Module 2 anti-asthmatic drugs

Question 1

airway smooth muscle contraction

Answer 1

SNS: 
- bronchodilation 
- B2
PSNS: 
- bronchoconstriction
- muscarinic receptors
Leukotrienes

Question 2

leukotrines and asthma

Answer 2

IL-10, IL-4 activate T lymphocyte

• > mast cell, eosinophil, and plasma cell activation
• > airway edema, smooth muscle hyperresponsiveness, goblet cell hyperplasia, and subepithelial fibrosis

Question 3

chronic asthmatic reaction

Answer 3

bronchoconstriction
vasogenic edema
mucus hyper-secretion
chronic inflammation
airway remodeling

Question 4

acute asthmatic reacction

Answer 4

bronchoconstriction
airway edema
mucus production

Question 5

B agonist drugs and their receptors

Answer 5

epinephrine: B2, B1, a
isoproterenol: B2, B1
metaproterenol: B2, B1
terbutaline, albuterol, pirbuterol, bitolterol: B2
levalbuterol: B2

Question 6

B agonist drugs use

Answer 6

rescue inhaler
prophylactic (exercise)
all asthmatics

Question 7

B agonist AE

Answer 7

peripheral skeletal muscle tremor

tachycardia, palpitation, arrhythmia (B1)

Question 8

B agonist onset

Answer 8

15-30 minutes

Question 9

B agonist peak

Answer 9

30-60 minutes

Question 10

B agonist duration of action

Answer 10

4-6 hours

Question 11

LABA: long acting B agonist drugs

Answer 11

salmeterol

formoterol

Question 12

LABA MOA

Answer 12

B2 agonist

lipophilic side chains that resist degradation

Question 13

LABA AE

Answer 13

black box: asthma-related deaths

cardiac toxicity

Question 14

LABA duration

Answer 14

12-24 hours

Question 15

LABA administration

Answer 15

not for monotherapy

• do not treat underlying inflammation
• use with corticosteroid

Question 16

Anticholinergic drugs

Answer 16

ipratropium bromide

tiotropium

Question 17

anticholinergic MOA

Answer 17

competitive ACh receptor antagonist (M3)
inhibits PSNS
- quatenary ammonium salt: prevents absorption across resp. epithelium (ionized)

Question 18

Anticholinergic uses

Answer 18

mainly COPD

asthma

Question 19

Tritropium duration

Answer 19

longer action: once daily dosing

- slow dissociation from receptors

Question 20

methylxanthines drugs

Answer 20

theophylline

aminophylline

Question 21

Methylanthines MOA

Answer 21

inhibit phosphodiesterase in turn inhibiting cAMP breakdown
- non-specific
adenosine receptor antagonism
b agonist

Question 22

Methylxanthines AE

Answer 22

N/V/D
HA
irritability
insomnia
seizures
brain damage
hyperglycemia 
hypokalemia 
hypoTN
arrhythmia 
death

Question 23

Methylaxathines precautions

Answer 23

Narrow TI
CYP1A2 metabolism
- cigarettes induce CYP1A2

Question 24

Methylaxathines labs

Answer 24

theophylline levels: therapeutic range

Question 25

Methylaxathines administration

Answer 25

PO

Question 26

phosphodieterase inhibition

Answer 26

bronchodilation

anti-inflammatory

Question 27

adenosine receptor antagonism

Answer 27

inc. ventilation with hypoxia
inc. endurance of diaphragmatic muscles
dec. mast cell release