Bronchodilators

Question 1

Beta2- Adrenergic Agonists- Terols MOA

Answer 1

Activation of the beta2-adrenergic receptors- promote bronchodilation and relieve bronchospams
- additional role in suppressing histamine release and increasing ciliary motility

Question 2

Beta2- Adrenergic Agonists- LABA

-use

Answer 2

Used on a fixed schedule to prevent exacerbations- must always be combined with an inhaled ICS in asthma use- monotherapy a/w increased incidence as asthma-related death

Question 3

Beta2- Adrenergic Agonists- SABA

Answer 3

Used to abort an ongoing attack or prior to exercise to prevent EIB (exercise induced bronchoconstriction)- nebulized in hospitalized patients

Question 4

Beta2- Adrenergic Agonists- use

Answer 4

Most effective drugs available for relieving acute bronchospasm and preventing exercise induced bronchospams
-virtually all patients with asthma use these as first line agents

Question 5

ADR Beta2- Adrenergic Agonists-

Answer 5

1) tachycardia
2) angina
3) tremor
4) nervousness
5) excitement

Question 6

Albuterol indications and drug class

Answer 6

bronchospasm, exercise induced bronchospasm

-SABA

Question 7

moa albuterol

Answer 7

beta 2 agonist

short acting

Question 8

Levalbuterol as compared to albuterol

Answer 8

initially thought to have less jitters, tachycardia- not proven but may be the case on some patients

-SABA

Question 9

Long acting beta agonists (LABA) types

Answer 9

formoterol
salmeterol

rarely used as a monotherapy

Question 10

Muscarinic antagonists (anticholinergics) use

Answer 10

Historically only approved for COPD but were used off label for asthma for years- have slowly been gaining approvals for asthma (typically the combo products)

Question 11

MOA of anticholinergics

Answer 11

1) antagonists at muscarinic receptor in the bronchi- reduce bronchoconstriction

Question 12

SAMA

• use
• dose

Answer 12

Shorter duration of action and faster onset- used for attacks (COPD exacerbation)- often combined with albuterol. Typically 4x/day inhalations

example: ipratropium

Question 13

LAMA

• use
• dose

Answer 13

Similar to LABAs- used more control and long term prophylaxis/prevention- typically 1-2 times per day inhalations

Question 14

ADR of anticholinergics

Answer 14

Dry mouth (anticholinergic effect), irritation of the pharynx, urinary retention

Question 15

Ipratropium (atrovent) MOA and drug class, indications

Answer 15

• short acting muscarinic antagonist
• SAMA
• used for COPD

Question 16

What are the long acting beta agonists? (names of the drugs)

Answer 16

1) formoterol
2) olodaterol
3) salmeterol
4) vilanterol
5) arformoterol
6) indacterol

NOT albuterol or levoalbuterol

Question 17

Names of the LAMAs

Answer 17

1) tiotropium
2) aclidinium
3) umeclidinium
4) revefenacin
5) glycopyrrolate