivatives extracted from plants (tea, coffee, cocoa)

Question 13

What are the methylxanthines used in bronchodilation?

Answer 13

• Theophylline

Question 14

Theophylline
- MOA
- Effect
- Indication
- SE
- ROA

Answer 14

• Competitive inhibition of phosphodiesterase 5 (PDE5)
• Bronchodilation, decrease of inflammatory mediators, increased ciliary activity
• For prevention of asthmatic attacks
• Can cause anxiety, seizures, high BP, high GFR
• Oral