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MQW U4 > Pharm--Asthma/CHF > Flashcards

Pharm--Asthma/CHF Flashcards

1
Q

Asthma vs smoking COPD:

  • -Which is reversible airway obstruction
  • -Which is responsive to steroids
  • -Which causes cough, SOB and increased sputum
  • -Which causes wheezing, and chest tightness
  • -Which has B-cell involvment
  • -Which has Th1 cell involvment
A
  • -Reversible = Asthma
  • -Steroid sensitive = Asthma
  • -cough, SOB, sputum = COPD
  • -Wheezing, tightness = Asthma
  • -B-cell = Asthma
  • -Th1 cell = COPD (Asthma = Th2)
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2
Q

Short acting B2 agonists:

  • -Examples?
  • -Onset of action time
  • -Peak effect time
  • -Duration of action time
A
  • -Albuterol, Terbutaline, Metoproterenol, Pirbutol
  • -5min
  • -30-60min
  • -4-6hr
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3
Q

Levalbuterol is a racemic mixture of R and S isomers:

  • -What does R isomer do?
  • -What does S isomer do?
A 
R = B agonist effects
S = promote inflammation, side effets (esp. tachycardia)
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4
Q

When must Beta agonists always be combined w/ inhaled steroids?

A

Long term control of asthma with long acting B-agonists

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5
Q

[Salmeterol/Formoterol] is a full B2 agonist (as opposed to partial agonist)

A

Formoterol = full agonist

Salmeterol = partial agonist

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6
Q

First line agent for chronic COPD treatment

A

Tiotropium – anti-muscarinic

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7
Q

Methylxanthine bronchodilation mechanism:

A

Non selective phosphodiesterase inhibitor (PDE3,4,5)

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8
Q

3 Methylxanthines:

A
  • -Theophylline
  • -Theobromine
  • -Caffeine
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9
Q

In steroid resistant inflammation (COPD, severe asthma, asthmatics who smoke), steroid sensitivity can be restored with what?

A

Low dose theophylline

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10
Q

What anti-muscarinic used for COPD has an extremely short circulating half-life?

A

Aclidinium Bromide – functionally similar to tiotropium

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11
Q

What inhaled corticosteroid has these characteristics:

  • -Inhaled pro-drug
  • -On site activation by airway esterase
  • -Less systemic side effects
A

Ciclesonide

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12
Q

Metered dose vs Dry powder inhalation:

  • -Is in solution or suspended
  • -Non propellant based
  • -Patient controls inhalation
  • -Machine actuated
  • -Fast inspiratory flow rate
A
  • -Is in solution or suspended = metered dose
  • -Non propellant based = dry powder
  • -Patient controls inhalation = dry powder
  • -Machine actuated = metered dose
  • -Fast inspiratory flow rate = dry powder***
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13
Q

Drug of choice for aspirin induced asthma and for prophylaxis of exercise induced bronchospasm?

A

Leukotriene inhibitors = Sodium cromoglycate, neodocromil sodium

–prevent mast cell degranulation and mediator release from macrophage and eosinophil

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14
Q

Omalizumab is given by subcutaneous injection every 2-4 weeks. What is it’s mechanism?

A

Anti - IgE monoclonal antibody

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15
Q

Patients w/ heart failure have neurohormonal impact of increase what? (6 things)

A
  • -NE
  • -Angiotensin II
  • -Aldosterone
  • -Endothelin
  • -Vasopressin (ADH)
  • -Cytokines
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16
Q

Peripheral circulation compensation in heart failure involves arterial vaso[constriction/dilation] and venous vaso[constriction/dilation]

A

Arterial vasoconstriction –> high afterload

Venous vasoconstriction –> high preload

17
Q

7 Groups of drugs used for heart failure

A
  • -Diuretics
  • -Digoxin
  • -Inotropes = Dobutamine
  • -Nitrates
  • -ACE-I/ARB
  • -B-blockers
  • -Aldosterone antagonists = spirinolactone, eplerenone
18
Q

Inotropes: Dobutamine vs. Milrinone

  • -Has half life of 2min
  • -Given as continuous infusion
  • -PDE3 inhibitor
  • -No tolerance
  • -B-1 direct stimulation
A
  • -Has half life of 2min = Dobutamine
  • -Given as continuous infusion = BOTH
  • -PDE3 inhibitor = Milrinone
  • -No tolerance = Milrinone (Dobutamine = tolerance in 24-48hours)
  • -B-1 direct stimulation = Dobutamine
19
Q

In Heart failure:
Wet/Dry is determined by?
Warm/Cold is determined by?

A 
Wet/Dry = congestion at rest (wet) vs not
Warm/Cold = hypoperfusion at rest (cold) vs not
20
Q

What pharmacologic treatment?

  • -Warm and dry
  • -Warm and wet
  • -Cold and dry
  • -Cold and wet
A
  • -Warm and dry = none
  • -Warm and wet = diuretic/vasodilator
  • -Cold and dry = inotrope???
  • -Cold and wet =diuretic/vasodilator (also maybe inotrope)

MQW U4 (9 decks)

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