Drugs for Allergy and Asthma

Question 1

Beta-2 Agonst MOA

Answer 1

Stimulate adenylyl cyclase causing ↑ of cAMP resulting in bronchodilation and also inhibits release of mediators from mast cells

Question 2

Beta-2 Agonist ROA

Answer 2

1. Inhalation
2. Oral
3. SC (Terbutaline)

Question 3

Beta-2 Agonist Clinical Use

Answer 3

Symptom relief of bronchospasm in acute asthma attacks

Question 4

Beta-2 Agonist SE

Answer 4

1. Skeletal muscle tremors
2. Tachycardia
3. Anxiety, restlessness, apprehension

Question 5

Theophylline MOA

Answer 5

1. Inhibits cAMP phosphodiesterases causing ↑ of cAMP

2. Competitive antagonist at adenosine receptors

Question 6

Theophylline ROA

Answer 6

1. Oral

2. Slow IV over 40 mins

Question 7

Theophylline Clinical Use

Answer 7

Maintenance therapy for chronic asthma - rarely used though due to SE

Question 8

Theophylline SE

Answer 8

1. Narrow therapeutic window
2. Convulsions
3. Tachycardia
4. Circulatory collapse

Question 9

Ipratropium MOA

Answer 9

Competitively blocks the muscarinic receptors in the airways

Question 10

Ipratropium ROA

Answer 10

1. Inhalation

Question 11

Ipratropium Clinical Use

Answer 11

Alone or in combination with beta-2 adrenergic agonists in acute asthma

Question 12

Ipratropium SE

Answer 12

Minimal, if dosage is to high may cause atropine like effects

Question 13

Corticosteroids MOA

Answer 13

Reduce the synthesis of arachidonic acid by phospholipase A2 which inhibits the release of leukotrienes and prostaglandins

Question 14

Corticosteroids ROA

Answer 14

1. Inhalation
2. Oral
3. IV

Question 15

Corticosteroids Clinical Use

Answer 15

Maintenance therapy for chronic asthma

Question 16

Corticosteroids SE

Answer 16

1. Short term- increaesd energy, insomnia, hunger, agitation and mood alterations
2. Long term- osteoporosis, cataracts, myopathy, hypothalamic – pituitary adrenal axis suppression, depression

Question 17

Cromolyn MOA

Answer 17

Decrease in the release of mediators such as histamine and leukotrienes

Question 18

Cromolyn ROA

Answer 18

Inhalation

Question 19

Cromolyn Clinical Use

Answer 19

Prophylactic therapy for preventing bronchospasm

Question 20

Cromolyn SE

Answer 20

Occasional coughing

Question 21

Zafirlukast and Montelukast MOA

Answer 21

1. Antagonist at the LTD4 leukotriene receptor

2. The LTE4 receptor is also blocked

Question 22

Zafirlukast and Montelukast ROA

Answer 22

Oral

Question 23

Zafirlukast and Montelukast Clinical Use

Answer 23

Prophylactic therapy for preventing bronchospasm

Question 24

Zafirlukast and Montelukast SE

Answer 24

1. Headache

2. Nausea

Question 25

Zileuton MOA

Answer 25

Inhibits 5- lipooxygenase to decrease production of leukotrienes

Question 26

Zileuton ROA

Answer 26

Oral

Question 27

Zileuton Clinical Use

Answer 27

Prophylactic therapy for preventing bronchospasm

Question 28

Zileuton SE

Answer 28

Contraindicated in patients with hepatic disease

Question 29

What is the difference in the pharmokinetics of 1st and 2nd generation antihistamines?

Answer 29

1st generation – cause significant sedation. They are lipophilic and cross the blood brain barrier. 􏰉 2nd generation- These were developed to avoid the central nervous system effects. May be associated with weight gain though.

Question 30

What is the first line treatment in patients with nasal rhinitis due to allergy?

Answer 30

Glucocorticoid Nasal Sprays

Question 31

What are the 1st generation antihistamines?

Answer 31

Diphenhydramine | Chlorpheniramine

Question 32

What are the 2nd generation antihistamines?

Answer 32

Fexofenadine Loratadine Cetirizine Doxepin

Question 33

What are some of the short acting beta-2 agonists used in treating asthma?

Answer 33

1. Albuterol (Proventil®) 2. Terbutaline (Brethaire®) 3. Metaproterenol (Metaprel®) 4. Bitolterol (Tornalate®)

Question 34

What are some of the long acting beta-2 agonists?

Answer 34

1. Salmeterol 2. Formoterol 3. Vilanterol

Question 35

What are the SE of decongestants?

Answer 35

- hypertension - insomnia - irritability - headache