Extra Resp Flashcards
Does the early or late reaction phase of asthma cause more problems?
late because you get a “rebound” phase with cytokines present (meds act on the initial attack)
9 categories of resp disease meds
Beta 2 agonists methylxanthines muscarinic antagonists corticosteroids cromolyn leukotriene modifiers PDE4 inhibitor Anti IgE antibody IL-5 receptor antagonist
What is the primary use for Muscarinic antagonists?
COPD management
What type of drugs do not work well for COPD management?
ICS
What is specific about the half life for methylxanthines?
it is variable in different populations (most vulnerable for smokers and children 1-9 yrs). these populations metabolize the drug quicker so less concentration in the body
what form is methylxanthines given in?
IV or oral
what is the MOA of inhaled corticosteroids?
inhibit COX 2 transcription of inflammatory cytokines AND annexin 1 inhibits immune response
what % is deposited in the lung for ICS? how about swallowed?
10-40% lung
60-90% swallowed
what happens to the ICS if it is deposited in the lung?
it goes into systemic circulation
what happens to the ICS if it is swallowed?
goes to GI tract and then liver (1st pass inactivation) and then systemic circulation (decreased systemic side effects)
what is the time for initial effect (ICS)
4-12 hours
explain drug-drug interactions for theophylline
interacts with/is a substrate for enzymes CYP1A2 and CYP3A4 (increase/decrease in theophyllines concentration)
what is important about cromolyn’s absorption?
it has very low absorption (<1%) so not many ADRs
What is an issue when a patient is taking Cromolyn?
compliance: has to be taken 4x/day
what is the specific contraindication for leukotriene modifiers Zafirlukast and Zileuton?
hepatic injury- monitor LFTs
