katzung: drugs used in asthma and COPD

Question 1

What is a strategy of treating acute asthma?

Answer 1

reliever drugs

B2 agonists, muscarine antagonists, theophylline

Question 2

What is the strategy for treating long term asthma?

Answer 2

controller drugs such as corticosteroids, anti-IgE antibodies
-leukotriene antagonists are useful in bronchoconstriction and inflammation which are only used for prophylaxis

Question 3

What are some direct short acting B-selective agonists?

Answer 3

albuterol, terbutaline, metaproterenol

Question 4

What are some direct long acting B2-selective agonists?

Answer 4

these are used for prophylaxis: salmeterol, fermoterl, indacterol

Question 5

How are B-adrenoceptor agonists given?

Answer 5

they are given by inhalation to decrease systemic effects

Question 6

What is the moa of B-adrenoceptor agonists in asthma?

Answer 6

stimulate adenyl cyclase which stimulates cAMP in smooth muscle cells resulting in a powerful bronchodilator response; they are the most effective in treating acute asthma at high doses they have significant B1 effects

Question 7

What is the moa of methylyanthines?

Answer 7

inhibit PDE(phosphodiesterase) which degrades cAMP->AMP; basically it increases the amount of cAMP to allow for bronchodilation; major uses are in asthma and in COPD

Question 8

What are some examples of methylyanthines?

Answer 8

caffeine, theophylline, theobromine, aminophylline, pentoxifylline;
the slow release theophylline ist he most commonly used in nocturnal asthma

Question 9

What are the side effects of methylyanthines?

Answer 9

GI distress, tremor, and insomnia

Question 10

What are the names of muscarinic antagonists?

Answer 10

ipatropium and tiotropium; tiotropium is longer lasting

Question 11

What is the moa of muscarinic antagonists in asthma?

Answer 11

competitively block muscarinic receptors in the airways and prevent bronchoconstriction ; reverse bronchoconstriction in children and in patients with COPD ; they don’t cause tremors nor arrhythmias

Question 12

What is the moa of cromolyn and nedocromil?

Answer 12

no bronchodilator action but prevent bronchoconstriction; they have only local effects and are used for asthma in children ; given by aersol

Question 13

What is the moa of corticosteroids in asthmatics?

Answer 13

reduce synthesis of arachidonic acid by inhibiting phospholipase A2; increase responsiveness of B-adrenoceptors (synergy); prevent inflammation and allergy

Question 14

What are the names of corticosteroids that are taken via local aerosal administration?

Answer 14

relatively safe and are now the first line therapy in treating asthma:
beclomethasone, budesonide, dexamethasone, flunisolide, fluticasone, mometasone

Question 15

Which are the corticosteroids used in treatment of status asthmaticus?

Answer 15

predisolone and hydrocortisone

Question 16

How are corticosteroids used in COPD patients? What are the side effects of corticosteroids?

Answer 16

COPD patients are resistant to the effects of steroids; steroids may cause mild growth retardation in children

Question 17

How effective are leukotriene antagonists in the treatment of severe asthma?

Answer 17

they are not as effective as corticosteroids in treating severe asthma

Question 18

What is the moa of leukotriene receptor blockers?

Answer 18

antagonists at LTD4 and LTE4 leukotriene receptors
they prevent antigen, exercise, and aspirin induced bronchospasms
not recommended for acute episodes of asthma

Question 19

What are examples of leukotriene receptor blockers?

Answer 19

zafirlukast and montelukast

Question 20

What is the moa of lipoxygenase inhibitors? What is an example of a lipoxygenase inhibitor?

Answer 20

they treat antigen and exercise induced bronchospasms; effective in aspirin allergy bronchospasms;
zileuton

Question 21

What is the moa of anti-IgE antibody therapy? What is an example of such a drug?

Answer 21

prevents activation of sensitized mast cells when an antigen is present;
omazilumab