Pulmonary Pharmacology: Anti-inflammatory Rx Flashcards
What are the 4 general categories of anti-inflammatory drugs?
- ICS (1st & 2nd gen)
- Oral & IV corticosteroid
- Leukotriene pathway inhibitor
- Monoclonal antibodies
Why are there no drug interactions for monoclonal antibody drugs?
metabolized by antibodies
Hoarse voice and oropharyngeal candidiasis are common side effects of which class of drugs?
corticosteroids
What is the genomic vs. non-genomic mechanism of action for anti-inflammatory Rx?
genomic: decreases TH2 cytokines
non-genomic: inhibits arachidonic acid production
If a patient has perennial aeroallergen that is not well controlled w/inhaled corticosteroids, what would you recommend?
omalizumab
Which bronchodilator is used to treat nasal polyps that are not responding to nasal corticosteroids?
omalizumab
(costs up to $2,706 for one month’s supply)
Which bronchodilator blocks binding of IgE to FcERI on mast cells and basophils?
omalizumab
How does omalizumab provide extra protection after viral illness?
enhances type 1 IFN, reducing FCeRI
How is omalizumab dosed?
measure IgE + patient’s body weight
bronchospasm, hypotension, syncope, uticaria, angioedema of throat are symptoms of which condition?
anaphylaxis
(omalizumab, ipratropium & tiotropium may cause this)
Hoarse voice and oropharyngeal candidiasis are common side effects of which class of drugs?
corticosteroids
Dupilumab v. omalizumab: both decrease prevent the effects of IgE. How are they different?
Dupilumab: IL-4 Receptor blocker (prevents IgE synthesis)
Omalizumab: IgE binding
(decreasing production ineffective, MUST bind receptor)
When would you use omalizumab or Dupliumab?
severe asthma
symptoms inadequately controlled w/ICS
What is the main difference in the function of IL-4 and IL-5 as it pertains to respiratory inflammation?
IL-4 enhances IgE synthesis
IL-5 keeps eosinophils alive
“5 keeps eosinophils alive”
Which 2 drugs target IL-5 antibodies?
(prevents eosinophil survival)
- mepolizumab
- reslizumab
Which drug targets IL-5 receptor?
(prevents eosinophil survival)
Benralizumab
IL-5 inhibitors benefit the patient by decreasing the need for which therapies?
maintenance dose of ICS
(reduces exacerbations by 50%)
Which general class of medicine is indicated for severe asmtha, but NOT reducing COPD exacerbations?
IL-5 inhibitors