Obstruction Pharmacology

Question 1

Albuterol

Answer 1

Class: SABA
Used for: asthma/COPD
SAE: tremor, tachycardia

Question 2

Salmeterol

Formoterol

Answer 2

Class: LABA
Used for: asthma, COPD, also exercise induced bronchospasm
SAE: cough, runny nose, sneezing, headache
Note: LABA monotherapy is not indicated for asthma, but is alright for COPD

Question 3

Theophylline

Answer 3

Class: Methylxanthines
MOA: PDE3 inh, adenosine receptor antagonist
Used for: acute asthma, or as a controller medication
SAE: insomnia, tremor, anorexia
Note: narrow therapeutic index

Question 4

Ipratropium

Answer 4

Class: muscarinic antagonist
MOA: works at M3
Used for: controller for COPD and asthma
SAE: dry mouth, cough

Question 5

Fluticasone

Answer 5

Class: Inhaled corticosteroid
MOA: glucocorticoid receptor antagonist
Used for: asthma controller medication 
SAE: cough, headache, nausea
Note: CYP3A4 substrate

Question 6

Prednisone

Answer 6

Class: systemic corticosteroid
MOA: works at glucocorticoid receptor
Used for: asthma controller medication
SAE: cough, nausea, headache
Note: CYP3A4 substrate

Question 7

Cromolyn

Answer 7

Class/MOA: mast cell stabilizer
Used for: asthma controller medication
SAE: cough, nausea, throat irritation

Question 8

Roflumilast

Answer 8

Class: Phosphodiesterase inh.
MOA: selective phosphodiesterase type 4 inh
Used for: reducing acute COPD exacerbations
SAE: diarrhea, nausea, weight loss
Note: used if exacerbations are not controlled with long acting bronchodilators

Question 9

Montelukast

Answer 9

Class: leukotriene antagonist
MOA: CYST-LTR1 antagonist
Used for: asthma, exercise induced bronchospasm, allergic rhinitis
SAE: GI disturbances, hypersensitivities
Note: can be used for aspirin-induced asthma

Question 10

Azithromycin

Answer 10

Class: Macrolide abx
MOA: inhibits 50s subunit of bacterial ribosome, inhibiting RNA translation
Used for: acute COPD exacerbations
SAE: hearing impairment
Note: effects are additive with beta agonists and long acting muscarinic antagonists

Question 11

Omalizumab

Answer 11

Class: IgE sequesterant
MOA: binds serum IgE antibodies
Used for: asthma controller medication
SAE: headaches, dizziness, fatigue
Note: effective in asthma that can't be controlled with beta-2 agonists or steroids

Question 12

1st gen antihistamines

Answer 12

Examples: Diphenidramine, hydroxyzine, brompheniramine, promethazine
MOA: H1-histamine receptor antagonist
Used for: allergies and other conditions
SAE: sedation, anticholinergic activity (amount varies by drug)
Note: these drugs can cross the blood brain barrier and have CNS effects due to their limited selectivity

Question 13

Loratadine

Answer 13

Class: 2nd gen antihistamine
MOA: H1-histamine receptor antagonist
Used for: allergies only
SAE: none
Notes: non-sedating, no CNS activity