Drugs And Asthma Flashcards by Alice Caporn | Brainscape

Q

Muscarinic antagonists reduce the excessive mucus secretion which occurs in asthma and may increase clearance of bronchial secretions, true or false

A

True

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Q

True or false,status asthmaticus is another term for chronic asthma

A

False, it is another term for acute asthma

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Q

During an inflammatory reaction in the airways, mast cells release the following spasmogens

Histamine. 4. Tumour necrosis factor-alpha
Interleukins (IL-4, IL-5, IL-13). 5. Prostaglandin D2
Leukotrienes (LTC4, LTD4)

A

Histamine, leukotrienes and prostaglandin D2

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Q

True or false, the problem with stopping steroid treatment abruptly is that the body over produces steroids

A

False

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Q

When treating asthma, the aim of drug treatment is to reduce inflammation and prevent bronchodilation, true or false

A

False

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Q

True or false, salbutamol has a longer duration of action than salmeterol

A

False

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Q

Oropharangeal thrush and dysphonia are adverse effects associated with the use of inhaled steroids, true or false

A

True

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Q

True or false, chronic asthma involves recurrent attacks of reversible airway obstruction

A

True

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Q

True or false, stimulating B2 adrenoceptors involves activation of a G protein coupled receptor, and increSe in cAMP and activation of protein kinase A

A

True

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Q

Match the following bronchodilators with their MOA

Terbutaline. A. B2 adrenergic agonist
Monteleukast. B. Leukotriene Rs antagonist
Theophylline C. Muscarinic Rs antagonist
Ipratropium. D. Leukotriene Rs antagonist
Zafirleukast. E. Phosphodiesterase inhibitor
Salmeterol. F. B2 adrenergic Rs agonist

A

1 - A
2 - B
3 - E
4 - C
5 - D
6 - F

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Q

Which type of asthma is not as susceptible to drugs; chronic or acute?

A

Acute

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Q

True or false, the aim of drug treatment in asthma is to reduce inflammation and prevent bronchoconstriction

A

True

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Q

Asthma that is classified as non-atopic is triggered by what?

A

Intrinsic trigger; exercise, respiratory infection, atmospheric pollutants

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Q

Asthma that is classified as atopic is triggered by what?

A

Allergic trigger, extrinsic trigger; pollen, dust mite proteins, animal dander

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Q

During the early phase of an asthma attack mast cells release the following inflammatory mediators

Interleukins (IL-4, IL-5, IL-13)
Histamine
Macrophage inflammatory protein
Tumour necrosis factor
Prostaglandin D2
Chemo taxing & chemokines

A

Interleukins
Macrophage inflammatory protein
Tumour necrosis factor
Chemotaxins and chemokines

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Q

What happens during the late phase of an asthma attack; bronchospasm or inflammation

A

Inflammation

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Q

Which of the following is not a type of bronchodilator 
B2 adrenergic receptor agonist 
Theophylline 
Muscarinic receptor agonist 
Leukotriene receptor antagonist

A

Muscarinic receptor agonist - it is a Muscarinic receptor antagonist

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Q

How do B2 adrenergic receptor agonists work?

A

Act on B2 adrenoceptors on bronchiole smooth muscle to relax muscle

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Q

Salbutamol, salmeterol and terbutaline are all types of what drug

A

B2 adrenergic receptor agonists - bronchodilators

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Q

How long does it take for salbutamol to have its maximum effect?

A

30mins

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Q

What is the duration of action if salbutamol and terbutaline

A

4-6 hours

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Q

How often would an individual with asthma take salbutamol

A

As and when needed

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Q

What duration of action does salmeterol have

A

12 hours

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Q

How often should a patient take salmeterol

A

Twice daily

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Q

Why are B2 agonists given by inhalation?

A

To decrease systemic effects

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Q

What is the most common unwanted effect of B2 agonists

A

Tremor

Q

Some tolerance can be developed to B2 agonists, how can this be prevented

A

By using a glucocorticoid

Q

True or false, theophylline is a phosphodiesterase inhibitor

A

True

Q

When is theophylline used in the treatment of asthma?

A

As a second line treatment, when B2 agonists are not working

Q

In acute asthma theophylline might be given, how would it be administered?

A

IV - severe bronchoconstriction so inhalation wouldn’t work

Q

Ipratropium is used in asthma, what kind of drug is it

A

Muscarinic receptor antagonist

Q

How long does it take for the maximum effect of ipratropium to be reChed

A

30mins

Q

What is the duration if action of ipratropium

A

3-5 hours

Q

How is the Muscarinic receptor antagonist ipratropium administered

A

Aerosol Inhalation

Q

The drugs monteleukast and zafirlukast and what types of drugs used to prevent exercise induced and aspirin sensitive asthma

A

Leukotriene receptor antagonists

Q

How are the Leukotriene receptor antagonists monteleukast and zafirlukast administered

A

Orally

Q

Where do the Leukotriene receptor antagonists work.?

A

At cysteinyl-leukotriene receptors (on bronchiole smooth muscle cells)

Q

Which glucocorticoids are only occasionally given to people with asthma 
Beclomethasone 
Prednisolone
Budesonide
Hydrocortisone
Fluticasone

A

Prednisolone and hydrocortisone

Q

How are glucocorticoids administered to people with asthma

A

Inhalation

Q

True or false, the actions of glucocorticoids are immediate

A

False, it takes a few days for their full effect

Q

Glucocorticoids work as anti inflammatory drugs because they reduce which of the following

Cytokines
Spasmogens (LT4, LTD4)
Tumour necrosis factor
Leucocyte Chemotaxins (LTB4, PAF)

A

1, 2 and 4

Q

True or false, the actions of glucocorticoids in asthma reduces bronchospasm and increases recruitment and activation of inflammatory cells

A

False, reduces both

Q

Which intracellular receptors do glucocorticoids bind to in cytoplasm

A

GR alpha

GR beta

Q

What do glucocorticoids inhibit that blocks the entire bronchoconstriction pathway

A

Phospholipase A2

Q

For patients with severe asthma, give inhaled steroid with which additional agent

A

B2 agonist or theophylline

Q

For acute asthma attacks which two glucocorticoids would be given, and how would they be administered

A

Hydrocortisone - IV

Prednisolone - oral

Q

How can the adverse effects of inhaled steroids, such as oropharyngeal thrush and dysphonia be minimised

A

Using a spacer device

Q

Why can oral/regular large doses of glucocorticoids hVe serious effects

A

Adrenal suppression - stop natural production of glucocorticoids

Patients must carry a steroid card

Q

Which drug can reduce both early (bronchoconstriction) and late (inflammation) phases of asthma attack

A

Cromoglicate

Q

True or false, cromoglicate when used for the treatment of asthma is more effective in adults than children

A

No, children respond better than adults

Q

The asthma drug cromoglicate is effective in asthma caused by what?

A

Antigen

Exercise

Irritants

Q

Cromoglicate’s mechanisms are not understood. It is a mast cell stabiliser, it is thought it may;

Reduce neuronal reflexes (desensitise to irritants)
Increase release of T cell cytokines
Affect inflammatory cells and mediators

A

1 & 3

It inhibits the release of T cell cytokines

Q

What are the side effects of the asthma drug cromoglicate

A

Irritation of upper respiratory tract

Hypersensitivity reactions - rare

Q

How is the drug cromoglicate administered

A

Inhalation

Q

Is the asthma drug cromoglicate used as a prophylaxis or in treatment

A

Prophylaxis

Q

True or false, the effects of the drug cromoglicate are seen immediately

A

False, they take weeks to develop

Q

Which asthma drug is recombinant DNA-derived humanised IgG1 monoclonal antibody

A

Omalizumab

Q

How is the asthma drug omalizumab administered

A

Sub cut injection, every 2-3 weeks

Q

Omalizumab is sub cutaneously injected every 2-3 weeks and is slowly absorbed, when is the peak plasma concentration

A

7-8 days

Q

What does the asthma drug omalizumab bind to

A

IgE, which inhibits the binding if IgE to IgE receptors on the surface if mast cells and basophils, inhibiting the IgE mediated cascade of asthma

Q

What side effects may be seen from the drug omalizumab

A

Anaphylaxis

Malignancies

Q

What drug treatment would be used with someone who had mild asthma with rare attacks

A

Inhaled B2 agonist prn

Q

What drug therapy would be used with someone with mild asthma, with more frequent attacks

A

Glucocorticoid for prophylaxis

B2 agonist prn

Q

What drug therapy would be given for someone with moderate to servers asthma

A

B2 agonist with glucorticoid in combined inhaler