Pharmacology Flashcards
T or F: steroids are largely ineffective against asthma
F: effective; largely ineffective against COPD
Which disease, asthma or COPD, is marked with major fibrosis?
COPD
What class of drugs good against bronchoconstriction?
beta agonists
leukotriene antagonists
antimuscarinics
What drugs are good against inflammatory processes?
corticosteroids
biologics
Acetylcholine acts on what receptors?
muscarinic receptors
What is the effect of acetylcholine and leukotriene?
bronchoconstriction
T or F: long acting beta2-agonists are given in addition to glucocorticoids
T
Which drugs are selective for Beta2 receptors and mimic adrenaline?
salbutamol
terbutaline
What are examples of LABA?
Salmeterol [partial agonist] and formoterol [full agonist]
What is a ultra-LABA?
indacaterol
What are some issues of B2 agonists?
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
For asthma, should LABA used as monotherapy?
NOOOOOO
Equivocal reports on increased mortality but may only occur if used as monotherapy – never use as monotherapy for asthma!
COPD OK
What chemical are antimuscarinics?
Are quaternary ammoniums – minimizes ability to pass through blood brain barrier
Antimuscarinic agents are useful in COPD or asthma?
COPD
What is the difference between M2 and M3 receptors?
M2 is at the presynaptic cells to serve as negative feedback
M3 is found at effector and causes bronchoconstriction, mucus secretion,
What are some antimuscarinic agents?
tiotropium [short-acting]
ipratropium [long-acting]
glycopyrronium [long-acting but fast onset]
What are side effects of antimuscarinics?
Dry mouth (most common)
Nausea, constipation
Headache
Tiotropium can cause urinary retention in men with prostatism
Can contribute to angle-closure glaucoma (direct exposure)
What are leukotriene antagonists?
montelukast
zafirlukast
What are effects of LTRA?
blocks edema
bronchodilation
T or F: LTRA are used for COPD
F
What are side effects of LTRA?
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
