Pulmonology - Pharmacology

Question 0

2 Mechanisms to Reduce Inhaler Side Effects

Answer 0

1) Poorly absorbed from GI Tract

2) Rapidly cleared by first pass metabolism

Question 1

Salmeterol - Class + Use

Answer 1

Class - Long Acting B2 Agonist

Use - Asthma Prophylaxis - Combo with Fluicasone

Question 2

B2 Selective Agonists - Categories (2) + Names (5) + Uses + Toxicity (2)

Answer 2

1) Short Acting - SABA - Albuteral + Terbutaline + Metaproterenol
Use - Acute Exacerbation

2) Long Acting - Salmeterol + Formoterol
Use - Long Term Prophylaxis
Toxicity = Tremor + Arrhythmia

Question 3

Albuteral - Class + Use

Answer 3

Class - Short Acting B2 Agonist

Use - Acute Asthma Exacerbation

Question 4

Tiotropium Bromide - Class + Use

Answer 4

Class -M3 Receptor Antagonist

Use - Prevents bronchoconstriction in asthma and COPD - COPD = Primary

Question 5

Inhaled Corticosteroids - Names (3) + Use + Mechanism + Toxicity (1)

Answer 5

Names - Fluticasone + Budesonide + Beclomethasone

Use - Combination therapy to reduce asthma induced inflammation
Mechanism - Inactivates NF-Kappa-Beta transcription factor reducing TNF-Alpha and inflammatory factors

Toxicity - Increased Candida Infection - No real risk for growth etc.

Question 6

Zafirlukast - Class + Use

Answer 6

Class - Antileukotrine - LTD4 Receptor Inhibition

Use - Asthma

Question 7

2 Major B2 Agonist/Steroid Therapies

CLASS ONLY

Answer 7

Salmeterol-Fluticasone (Advair)

Formoterol-Budesonide (Symbicort)

Question 9

Fluticasone - Class + Use

Answer 9

Class - Inhaled Corticosteroid

Use - Asthma Prophylaxis - Combo with Salmeterol

Question 10

When to Add Asthma Prophylaxis (3)

Class Only

Answer 10

1) Rescue Needed > 2x Weekly
2) Noctornal Symptoms >2x Monthly
3) FEV1 < 80% Predicted

Question 11

Budesonide - Class + Use

Answer 11

Class - Inhaled Corticosteroid

Use - Asthma Prophylaxis - Combo with Formoterol

Question 13

Aminophylline - Class + Use

Answer 13

Class - Inhaled Methylxanthiine Drug

Use - Asthma - Limited (Narrow Theuroputic Window)

Question 14

Inhaled M3 Receptor Antagonists - Name (2) + Use + Mechanism + Toxicity

Answer 14

Name - Ipratropium Bromide (Asthma) + Tiotropium Bromide (COPD - Very Long Long Lasting)

Use - Asthma + COPD - B2 Agonist Synergy
Mechanism - Prevents M3 Bronchoconstriction - Not absorbed by GI Tract

Toxicity - None

Question 15

Terbutaline - Class + Use

Answer 15

Class - Short Acting B2 Agonist

Use - Acute Asthma Exacerbation

Question 15

Formoterol - Class + Use

Answer 15

Class - Long Acting B2 Agonist

Use - Asthma Prophylaxis - Combo with Budesonide

Question 16

Theophylline - Class + Use

Answer 16

Class - Inhaled Methylxanthiine Drug

Use - Asthma - Limited (Narrow Theuroputic Window)

Question 18

Antileukotriene Drugs - Names (3) + Use + Mechanism (2) + Toxicity

Answer 18

Names - Montelukast + Zafirlukast + Zileuton

Use - Asthma - Long Term Therapy - Leukotrienes are bronchoconstrictors that causes mucous hypersecretion
Effects/Response not equal in all people

Mechanism - Montelukast/Zafirlukast - Block LTD4 Luekotrine Receptors
Zileuton - Block 5-Lipoxygenase Production)

Toxicity - Zileuton = Hepatotoxicity + Oral

Question 19

Zileuton - Class + Use

Answer 19

Class - Antileukotrine - 5-Lipoxyganse Inhibition

Use - Asthma - Oral

Question 20

Omalizumab - Class + Use

Answer 20

Class - Monoclonal Anti-IgE

Use - Asthma - Severe refractory allergic asthma

Question 21

Anti-IgE Antibodies - Name + Use + Mechanism + Toxicity

Answer 21

Name - Omalizumab

Use - Asthma - Severe refractory allergic asthma

Mechanism - Prevent inflammation via serum IgE inhibition - No cross linking

Toxicity - Anaphylaxis + Neoplasms

Question 22

COPD Specific Steroid Therapies (4)

Answer 22

1) Tiotropium-Bromide - COPD M3 Antagonist
2) Formaterol - LABA
3) Arformaoterol - LABA
4) Fluicaseon-Vilanterol - Specific Combo

Question 23

Ipratropium-Bromide - Class + Use

Answer 23

Class -M3 Receptor Antagonist

Use - Prevents bronchoconstriction in asthma and COPD - Asthma = Primary

Question 25

Metaproterenol - Class + Use

Answer 25

Class - Short Acting B2 Agonist

Use - Acute Asthma Exacerbation

Question 25

Methylxanthine Drugs - Names (2) + Use + Mechanism + Toxicity

Answer 25

Names - Theophylline + aminophyliline

Use - Asthma - No Longer Used (Narrow Therapeutic Window) - Requires blood monitoring
Mechanism - Inhibits phosphodiesterase - Increaes cAMP and bronchodilation

Toxicity - Super narrow theuraputic window + CYP450 - Cardiotoxicity + Neurotoxicity

Question 25

Montelukast - Class + Use

Answer 25

Class - Antileukotrine - LTD4 Receptor Inhibition

Use - Asthma