(L4- Respiratory Drugs)

Question 1

list the types of drugs used for Asthma

Answer 1

• Bronchodilators: β2 agonists, muscarinic antagonist, methylxanthines (theophylline)
• Anti-Inflammatories: inhaled / systemic corticosteroids
• Release Inhibitors (cromolyn, nedocromil)
• Immunomodulators (omalizunab)
• LTMAs

Question 2

list the types of drugs used for COPD

Answer 2

• Bronchodilators: β2 agonists, muscarinic antagonist
• Anti-Inflammatories: inhaled corticosteroids
• Mucolytic Agents (N-acetlycysteine)
• Antibiotics

Question 3

list the types of drugs used for Allergic Rhinitis

Answer 3

• glucocorticoid spray
• oral antihistamines
• cromolyn sodium
• montelukast
• nasal decongestants

Question 4

what are the two cough suppressing drugs, indicate the preferred drug

Answer 4

• dextromethorphan: preferred b/c less AEs and less chance of abuse
• codeine

Question 5

list the β2 agonists used as inhalers

Answer 5

SABA: albuterol, terbutaline, pirbuterol

LABA: salmeterol, formoterol

Question 6

what type of drugs are the following:

• albuterol
• formoterol
• pirbuterol
• salmeterol
• terbutaline

Answer 6

β2 agonists:
-SABA: albuterol, terbutaline, pirbuterol

-LABA: salmeterol, formoterol

Question 7

theophylline is a (1) type drug with a (2) MOA, and is used in (3) circumstances

Answer 7

1- methylxanthine, bronchodilator (IV, oral)

2- phosphodiesterase inhibitor –> inc cAMP => bronchodilation

3- alternative to long-term asthma control (it has narrow TW and many AEs, so used as alternative if others aren’t tolerated)

Question 8

list the ICS

Answer 8

• beclomethasone
• budesonide
• flunisolide
• fluticasone

Question 9

list the oral / systemic corticosteroids

Answer 9

• prednisolone
• prednisone
• dexamethasone

Question 10

what type of drugs are the following:

• beclomethasone
• budesonide
• dexamethasone
• flunisolide
• fluticasone
• prednisolone
• prednisone

Answer 10

ICS: beclomethasone, budesonide, flunisolide, fluticasone

Systemic corticosteroids: prednisolone, prednisone, dexamethasone

Question 11

(1) are the release inhibitors that prevent (2) and are used for (3) and or (4) purposes

Answer 11

1- cromolyn, nedocromil
2- mast cell degranulation

3- alternate for long-term mild persistent asthma
4- prevent exercise induced asthma

Question 12

(1) is an immunomodulator used in asthma with a (2) MOA and is used for (3) situations

Answer 12

1- omalizumab
2- (monoclonal Ab) binds IgE –> prevents basophil and mast cell degranulation
3- long-term control for severe persistent asthma with evidence of allergy indication

(only used in hospitals b/c anaphylaxis as AE)

Question 13

list the LT-modifying agents

Answer 13

LT receptor antagonists:

• montelukast
• zafirlukast

5-Lipoxygenase inhibitors:
-zileuton

MOA- interfere with LT synthesis or action to prevent bronchocontriction

Question 14

Montelukast, Zafirlukast are used in the following situations for asthma…. (hint- 3)

Answer 14

• alternative for long-term asthma control
• prevent exercise induced asthma
• Tx for NERD (NSAID exacerbated respiratory distress)

Question 15

Asthma Control:

• (1) drug of choice for short-term asthma attacks, (2) is the alternative or adjunct
• (3) are the drugs used to prevent exercise-induced asthma
• (4) is the drug of choice for β-blocker induced bronchoconstriction
• (5) is the drug of choice for NERD

Answer 15

1- albuterol / SABA
2- ipratropium / SAMA OR systemic corticosteroids
3- *SABA, cromolyn / nedocromil, montelukast / zafirlukast
4- SAMA, ipratropium
5- LT receptor antagonist (montelukast / zafirlukast)

Question 16

General Asthma Tx:

• (1) intermittent asthma
• (2) mild persistent
• (3) moderate persistent
• (4) severe persistent

Answer 16

1- SABA prn
2- low-dose ICS qd; SABA prn
3- medium-dose ICS qd OR low-dose ICS + LABA qd; SABA prn
4- medium/high-dose ICS, LABA qd; SABA prn

Question 17

COPD short-term management cascade

Answer 17

1) SABA +/- SAMA
2) systemic corticosteroids
3) antibiotics
4) O2 therapy

Question 18

COPD long-term management cascade

Answer 18

1) LABA +/- LAMA
2) LABA +/- LAMA and or ICS
3) LABA, (LAMA and or ICS), O2 therapy

Question 19

_____ will break-up mucus in severe COPD

Answer 19

N-acetylcysteine (mucolytic agent)

Question 20

Allergic Rhinitis management:

• (1) 1st line
• (2) 2nd line

Answer 20

1- glucocorticoid spray

2- second generation H1 antagonist (inverse agonist)