PULM - asthma/COPD

Question 1

bronchodilator types

Answer 1

beta-2 agonists, anti-cholinergics, methylxanthines

Question 2

corticosteroids systemic and inhaled eg, MOA,

Answer 2

prednisone, inhaled: fluticasone, budenoside; act in nucleus, inhibit expression of pro-inflammatory cytokines, inhibit COX-2, immunosuppressant

Question 3

anticholinergic reg eg, LAMA eg, MOA

Answer 3

ipratropium, tiotropium; antagonize M1, M3 receptors (which will inhibit bronchoconstriction, bronchial secretions)

Question 4

leukotriene antagonist eg, MOA, effectivenesss

Answer 4

montelukast; only oral option; LT1 receptor antagonist; not very effective

Question 5

beta-2 agonist MOA

Answer 5

beta receptor > G-protein > adenyl cyclase, ATP&raquo_space; cAMP > bronchodilation

Question 6

prednisone drug type, SE

Answer 6

systemic corticosteroid; osteoporosis, fat redistribution, obesity, hyperglycemia

Question 7

SABA eg, onset, SE

Answer 7

salbutamol; onset within minutes; generally well-tolerated, tachycardia, tremor

Question 8

monoclonal antibody eg, MOA, pros & cons

Answer 8

omalizumab; prevent interaction of allergen with IgE; pro-administered every few weeks, cons-expensive, immune reactions

Question 9

LABA eg, SE

Answer 9

salmeterol; may downregulate beta receptors over time

Question 10

budenoside, fluticasone drug type, SE

Answer 10

inhaled corticosteroid; thrush, dysphonia (hoarseness)

Question 11

methylxanthine eg, MOA, SE

Answer 11

theophylline; inhibit phosphodiesterase, prevent cAMP breakdown; narrow margin of safety, nausea & vomiting, stimulatory (restlessness, insomnia, tremor), arrhythmias, drug interactions common

Question 12

disadvantage of pressurized metered dose inhalers (MDI)

Answer 12

requires coordination, most of drug ends up in back of throat

Question 13

why combine inhaled corticosteroid with LABA?

Answer 13

chronic use of LABA may downregulate beta-2 receptors, corticosteroids upregulate beta-2 receptors in the lung