Chapter 80 Drugs for Asthma and Chronic Obstructive Pulmonary Disease Flashcards
What is the pathophysiology of asthma?
A chronic disorder characterized by airway obstruction and inflammation, bronchial hyperresponsiveness, and airway remodeling.
What triggers airway inflammation in asthma?
An immune response to known allergens that bind to immunoglobulin E (IgE) antibodies on mast cells.
What mediators are released during an asthma attack?
- Histamine
- Leukotrienes
- Prostaglandins
- Interleukins
What are the symptoms of asthma?
- Cough
- Wheezing
- Dyspnea
- Chest tightness
What is the significance of spirometry in asthma diagnosis?
It assesses lung function and helps diagnose recurrent airway obstruction.
What is the forced expiratory volume in 1 second (FEV1)?
A measure of how much air a person can forcefully exhale in one second.
What is the predicted FEV1 percentage for individuals aged 8 to 19?
85% or higher.
What is the goal of asthma management?
- Reduce impairment
- Reduce risk
What does GINA recommend for asthma management?
Adults and adolescents should not be treated with a short-acting bronchodilator alone; a daily inhaled corticosteroid is recommended.
What are the adverse effects of regular use of SABA?
- Beta-receptor downregulation
- Decreased broncho protection
- Rebound hyperresponsiveness
- Increased eosinophilic airway inflammation
What is the role of glucocorticoids in asthma treatment?
They suppress inflammation, decrease mucus production, and reduce bronchial hyperactivity.
Name a common inhaled glucocorticoid.
- Budesonide
- Fluticasone
What are the potential adverse effects of inhaled glucocorticoids?
- Oral candidiasis
- Dysphonia
- Adrenal suppression with high doses
What is the mechanism of action (MOA) of leukotriene modifiers?
They suppress the effects of leukotrienes.
What is a black box warning associated with leukotriene modifiers?
Neuropsychiatric effects.
What is the MOA of mast cell stabilizers like Cromolyn?
They suppress inflammation and prevent the release of histamine.
What is Omalizumab used for?
Moderate to severe asthma that is allergy-related and has failed inhaled glucocorticoid therapy.
What is the primary use of bronchodilators in asthma?
For symptomatic relief, particularly acute bronchospasm.
What are the two types of beta-2 adrenergic agonists?
- Short-acting beta-2 agonists (SABAs)
- Long-acting beta-2 agonists (LABAs)
What is the recommended oxygen saturation target during COPD exacerbations?
88% to 92%.
What characterizes the classification of airflow limitation in COPD?
- Mild: FEV1 > 80%
- Moderate: FEV1 50%-80%
- Severe: FEV1 30%-50%
- Very severe: FEV1 < 30%
What does the GOLD assessment tool classify?
The severity of COPD based on symptoms and risk.
What is the treatment goal for COPD?
- Reduce symptoms
- Improve exercise tolerance
- Prevent disease progression
What is the MOA of Roflumilast?
It is a phosphodiesterase type 4 inhibitor that prevents inflammation and decreases lung tissue damage.
What are common adverse effects of theophylline?
- Ventricular fibrillation
- Convulsions
What are the adverse effects of anticholinergic drugs like Ipratropium?
- Increased intraocular pressure
- Cardiovascular events
True or False: Tiotropium is approved for asthma treatment.
False
Fill in the blank: The initial pediatric dose of oral glucocorticoids for asthma is ______.
1-2 mg/kg/day for 3-10 days
What should patients with severe asthma continue during COVID-19?
Inhaled corticosteroids and oral corticosteroids.
