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Phar 301 > Drugs for asthma > Flashcards

Drugs for asthma Flashcards

1
Q

What happens to the airway of an asthmatic patient? (3)

A

Tightened muscles constrict airway

Mucus filles channel

Inflamed/thickened airway wall

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2
Q

What causes the mucosal inflammation seen in asthma patients?

A

activated eosinophils, mast cells and T lymphocytes within the context of a remodelled airway with mucous metaplasia

An increase in smooth muscle

fibrosis and angiogenesis

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3
Q

What is the hallmark of COPD?

A

Airflow limitation

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4
Q

How does COPD differ from asthma? (4)

A

Different in terms of etiology, cellular mediators, treatment, and prognosis

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5
Q

Describe Forced Vital capacity

A

Determination of vital capacity from a maximally forced effort

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6
Q

Define expiratory volume (FEV1)

A

Volume that has been exhaled at the end of the end of the first second of forced expiration

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7
Q

What do asthma and COPD patients have in common regarding their respiration?

A

Decreased FEV relative to their FVC

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8
Q

What does Omalizumab block?

A

IgE

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9
Q

What does Mepolizumab and Reslizumab inhibit?

A

Interleuken 5

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10
Q

How are inflammatory mediators released by mast cells?

A

Immunological stimuli activate IgE receptors

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11
Q

What are the three therapeutic benefits of asthma/COPD and what are two* examples of each?

A

Decreased inflammation

  • Glucocorticoids
  • Antileukotrienes

Bronchodilation

  • beta2 adrenergic receptor agonists
  • Muscarinic receptor antagonists

Decreased inflammation and bronchodilation

  • methylxanthines
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12
Q

How do glucocorticoids decrease inflammation?

A

Suppression of gene expression

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13
Q

How to antileukotrienes decrease inflammation?

A

Decrease of leukotriene synthesis

OR

antagonization of CysLTR

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14
Q

How do beta adrenergic receptor agonists dilate brochi?

A

Increasing cAMP

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15
Q

How do muscarinic receptor antagonists dilate broncholes?

A

By blocking activation of muscarinic receptors by endogenous acetylcholine

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16
Q

How do methylxanthines decrease inflammation and dilate broncholes?

A

By inhibiting adenosine receptor and increasing cAMP

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17
Q

Name a clucocorticoid

A

Budesonide

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18
Q

What are all the effects of glucocorticoids?

A

local and systemic inhibition of inflammatory mediator synthesis, and phagocytosis

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19
Q

What are the antiinflammatory actions of glucocorticoids?

A

Decreased production of prostaglandins, cytokines and interleukins

Decreased proliferation and migration of lymphocytes/macrophages

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20
Q

What cells are decreased after the actions of glucocorticoids?

A

Airway immune mediators: eosinophils, Th2 lymphocytes, mast cells, macrophages, and dendritic cells

Also redutions in epithelial cell inflammation, endothelial cell permeability, and hyperreactivity of bronchiolar smooth muscle

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21
Q

True/False? Corticosteroid therapy is of significant benefit to both asthma and COPD patients

A

True/False? Corticosteroid therapy is of significant benefit to both asthma and COPD patients

minimal benefit for COPD patients

22
Q

What is the mechanism of action of glucocorticoids?

A

They bind to the glucocorticoid receptors, activate histone deacetylase 2 (HDAC2) and inhibit histone acetyltransferases (HAT)

23
Q

How are (most) leukotrienes named?

A

Montelukast

zafirlukast

——lukast

24
Q

How to leukotrienes work?

A

Competitive antagonists of CysLTR1

25
Q

Are antileukotrienes work better to treat acute episdes of bronchoconstriction, or rather as a prophylactic?

A

Prophylactic

26
Q

Which autonomic nervous system causes bronchodilation?

A

Sympathetic

27
Q

How do beta adrenergic receptor agonists work?

A

Beta adrenergic receptors are found all over bronchial smooth muscle

Activation of Beta2 receptors leads to smooth muscle relaxation and therefore bronchodilation

Agonists sensetize these receptors

28
Q

How does Ma Huang (ephedrine) work to treat asthma?

A

Nonselectie adrenergic agonist

29
Q

What is the medication of choice for all types of asthma?

A

Salbutamol (albuterol)

30
Q

How does Salbutamol work?

A

Short acting beta2 receptor agonist

Rapid onset of action (15 mins)

31
Q

Is salbutamol better prophylactically or acutely?

A

acute

32
Q

True/False? Albuterol is a racemix mixture, but R-albuterol is more effective

A

True/False? Albuterol is a racemix mixture, but R-albuterol is more effective

33
Q

Name a methylxanthine

A

Theophylline

Caffeine

34
Q

How do methylxanthines work?

A

Phosphodiesterase inhibitor, leading to increased intracellular cAMP

35
Q

What are negative effects of Theyphylline?

A

Decreased number/activity of immune mediators,

36
Q

What is the principal autonomic influence in the normal regulation of bronchomotor tone?

A

Parasympathetic NS tone

37
Q

What is cholinergic control of airway smooth muscle dominated by?

A

Muscarinic receptor M3 subtype (but all are present)

38
Q

What is the bronchodilator of choice for the treatment of COPD?

A

Inhaled muscarinic receptor antagonists

39
Q

What drugs are used to prevent acute episodes of Asthma and COPD?

A

Inhaled glucocorticoids (in more serious cases, LABAs)

40
Q

What drug is used to treat an acute episode?

A

SABAs

41
Q

What are advantages of routine first-line therapies for asthma and COPD delivered by inhalation?

A

Convey drug directly to the site of patholoty

Much lower doses

Reduces side effects

42
Q

What is the typical treatment for asthma?

A

Multiple drugs with continuous evaluation and adjustment depending on patient responses

43
Q

What should adults with mild/intermittent asthma take?

A

Infrequent use of fast acting “rescue” bronchodilator (SABAs)

44
Q

What are signs of increasing asthma severity

A

Nocturnal symptoms, daytime symptoms more than twice a week, limited normal activity

45
Q

What is a risk of LABA monotherapy? How is this countered?

A

Death (yikes) take in combination with inhaled corticosteroids

46
Q

What happens if the medication doesn’t help?

A

Larger dose

47
Q

What should you take for severe asthma?

A

Oral corticosteroids

48
Q

Stopping inhaled corticosteroid therapy altogether (is/is not) recommended for adults

A

Stopping inhaled corticosteroid therapy altogether (is/is not) recommended for adults due to increased risk of exacerbated

49
Q

What drugs treat COPD?

A

Salmeterol or Formoterol (LABAs)

50
Q
A

Phar 301 (23 decks)

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