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Respiratory Exam 1 > OLD Pharm > Flashcards

OLD Pharm Flashcards

1
Q

two drug targets in asthma and COPD

A

inflammation and constricted airways (bronchodilators)

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2
Q

6 inhaled corticosteroids

A

beclomethasone, triamcinolone, flunisolide, fluticasone, budesonide, mometasone

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3
Q

IV corticosteroid

A

solumedrol

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4
Q

Oral corticosteroid

A

prednisone

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5
Q

LOX inhibitor

A

zileuton

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6
Q

leukotriene antag

A

motelukast, zafirlukast

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7
Q

omalizumab

A

IgE antibody

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8
Q

mepolizumab

A

IL-5 antibody

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9
Q

dupilumab

A

IL-4 antibody

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10
Q

PDE4 inhib

A

rolumilast

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11
Q

mast cell stabilizer

A

cromolyn

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12
Q

SABAs

A

albuterol, epi

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13
Q

LABAs

A

salmeterol, formoterol, indacaterol

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14
Q

SAMAs (short acting anti cholinergic)

A

ipratropium

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15
Q

LAMAs (long acting anti cholinergic)

A

tiotropium, aclinidium, umeclidinium, glycopyrronium

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16
Q

ANS regulation of bronchiole SM

A

PSNS: less O2 needed, M3 activation and constriction

SNS: more O2, B2 activatio and dilation

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17
Q

M3 agonist

A

methacholine

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18
Q

maintenance therapy for asthma

A

LABAs, LAMAs, SAMAs

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19
Q

indications for epi, target, delivery

A

hits all SNS receptors, for anaphylaxis

subQ

20
Q

ITD for albuterol (indications, target, delivery)

A

B2, asthma acute, inhalation prn

21
Q

why albuterol only for rescue?

A

receptor desensitization/ downregulation w/ regular use

22
Q

differentiate LABAs salmeterol/formoterol from indacaterol w/ ITD

A

all are B2 selective

first two are indicated for asthma and COPD, second is only COPD

all orally inhaled twice daily except indacaterol is once daily

23
Q

important toxicities of B2 agonists

A

mainly cardiac for cross agonism of B1 (tachycardia, angina, a fib, etc)

24
Q

strength of B2 agonist on receptor

A

all partial except epi

25
Q

3 variables for toxicities of inhaled drugs

A

how much is systemically (blood) absorbed?

clearance/metabolism

receptor selectivity

26
Q

how is most inhaled drug absorbed

A

95% swallowed, some is indirectly from mucociliary clearance then swallowed, toxicites occur in systemic circulation

27
Q

most cardiotoxic B2 agonists

A

epi, indacaterol, then formoterol is moderate

28
Q

which 2 M3 antagonists are indicated for asthma in addition to COPD?

A

ipratropium (SAMA), tiotropium (LAMA)

29
Q

toxicities of M3 antagonists

A

parasympathetic related (lowering rest and digest): dry mouth (xerostomia), constipation, tachycardia, Urinary retention (Umeclidinium)

except aclidinum?

30
Q

two main aspects of inflammation inhibition from steroids

A

reduction of cells: eos, mast cells, dendritic cells

reduction of cytokines: from t lymphos, macros, epithelial cells, SM

31
Q

consequence of chronic steroid use

A

infection susceptibility- thrush and pneumonia from oral inhalation

32
Q

pregnancy risk for CS

A

inhaled options relatively safe, prednisone less so

33
Q

CS combo drugs

why?

A

LABAs always combined w/ inhaled corticosteroids

LABAs alone had higher asthma death rate

34
Q

CS effect on bronchiole SM

A

increases B2 receptors, higher responsiveness to bronchodilators

35
Q

effect of leukotriene inhibs

A

reduce Sx of respiratory inflammation

36
Q

zileuton target

A

LOX enzymes in mast cells and eos- inhibit LT production

37
Q

-lukast target

A

LT receptors in bronchiole SM, prevent constriction, plasma exudation/mucus

38
Q

CS effect on LK activity

A

stimulate lipocortin production which inhibts phospholipase A2 and thus all eicosanoids

39
Q

indication for LK inhibs

A

allergic asthma

40
Q

montelukast toxicities (2)

A

Churg Strauss syndrome (eosinophilic granulamatosis w/ polyangiitis, autoimmune vasculitis)

reports of neuropsych disturbances- suicide
(not FDA confirmed)

41
Q

indication of omalizumab

A

IgE allergic asthma, given once every 4 weeks

42
Q

indication of mepolizumab

A

severe eosinophilic asthma, once every 4 weeks

43
Q

theophylline moa

A

bronchodilation: inhibits PDEs (allows for cAMP buildup and more more inhibition of contraction), competitive adenosine antagonist (adenosine causes contraction)

also has anti inflammatory mechanisms

44
Q

theophylline toxicities

A

CNS- headache, seizures
cardiac- arrhythmias
GI- nausea, diarrhea

non selective PDE inhib, low therapeutic index

45
Q

moa of cromolyn

A

stabilize mast cell and prevent release of inflammatory mediators (in response to IgE/allergen

46
Q

roflumilast moa

A

PDE4 selective inhib- fewer toxicities than theophylline

47
Q

indications/dosing of roflumilast

A

for COPD, oral

Respiratory Exam 1 (14 decks)

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