Pharmacology

Question 1

T or F: steroids are largely ineffective against asthma

Answer 1

F: effective; largely ineffective against COPD

Question 2

Which disease, asthma or COPD, is marked with major fibrosis?

Answer 2

COPD

Question 3

What class of drugs good against bronchoconstriction?

Answer 3

beta agonists
leukotriene antagonists
antimuscarinics

Question 4

What drugs are good against inflammatory processes?

Answer 4

corticosteroids

biologics

Question 5

Acetylcholine acts on what receptors?

Answer 5

muscarinic receptors

Question 6

What is the effect of acetylcholine and leukotriene?

Answer 6

bronchoconstriction

Question 7

T or F: long acting beta2-agonists are given in addition to glucocorticoids

Answer 7

T

Question 8

Which drugs are selective for Beta2 receptors and mimic adrenaline?

Answer 8

salbutamol

terbutaline

Question 9

What are examples of LABA?

Answer 9

Salmeterol [partial agonist] and formoterol [full agonist]

Question 10

What is a ultra-LABA?

Answer 10

indacaterol

Question 11

What are some issues of B2 agonists?

Answer 11

From overstimulation of sympathetic system
Tremor – increased muscle spindle discharge
Tachycardia – due to some b2 receptors in atria and ventricles
Anxiety
Ketoacidosis risk in diabetics – b2 stimulation in the liver induces glycogenolysis
Side effects tend to not be severe because of limited distribution when taken via inhalation

Question 12

For asthma, should LABA used as monotherapy?

Answer 12

NOOOOOO
Equivocal reports on increased mortality but may only occur if used as monotherapy – never use as monotherapy for asthma!

COPD OK

Question 13

What chemical are antimuscarinics?

Answer 13

Are quaternary ammoniums – minimizes ability to pass through blood brain barrier

Question 14

Antimuscarinic agents are useful in COPD or asthma?

Answer 14

COPD

Question 15

What is the difference between M2 and M3 receptors?

Answer 15

M2 is at the presynaptic cells to serve as negative feedback

M3 is found at effector and causes bronchoconstriction, mucus secretion,

Question 16

What are some antimuscarinic agents?

Answer 16

tiotropium [short-acting]
ipratropium [long-acting]
glycopyrronium [long-acting but fast onset]

Question 17

What are side effects of antimuscarinics?

Answer 17

Dry mouth (most common)
Nausea, constipation
Headache
Tiotropium can cause urinary retention in men with prostatism
Can contribute to angle-closure glaucoma (direct exposure)

Question 18

What are leukotriene antagonists?

Answer 18

montelukast

zafirlukast

Question 19

What are effects of LTRA?

Answer 19

blocks edema

bronchodilation

Question 20

T or F: LTRA are used for COPD

Answer 20

F

Question 21

What are side effects of LTRA?

Answer 21

Abnormal liver function tests
Rarely reports of Churg Straus syndrome
systemic eosinophilia (high levels of immune cells in blood) and vasculitis
initial symptoms resemble asthma
Headaches, GI disturbance