Drugs to Tx Asthma and COPD

Question 1

What are the two drug categories used to treat asthma?

Answer 1

1) Anti-inflammatory drugs such as corticosteroids

2) Brondiolators such as Beta-2 agonists

Question 2

What do β2-agonists act primarily on in order to reverse the bronchoconstriction of asthma?

Answer 2

Airway smooth muscle

Question 3

Albuterol, terbutaline, metaproterenol, pirbuterol, and levalbuterol are all what type of bronchodilators?

Answer 3

Short acting beta agonists

Question 4

Terbutaline is the only beta-2 drug available by what route of administration?

Answer 4

Subcutaneous injection

Question 5

What are some warning/cautions that the inhaled beta adrenergic agonists can cause?

Answer 5

1) CV effects

2) Paradoxical bronchospasm

Question 6

Beclomethasone, Budesonide, Ciclesonide, Flunisolide, Fluticasone, Mometasone, Triamcinolone, are all?

What is their clinical application?

Answer 6

1) Inhaled corticosteroids

2) Maintenance treatment for asthma and as prophylactic therapy

Question 7

Particular care is needed in patients who are transferred from systemically active corticosteroids to Beclomethasone because?

After withdrawal from systemic corticosteroids, a number of months are required for?

Answer 7

1) Deaths due to adrenal insufficiency have occurred

2) Recovery of hypothalamic-pituitary adrenal (HPA) function

Question 8

How are inhaled corticosteroids viewed in the management of asthma?

Answer 8

Most effective controllers for asthma

Question 9

What cell types do inhaled corticosteroids reduce in the airways and sputum?

Answer 9

1) Eosinophils
2) T cells
3) Mast cells

Question 10

Inhaled corticosteroids are usually given how many times a day?

Answer 10

Twice

Question 11

What appears to prevent irreversible changes in airway function that occur with chronic asthma?

Answer 11

Early treatment with inhaled corticosteroids

Question 12

What is the first line therapy for patients with persistent asthma?

If that does not control symptoms, what is usually added to the regimen?

Answer 12

1) Inhaled corticosteroids

2) Long acting beta agonist

Question 13

When is ciclesonide and fluticasone not indicated?

Answer 13

1) For the relief of acute bronchospasm

2) Patient has oral Candida albicans infection

Question 14

When is budesonide and mometasone not indicated?

Answer 14

Patient with known hypersensitivity to milk proteins

Question 15

Triamcinolone is used in patients who require?

Answer 15

Systemic corticosteroid administration

Question 16

What are used in combination with short acting beta agonists to treat moderate to severe asthma flare-ups?

Answer 16

Oral corticosteroids

Question 17

Between oral corticosteroids and inhaled corticosteroids, which are more likely to cause side effects?

Answer 17

Oral corticosteroids

Question 18

What is the oral corticosteroid used in the treatment of asthma?

Answer 18

Prednisone

Question 19

What caution/warning is associated with prednisone?

Answer 19

Hypothalamic-pituitary-adrenal (HPA) axis suppression

Question 20

Formoterol, Salmeterol, Indacaterol, Vilanterol, and Olodaterol all make up what type of bronchodilator?

Answer 20

Long acting beta agonist

Question 21

Long acting beta agonists are used in maintenance treatment of bronchoconstriction in what patients?

Answer 21

COPD patients

Question 22

The use of long acting beta agonists increases the risk of?

Answer 22

Asthma-related deaths

Question 23

Long acting beta agonists should be prescribed for asthma only as concomitant therapy with a long-term control medication such as?

Answer 23

Inhaled corticosteroid

Question 24

Atropine, Ipratropium, Tiotropium, and Aclidinium are classified as what type of drugs?

Answer 24

Anticholinergic drugs

Question 25

The anticholinergic drugs are indicated for?

Answer 25

Maintenance treatment of bronchospasm associated with COPD

Question 26

What do anticholinergics block from binding to its receptors on certain nerve cells?

Which nerve impulses does this inhibit?

Answer 26

1) Acetylcholine

2) Parasympathetic

Question 27

What is a muscarinic antagonist indicated for temporary blockade of severe or life threatening muscarinic effects?

Answer 27

Atropine

Question 28

When the recurrent use of atropine is essential in patients with coronary artery disease, what should the total dose be restricted to in order to avoid the detrimental effects of atropine-induced tachycardia on myocardial oxygen demand?

Answer 28

2 to 3 mg

Question 29

Methylxanthines which are used in the treatment of asthma/COPD are a unique class of drug that are derived from?

Answer 29

The purine base xanthine

Question 30

What everyday food and drink is methylxanthine found?

Answer 30

1) Coffee (caffeine)

2) Chocolate (Theobromine)

Question 31

Theophylline which is used in the treatment of asthma, has what two distinct actions in the airways?

Answer 31

1) Smooth muscle relaxation (bronchodilation)

2) Suppression of the response of the airways to stimuli

Question 32

Due to the increased risk of exacerbation, theophylline should be used with extreme caution in patients with?

Answer 32

1) Active peptic ulcer disease
2) Seizure disorders
3) Cardiac arrhythmias

Question 33

Zafirlukast, montelukast, and zileuton make up what class of drugs used to treat asthma?

Answer 33

Leukotriene antagonists

Question 34

Zafirlukast and Montelukast are selective reversible antagonists of?

Answer 34

Cysteinyl Leukotriene Receptors (CysLT1 receptors)

Question 35

What does montelukast inhibits the physiologic actions of at the CysLT1 receptor without any agonist activity?

What does zafirlukast inhibit at the receptor?

Answer 35

1) LTD4

2) LTD4 and LTE4

Question 36

What life-threatening warning is issued with zafirlukast?

Answer 36

Hepatotoxicity

Question 37

How does zileuton inhibit LTB4, LTC4, LTD4 and LTE4?

Answer 37

It inhibits 5-lipoxygenase

Question 38

What is omalizumab?

Answer 38

Anti-IgE antibody used to treat asthma