COPD Drugs & Decongestants

Question 1

Bronchodilators

Answer 1

Ex:
SABAs
LABAs (indacaterol only for COPD)
-LABAs can be used as monotherapy
Theophylline
Ipratropium (SAMA) and tiotropium (LAMA)

MOA:
Bronchiole smooth muscle
- block Gq coupled receptors (M3 and CysLT1)
- stimulate Gs coupled receptors (Beta-2)
- block PDE g h cAMP/PKA effects
* Bronchodilators help less compared to asthma

Immune cells
- inhibit inflammation
* Immune involvement is different (mast cells not important); ICS help less compared to asthma

AEs: Not Discussed

Question 2

Anti-inflammatory

Answer 2

Ex:
ICS
Theophylline
Roflumilast (oral PDE4 inhibitor only for COPD)

MOA:
Bronchiole smooth muscle
- block Gq coupled receptors (M3 and CysLT1)
- stimulate Gs coupled receptors (Beta-2)
- block PDE –> cAMP/PKA effects
* Bronchodilators help less compared to asthma

Immune cells
- inhibit inflammation
* Immune involvement is different (mast cells not important); ICS help less compared to asthma

AEs: Not Discussed

Question 3

Decongestants 1

Answer 3

Ex:
Phenylephrine (Oral, Intranasal)
Oxymetazoline (Intranasal)

MOA:
agonist to alpha-1 adrenergic receptor
–> increases vasoconstriction –>
decreases Pc

AEs:
Increased BP
Rebound nasal congestion if overused as nasal spray (from downregulation of alpha-1 receptors); * minimized if combined with
intranasal corticosteroid

Question 4

Decongestants 2

Answer 4

Ex: Pseudoephedrine

(Oral)
MOA:
Increased NE release, weak alpha-1 agonist

increases Stimulation of alpha-1 adrenergic receptor –> increases vasoconstriction –> decreases Pc

AEs: increases BP, increases HR
insomnia, nervousness