COPD drugs

Question 1

List the risk factors for COPD

Answer 1

Age, asthma pollution. smoking, chemical exposure, AAT deficiency, chronic bronchitis.

Question 2

is muscarinic receptor antagonist important for bronchodilation?

Answer 2

yes, as parasympathetic nervous system vagal nerve broncho constriction and mucus secretion contribute to COPD

Question 3

What is GOLD

Answer 3

Global initiative for COPD

Question 4

What is the class for Ipratropium bromide?

Answer 4

SAMA short acting muscarinic antagonist

onset 5-30 mins
6-8 hours

Question 5

What is the class for salbutamol

Answer 5

SABA short acting beta2 agonist

Question 6

Name some examples of LAMA

Answer 6

Glycopyronnium bromide and tiotropium bromide
onset 30 mins.
24 hours

Question 7

Name some examples of LABA

Answer 7

Formoterol and Indacaterol

Question 8

MOA of Muscarinic Receptor Antagonist - Bronchodilators

Answer 8

Inhibit M3 receptor mediated bronchoconstrictions

reverses vagal nerve mediated bronchospasm and mucus secretion

Question 9

Indication of Muscarinic Receptor Antagonist- Ipratropium bromide and Tiotropium bromide.

Answer 9

First line for COPD bronchodilation ( especially GOLD C and D)

Question 10

Adverse effects of Bronchodilators- muscarinic receptor antagonists

Answer 10

• unpleasant taste
• dry mouth
  urinary retention for elderly

limited systemic side effects in view of inhalation route.

Question 11

MOA of salbutamol SABA

Answer 11

B2 adrenoceptor activation mediated bronchodilation
increase in mucociliary clearance.

Question 12

Indication of SABA, LABA

Answer 12

usually 2nd in line for bronchodilation( more for GOLD A and B)
Combine with LABA with glucocorticoid prolongs effectiveness
often combined with SAMA, SABA or triple inhaler ( LAMA, LABA, glucocorticoid)

Question 13

Adverse effect of SABA, LABA

salbutamol

Answer 13

tremor, muscle cramps ( most common)
Peripheral vasodilation
palpitations and tachycardia ( for those nonselective)
Hypokalaemia and hyperglycaemia
Beta 2 adrenoceptor tolerance. * caution for those COPD with asthma patients.

Question 14

pharm class of theophylline

Answer 14

Methylxanthine

Question 15

Indication of theophylline- methylxanthine

Answer 15

For more severe cases of COPD

Question 16

Adverse effects of theophylline

Answer 16

Narrow therapeutic window ( 5-20mg/L)
many drug to drug interactions( caution)
GI: nausea vomiting abdominal discomfort, seizure
CNS: nervousness, tremor, anxiety, insomnia, seizures.

cardio: arrhyhtmias

Question 17

What is the pharmacological class of roflumilast?

Answer 17

Phosphodiesterase -4 inhibitor (PDE -4 inhibitor)

Question 18

uses and efficacy of roflumilast (PDE-4 inhibitor)

Answer 18

reduce episodes of exacerbation
slows progression of fibrosis

Question 19

Adverse effects of PDE-4 inhibitor roflumilast

Answer 19

Headaches dizziness insomnia
Weight loss, diarrhoea, nausea, decreased appetite
rare: anxiety depression and suicisdal
CAUTION: hepatic impairment

Question 20

What is Azithromycin

Answer 20

it is an antibiotic, antifibrotic and a smooth muscle relaxant

Question 21

MOA of azithromycin

Answer 21

Macrolide antibiotic prevents bacteria from growing by interfering with their protein synthesis.
Antifibrotic and airway smooth muscle relaxant through mechanisms that are not completely understood. w

Question 22

Uses and efficacy of azithromycin

Answer 22

Antifibrotic and airway smooth muscle effects reduce risk of exacerbations
prevention and treatment of exacerbations due to bacterial infections

Question 23

Adverse effects of azithromycin

Answer 23

Diarrhea, nausea, vomiting
cardiac arrhythmia

Question 24

Contraindications for azithromycin

Answer 24

CHolestatic jaundice or hepatic dysfunction