Drugs to Tx Asthma and COPD Flashcards
What are the two drug categories used to treat asthma?
1) Anti-inflammatory drugs such as corticosteroids
2) Brondiolators such as Beta-2 agonists
What do β2-agonists act primarily on in order to reverse the bronchoconstriction of asthma?
Airway smooth muscle
Albuterol, terbutaline, metaproterenol, pirbuterol, and levalbuterol are all what type of bronchodilators?
Short acting beta agonists
Terbutaline is the only beta-2 drug available by what route of administration?
Subcutaneous injection
What are some warning/cautions that the inhaled beta adrenergic agonists can cause?
1) CV effects
2) Paradoxical bronchospasm
Beclomethasone, Budesonide, Ciclesonide, Flunisolide, Fluticasone, Mometasone, Triamcinolone, are all?
What is their clinical application?
1) Inhaled corticosteroids
2) Maintenance treatment for asthma and as prophylactic therapy
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?
1) Deaths due to adrenal insufficiency have occurred
2) Recovery of hypothalamic-pituitary adrenal (HPA) function
How are inhaled corticosteroids viewed in the management of asthma?
Most effective controllers for asthma
What cell types do inhaled corticosteroids reduce in the airways and sputum?
1) Eosinophils
2) T cells
3) Mast cells
Inhaled corticosteroids are usually given how many times a day?
Twice
What appears to prevent irreversible changes in airway function that occur with chronic asthma?
Early treatment with inhaled corticosteroids
What is the first line therapy for patients with persistent asthma?
If that does not control symptoms, what is usually added to the regimen?
1) Inhaled corticosteroids
2) Long acting beta agonist
When is ciclesonide and fluticasone not indicated?
1) For the relief of acute bronchospasm
2) Patient has oral Candida albicans infection
When is budesonide and mometasone not indicated?
Patient with known hypersensitivity to milk proteins
Triamcinolone is used in patients who require?
Systemic corticosteroid administration
What are used in combination with short acting beta agonists to treat moderate to severe asthma flare-ups?
Oral corticosteroids
Between oral corticosteroids and inhaled corticosteroids, which are more likely to cause side effects?
Oral corticosteroids
What is the oral corticosteroid used in the treatment of asthma?
Prednisone
What caution/warning is associated with prednisone?
Hypothalamic-pituitary-adrenal (HPA) axis suppression
Formoterol, Salmeterol, Indacaterol, Vilanterol, and Olodaterol all make up what type of bronchodilator?
Long acting beta agonist
Long acting beta agonists are used in maintenance treatment of bronchoconstriction in what patients?
COPD patients
The use of long acting beta agonists increases the risk of?
Asthma-related deaths
Long acting beta agonists should be prescribed for asthma only as concomitant therapy with a long-term control medication such as?
Inhaled corticosteroid
Atropine, Ipratropium, Tiotropium, and Aclidinium are classified as what type of drugs?
Anticholinergic drugs
The anticholinergic drugs are indicated for?
Maintenance treatment of bronchospasm associated with COPD
What do anticholinergics block from binding to its receptors on certain nerve cells?
Which nerve impulses does this inhibit?
1) Acetylcholine
2) Parasympathetic
What is a muscarinic antagonist indicated for temporary blockade of severe or life threatening muscarinic effects?
Atropine
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?
2 to 3 mg
Methylxanthines which are used in the treatment of asthma/COPD are a unique class of drug that are derived from?
The purine base xanthine
What everyday food and drink is methylxanthine found?
1) Coffee (caffeine)
2) Chocolate (Theobromine)
Theophylline which is used in the treatment of asthma, has what two distinct actions in the airways?
1) Smooth muscle relaxation (bronchodilation)
2) Suppression of the response of the airways to stimuli
Due to the increased risk of exacerbation, theophylline should be used with extreme caution in patients with?
1) Active peptic ulcer disease
2) Seizure disorders
3) Cardiac arrhythmias
Zafirlukast, montelukast, and zileuton make up what class of drugs used to treat asthma?
Leukotriene antagonists
Zafirlukast and Montelukast are selective reversible antagonists of?
Cysteinyl Leukotriene Receptors (CysLT1 receptors)
What does montelukast inhibits the physiologic actions of at the CysLT1 receptor without any agonist activity?
What does zafirlukast inhibit at the receptor?
1) LTD4
2) LTD4 and LTE4
What life-threatening warning is issued with zafirlukast?
Hepatotoxicity
How does zileuton inhibit LTB4, LTC4, LTD4 and LTE4?
It inhibits 5-lipoxygenase
What is omalizumab?
Anti-IgE antibody used to treat asthma
