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Respiratory Exam 1 > Pharmacology of OLDs > Flashcards

Pharmacology of OLDs Flashcards

1
Q

which immune cells are in asthma

A
  • mast cells
  • eosinophils
  • Th2 lymphocytes
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2
Q

which immune cells are in COPD

A
  • neutrophils
  • macrophages
  • CTLs
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3
Q

what is the parasympathetic receptor in the lung

what happens when we activate it

A
  • M3

- bronchoconstriction

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4
Q

what is the sympathetic receptor in the lung

what happens when we activate it

A
  • B2

- bronchodilation

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5
Q

drugs that are beta 2 agonists

A
  • albuterol
  • epineprhine
  • salmeterol
  • formoterol
  • indacaterol

ISAFE

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6
Q

drugs that are M3 antagonists

A
  • Ipatropium (nonselective)
  • Tiotropium
  • Glycopyrrolate (nonselective)
  • Aclidinium
  • Umeclidium

ITAGU

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7
Q

drug that is M3 agonist

A
  • methacholine
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8
Q

SABA (short acting beta agonist) drugs

A
  • albuterol

- epinephrine

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9
Q

LABA (long acting beta agonist drugs)

A
  • salmeterol (A/COPD BID)
  • formoterol (A/COPD BID)
  • indacaterol (COPD QD)
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10
Q

short acting M3 antagonists

A
  • ipatropium
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11
Q

long acting M3 antagonists

A
  • tiotropium
  • aclidinium
  • umeclidinium
  • glycoprrolate

TAGU

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12
Q

rescue therapy used for

duration of effect

A
  • treatment of acute symptoms

< 12 hours

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13
Q

maintenance therapy used for

duration of effect

A
  • prevention of acute asthma symptoms

- > 12 hours or <12 with multiple dosing

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14
Q

can you use ipatropium for maintenance therapy?

how?

A
  • yes

- you take multiple doses per day (4 to be exact)

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15
Q

epinephrine selectivity

A
  • alpha 1, 2

- beta 1, 2

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16
Q

epinephrine indications

A
  • anaphlyaxis (allergy)
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17
Q

epinephrine dosing (how we put it in the patient)

A
  • subQ
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18
Q

albuterol indications

albuterol dosing (how we put it in the patient)

A
  • asthma (acute)

- inhalation, prn

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19
Q

what happens if you chronically use short acting beta agonists

A
  • beta 2 receptors will desensitize to it
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20
Q

chronic use of short term beta agonists how they become desensitized within minutes

A
  • phosphorylation by PKA and GPCR
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21
Q

chronic use of short term beta agonists and how they become down regulated within hours

A
  • receptor degradation
22
Q

important toxicities of beta two agonists are because of

some toxicities

are these effects major concerns?

A
  • cross agonism of beta 1 in the heart
  • they are only partial agonists
  • tachycardia
  • chest pain
  • a-fib
  • angina
  • vasoconstriction
  • hypertension
  • not generally major concerns
23
Q

what is the full beta 2 agonist

A
  • epinephrine
24
Q

what happens with the majority of drugs that you inhale

A
  • swallow vast majority
25
Q

important toxicities of M3 antagonists are primarily based on which system

examples of some toxicities

A
  • parasympathetic
  • inhibit rest and digest responses
  • dry mouth
  • urinary retention
  • constipation
26
Q

corticosteroid drugs

A
  • beclomethasone
  • triamcinolone
  • flunisolide
  • fluticasone
  • budesonide
  • mometasone
  • solumedrol
  • predinosone

BFFB TMSP

27
Q

which corticosteroid drug do you give via IV

A
  • solumedrol
28
Q

which corticosteroid drug do you give via oral

A
  • prednisone
29
Q

in which way do you give most corticosteroid drugs?

A
  • inhaled
30
Q

inhaled corticosteroid toxicities:

A
  • immunosuppression
  • thrush
  • pneumonia
31
Q

most inhaled steroids in pregnancy are which category

except which drug (what category)

A
  • C

- prednisone (D)

32
Q

why do we use corticosteroids with long acting beta 2 agonists

A
  • they increase bronchiole smooth muscle responsiveness to beta 2 agonists because they
  • increase the synthesis of the beta 2 receptor
33
Q

MOA of Zileuton

A
  • inhibit synthesis of leukotrienes by inhibiting 5-lipoxygenase
34
Q

MOA of Montelukast and Zafirlukast

A
  • competitive antagonists for leukotriene binding to receptors in bronchiole smooth muscle
35
Q

what inhibits leukotriene synthesis by also inhibiting phospholipase A2 activity

how?

A
  • corticosteroids

- increase expression of lipocortin

36
Q

leukotriene inhibitors treat what kind of asthma

A
  • allergic asthma
37
Q

side effects of montelukast

A
  • vasculitis (Churg-Strauss syndrome also known as eosinophilic granulomatosis with polyangiitis
  • suicide tendencies?
38
Q

can we use montelukast during pregnancy

A
  • yes
39
Q

mepolizumab target

used in which kind of asthma

A
  • IL-5

- severe eosinophilic asthma

40
Q

omalizumab target

used in which kind of asthma

A
  • IgE - inhibits mast cell activation

- IgE-mediated allergic asthma

41
Q

omalizumab and mepolizumab are given how

A
  • SubQ
42
Q

can you use omalizumab and mepolizumab in pregnancy

A
  • yes
43
Q

theophylline bronchodilator effects

A
  • inhibits phosphodiesterase in bronchiole smooth muscle

- competitive antagonist of adenosine (which induces smooth muscle contraction in bronchioles)

44
Q

theophylline toxicities

A
  • seizures

- arrhythmias

45
Q

why is theophylline use declining

A
  • difficulties in safe dosing

- low therapeutic index

46
Q

Moa of cromolyn

A
  • stabilizes mast cells
  • prevents degranulation of mast cells
  • prevents release of inflammatory mediators
47
Q

roflumilast MOA

A
  • inhibits phosphodiesterase-4 (very selective) in bronchiole smooth muscle
  • less toxicities
48
Q

only with COPD drugs do you see what

A
  • anti-cholinergic
49
Q

why don’t we use LABAs alone

A
  • they may increase risk of death from asthma
50
Q

what do we use roflumilast for (what condition)

A
  • COPD

Respiratory Exam 1 (27 decks)

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