Pulm Drugs

Question 1

Triamcinolone (Class, MOA, Physiologic effect, Indications, Adverse effect)

Answer 1

Class: Glucocorticoid
MOA: Inhibit inflammation by blocking PLA2 and AA, decreasing COX-2 synthesis, and blocking IFN-y, IL-1, and IL-2
Physiologic effect: Block leukotrienes and prostaglandins and prevent leukocyte and lymphocyte chemotaxis and activation
Indications: Asthma
Adverse effect: Headache, pharyngitis, GI upset, xerostomia (dry mouth), and facial edema

Question 2

Nedocromil (Class, MOA, Physiologic effect, Indications, Adverse effect)

Answer 2

PROPHYLACTIC
Class: mast cell stabilizer
MOA: antagonizes mast cell and eosinophil degranulation
Physiologic effect: inhibits bronchoconstriction from antigens
Indications: Asthma
Adverse effect: N & V, dysguesia (metal taste), and cough

Question 3

Omalizumab (Class, MOA, Physiologic effect, Indications, Adverse effect)

Answer 3

Class: monoclonal IgG antibody
MOA: binds to Fc receptor on IgE to prevent binding to mast cells
Physiologic effect: reduces mast cell degranulation
Indications: Asthma
Adverse effect: headache, URTI, sinusitis, pharyngitis, arthralgia

Question 4

Montelukast (Class, MOA, Physiologic effect, Indications, Adverse effect)

Answer 4

PROPHYLACTIC
Class: Leukotriene receptor antagonist
MOA: inhibit binding of leukotrienes to their receptor
Physiologic effect: reduces airway inflammation that causes bronchoconstriction, mucus secretion, and edema
Indications: Asthma
Adverse effect: headache gastritis URTI

Question 5

Zafirlukast (Class, MOA, Physiologic effect, Indications, Adverse effect)

Answer 5

PROPHYLACTIC
Class: Leukotriene receptor antagonist
MOA: inhibit binding of leukotrienes to their receptor
Physiologic effect: reduces airway inflammation that causes bronchoconstriction, mucus secretion, and edema
Indications: Asthma
Adverse effect: headache gastritis URTI, inhibits CYP450 so it causes a lot of drug-drug interactions

Question 6

Albuterol (Class, MOA, Physiologic effect, Indications, Adverse effect)

Answer 6

ORAL INHALATION
Class: β2 receptor agonist
MOA: activate adenylate cyclase which increases intracellular cAMP which relaxes SM
Physiologic effect: bronchodilation
Indications: COPD and Asthma
Adverse effect: most related to activation of sympathetic system (tremor, tachycardia, palpitations, anxiety, excitability, hypokalemia)

Question 7

Ipratoprium (Class, MOA, Physiologic effect, Indications, Adverse effect)

Answer 7

ORAL INHALATION
Class: Muscarinic receptor antagonist (AcH)
MOA: block effects of vagus nerve parasympathetic stimulation on the airway by antagonizing AcH at bronchial SM sites
Physiologic effect: bronchodilation. inhibits serous and seromucous gland secretions in the nasal mucosa
Indications: COPD
Adverse effect: airway irritation, GI upset, xerostomia, urinary retention, increased ocular pressure, anticholinergic effects

Question 8

Tiotoprium (Class, MOA, Physiologic effect, Indications, Adverse effect)

Answer 8

ORAL INHALATION
Class: Muscarinic receptor antagonist (AcH)
MOA: block effects of vagus nerve parasympathetic stimulation on the airway by antagonizing AcH at bronchial SM sites
Physiologic effect: bronchodilation. inhibits serous and seromucous gland secretions in the nasal mucosa
Indications: COPD
Adverse effect: airway irritation, GI upset, xerostomia, urinary retention, increased ocular pressure, anticholinergic effects