Pharm-Asthma/COPD

Question 1

Albuterol short or long?

Answer 1

short

Question 2

terbutaline short or long acting?

Answer 2

short

Question 3

formoterol short or long acting?

Answer 3

long

Question 4

Sympathomimetics main MOA (Beta agonists and epi?)

Answer 4

Increase cAMP which inhibits bronchial smooth muscle constriction –> airway dilation

Question 5

Sympathomimetics other MOAs?

Answer 5

Inhibit mast cell release; inhibit microvascular permeability, inhibit mucociliary transport (all to just a little bit)

Question 6

What AEs for sympathomimetics?

Answer 6

N/V HA
Hypotension
CNS - agitation, convulsions, coma…

Question 7

Ipratropium MOA

Answer 7

Competitive ACh muscarinic receptor antagonists; enhances B2 bronchodilation

Question 8

Ipratropium AEs

Answer 8

Pupil dilation, cycloplegia

Question 9

What is Combivent made of?

Answer 9

Ipratropium and Albuterol (ACH antag and Beta stim)

Question 10

What disease is Combivent used for?

Answer 10

COPD

Question 11

Theophylline AEs

Answer 11

N/V, CNS, high doses cause cardiac over excitation

Question 12

Cromolyn Sodium MOA

Answer 12

“Mast cell stabilizer” - no HIstamine release
Eosinophil stabilizer - no mediator release
Inhibit nerve - no cough

Question 13

Beclomethasone MOA

Answer 13

Glucocorticoid -
Dec cytokine production
Dec mucus secretion
Red bronchial hyperactivity
Enhance B2 agonist activity

Question 14

Glucocorticoid AEs

Answer 14

Inhaled: candidiasis

Oral: glucose int, inc BP, immunosuppression, cataracts, growth retardation

Question 15

Cushingoid syndrome?

Answer 15

From glucocorticoids
Weight gain in face and belly
Buffalo hump
Muscle weakness
High BP

Question 16

Steroids act on what enzyme to inhibit arachidonic acid production?

Answer 16

Phospholipase A2

Question 17

Monteleukast MOA and target

Answer 17

LTD4 receptor antagonist - blocks constriction and reactivity; decreases mucosal secretion and edema, dec inflammation too (Monte has 3 Ms - muscle, mucus, mation!)

Question 18

What is the most potent leukeotriene in terms of chemotaxis?

Answer 18

LTB4 (follow the bees!)

Question 19

Which leukotrienes mediate anaphylaxis and are potent bronchoconstrictors?

Answer 19

LTC4, LTD4, LTE4 (anaphylaxis is alphabet soup)

Question 20

Monteleukast AEs

Answer 20

URT infections esp in kids

Question 21

Zileuton AEs

Answer 21

Liver enzyme elevation - need LFTs

CYP1A2 inhibitor

Question 22

salmeterol short or long acting?

Answer 22

long

Question 23

Theophylline MOA?

Answer 23

Twofold:
Inhibits PDE - blocks bronchoconstriction

Adenosine receptor antagonist - resp for cardiac effects

Question 24

What AEs for sympathomimetics?

Answer 24

N/V HA
Hypotension
CNS - agitation, convulsions, coma…

Question 25

Ipratropium MOA

Answer 25

Competitive ACh muscarinic receptor antagonists; enhances B2 bronchodilation

Question 26

Ipratropium AEs

Answer 26

Pupil dilation, cycloplegia

Question 27

Theophylline is what class

Answer 27

Methylxanthines, like caffeine

Question 28

Theophylline AEs

Answer 28

N/V, CNS, high doses cause cardiac over excitation

Question 29

Cromolyn Sodium MOA

Answer 29

"Mast cell stabilizer" - no HIstamine release Eosinophil stabilizer - no mediator release Inhibit nerve - no cough

Question 30

Cromolyn Na AEs

Answer 30

Tastes bad, irritate trachea (even bronchospasm) NO systemic toxicity

Question 31

Zileuton acts on what enzyme to inhibit leukotriene formation?

Answer 31

5-LO

Question 32

Zileuton MOA

Answer 32

Inhibit leukotriene formation B, C, D, E

Question 33

Omalizumab MOA

Answer 33

Binds IgE and prevents IgE-mediated mediator release

Question 34

Omalizumab AEs

Answer 34

Severe allergic reactions | Cardiovascular

Question 35

What drugs are contraindicated in airway disease?

Answer 35

Sedatives, beta blockers, ASA/NSAIDS, ACE inhibitors, lidocaine with epi

Question 36

Ipratropium note about AEs

Answer 36

poorly absorbed from inhalation so no systemic side affects

Question 37

Name some treatment options for COPD

Answer 37

Nicotine replacement, bronchodilators, theophylline, guaifenesin (stim tract secretion flow), N-acetyl cystine