Drugs inflammatory and related disorder_ drugs used in Rx of Asthma

Question 1

_____ is an inflammatory disease associated with bronchial hyperactivity (BHR), bronchospasm, increase mucous secretion, edema, and cellular infiltration

Answer 1

Asthma

Question 2

___________ is lasting from 30-60 minutes, are associated with bronchospasm from the actions of released histamine and LTs

Answer 2

Early asthmatic response (EAR)

Question 3

________ involve infiltration of eosinophils and lymphocytes into airways —-> bronchoconstriction and inflammation with mucous plugging

Answer 3

Late asthmatic response (LAR)

Question 4

Management of asthma includes:

Answer 4

bronchodilators to provide short-term relief and anti-infalmmatroy agents that reduce bronchial hyperactivity and protect against cellular infiltration

Question 5

______ that inhibits acetylcholine

Answer 5

Ipratropium (relaxes bronchial smooth muscle)

Muscarnic receptor: vagal stimulation —->Ach =>bronchoconstriction which is blocked by muscarnic antagonists

Question 6

ipratropium and tiotropium are

Answer 6

muscarnic-receptor blockers

Question 7

_________ are choice in bronchospasm caused by beta-blockers

Answer 7

ipratropium ; tiotropium

Question 8

there are minor atropine-like effect in

Answer 8

ipratropium; tiotropium

Question 9

ipratropium and tiotropium are used via __________ which causes _________?

Answer 9

inhalation; bronchodilation in acute asthma, esp. COPD patients and may be safer than B-agonist in patients with cardiovascular disease

Question 10

safer than B-agonist in patients with cardiovascular disease

Answer 10

ipratropium; tiotropium

Question 11

Beta-receptors agonist also used in

Answer 11

Asthma patients

Question 12

which beta-agonists drugs are widely used in Rx of acute bronchoconstriction and prophylaxis of exercise-induced asthma

Answer 12

Beta-2 selective

Question 13

beta-2 selective drugs are

Answer 13

albuterol (short acting); metaproterenol; terbutaline

Question 14

longer acting beta-2 selective agonist

Answer 14

salmeterol

Question 15

_________ may decrease nighttime attacks (propylaxis only) and permit dosage reduction of other agents

Answer 15

Salmeterol; formerterol

***not used as monotherapy, always give with corticosteriods

Question 16

what is a long acting muscarnic blocker

Answer 16

tiotropium

Question 17

side effects of long acting beta-receptor agonists

Answer 17

HTN; arryhthymia; tremors

Question 18

aerosolic forms of asthma have ________ potential for systemic toxicity but may cause anxiety, muscle tremors and cardiovascular toxicity with overdose

Answer 18

Low (Beta-receptors agonist)

Question 19

_______ bronchodilates via inhibition of phosphodiesterase (PDE) —> increase cAMP due to decrease cAMP hydrolysis and also by antagonism of adenosine (bronchoconstrictor)

Answer 19

theophylline

Question 20

antagonism of adenosine causes

Answer 20

bronchoconstriction

Question 21

methylxanthines are

Answer 21

theophylline

Question 22

usage of _______ is limited b/c of its narrow therapeutic index (cardiotoxicity and neurotoxicity)

Answer 22

Theophylline

Question 23

Mainly adunctive; regular use may decrease symptoms but narrow therapeutic window

Answer 23

theophylline

Question 24

Many drug interactions; toxicity increases by erythromycin, cimetidine, and fluroquinolones

Answer 24

theophylline

Question 25

___________ sometimes used in bronchospasm and status asthmaticus

Answer 25

aminophylline IV

Question 26

Cromolyn and Nedocromil

Answer 26

prevents degranulation of pulmonary mast cells and decrease release of histamine, PAF and LTC4 from inflammatory cells

Question 27

prevents degranulation of pulmonary mast cells and decrease release of histamine, PAF and LTC4 from inflammatory cells

Answer 27

Cromolyn (inhaler. nebulizer); Nedocromil

Question 28

prophylactic use of Cromolyn and Nedocromil

Answer 28

decrease symptoms and bronchial hyperactivity (BHR), esp. responses to allergens

Question 29

has minimal systemic toxicity but may cause throat irritation and cough

Answer 29

Cromolyn and Nedocromil

Question 30

Relieved by beta-2 agonists

Answer 30

Cromolyn and Nedocromil

Question 31

__________ block mediator release and decrease BHR via decrease expression PGS, LTs and inflammatory ILs, TNF-gamma/alpha/Gm-CSF resulting in increase immunosuppression

Answer 31

Glucocorticoids

Question 32

__________ are a surface-active drugs used via inhalation for both acute attacks and for prophylaxis

Answer 32

Budesonide; Flunisolide

***are glucocorticoid groups

Question 33

_______ can cause oropharyngeal candidiasis which can be prevented via spacers and gargling

Answer 33

glucocorticoids

Question 34

_______ low dose may prevent desensitization of beta-receptors that can occur with overuse of beta-2 agonist

Answer 34

Glucocorticoids

Question 35

__________ (oral) and IV __________ generally reserved for severe acute attacks

Answer 35

Prednisone; Steroids (methylprednisone aka: solumedrol)

Question 36

All asthmatic need a ________________ for acute attacks ; for Prophylaxis _____________ are most often used

Answer 36

short-acting beta-2 agonist; Glucocorticoids

Question 37

For COPD (emphysema, chronic bronchitis), multiple ____________ are used including ___________ and ______ blockers

Answer 37

Bronchodilators; beta-2 agonists; M

Question 38

_____________ and ____________ are antagonists at LTD4 receptors with slow onset of action used prophylactically for many forms of asthma, including antigen, exercise or drug-induced (ASA)

Answer 38

Zafirlukast; Monetlukast

Question 39

__________ is selective inhibitor of lipoxygenases (LOX), decrease formation of all LTs from arachdonic acid

Answer 39

Zileuton

Question 40

__________ has more rapid onset (1-3 hrs) and is adjunctive to steroids

Answer 40

Zileuton

Question 41

side effects of Zileuton

Answer 41

Hepatotoxicity