drug for asthma and COPD

Question 1

prototype drug for glucocorticoid

Answer 1

beclomethasone

prednisone

Question 2

prototype drug for monoclonal antibodies

Answer 2

omalizumab ( anti igE anitbody )

Question 3

prototype drug for phosphodiesterase 4 inhibitors

Answer 3

roflumilast

Question 4

prototype drug for bronchodilators - anticholinergic drug

Answer 4

ipratropium ( short acting )

tiotropium ( long acting )

Question 5

prototype drug for bronchodilators - Beta2 adrenergic agonists

Answer 5

albuterol ( short acting )

Salmeterol ( long acting)
formonterol

Question 6

prototype drug for bronchodilators - methylxanthine

Answer 6

theophylline

Question 7

MOA of glucocorticoid

Answer 7

reduce respiratory symptom by suppressing inflammation via

decrease synthesis and release of the inflammatory mediators( leukotriene, histamine and prostaglandins

decrease infiltration and activity of the inflammatory cells

decrease edema of the airway mucosa

may increase brachial beat receptors and responsiveness to beta agonists

Question 8

therapeutic use of glucocorticoid

Answer 8

asthma prophylaxis and management of COPD exacerbation

Question 9

adverse effect of glucocorticoid

Answer 9

oropharyngeal candidiasis

dysphonia ( hoarseness)

adrenal suppression ( children with low BMI has higher risk)

grown suppression
bone loss

inc risk of cataract and glaucoma

Question 10

inhaled glucocorticoid should be administered on a __________, dose should be _____-

Answer 10

regular schedule,

does should be keep low as possible

Question 11

when using oral glucocorticoid for asthma the initial dosing are usually

Answer 11

higher aiming to bring symptoms under control and gradually dec dosage

Question 12

MOA of leukotriene receptor antagonist ( LTRAs) - Montelukast ( singulair )

Answer 12

second line therapy for asthma maintenance

suppress the effect of leukotriene - compounds that promotes smooth muscle constriction, blood vessel permeability, and inflammatory cells

decrease bronchoconstiction and mucus secretion

Question 13

LTRAs adverse effect

Answer 13

Liver injury, suicidal thoughts, depression, hallucinations, irritability

Question 14

the adverse effect of zileuton

Answer 14

liver injury

ALT should be monitored

Question 15

MOA of cromolyn

Answer 15

suppressed bronchial inflammation, used for prophylaxis tx in patients with mild and moderate asthma

Cromolyn does not cause brochialdialtion

it stabilizes the cytoplasmic membrane in the mast cell, preventing the release of histamine and another mediator as well as inhibiting other inflammatory cells

Question 16

therapeutic use of cromolyn

Answer 16

chronic asthma as an alternative to inhaled glucocorticoid

excerse induce bronchospasm

allergic rhinitis

Administer 15 mins before exercise and exposure to participating factors.

Long-term use should be administered on a regular schedule.

Question 17

Omalizumab - monoclonal antibody

Answer 17

Second-line agent for allergy relater asthma only when other options failed due to risk for anaphylaxis and cancer

SQ injection only

Question 18

MOA of Omalizumab

Answer 18

forms complex with free igE hence reducing the amount of igE available to bind with receptors on mast cells and limiting the release of histamine and leukotrienes

Question 19

adverse effect of omalizumab

Answer 19

due to igE suppression - viral infection, upper respiratory infection, sinusitis pharyngitis

malignancy, anaphylaxis

Question 20

interleukin 4 receptor alpha antagonist - dupilumab

Answer 20

IgG antibody binds to the IL4 RA subunit, inhibits the singling, and inhibits the IL4 cytokine-induced inflammatory response

tx eosinophilic asthma and atopic dermatitis

Question 21

mehylxanine

Answer 21

theophylline, caffeine

acts on CNS cause excitation, and bronchodialtion,

Question 22

theophylline

Answer 22

MOA- relaxing the bronchi smooth muscle by blocking adenosine receptors

therapeutic use - chronic stable asthma

prolong effect most appropriate for nocturnal attacks

adverse effect - N/V/D insomnia, restlessness

Question 23

theophylline toxicity

Answer 23

N/V/D insomnia, restlessness

severe dysthymia, convulsion

tx lidocaine, IV benzodiazepine