Respiratory

Question 1

Resilzumab

Answer 1

IL-5 receptor antagonist has been approved for severe eosinophillic asthma

Question 2

Severe asthma where patient eosinophil levels are elevated despite compliance and glutocorichoids

Answer 2

Eosinophillic asthma

Question 3

What are drug treatment strategies for patients who have stable copd and have fev1 value that is less then 70% of healthy individuals

Answer 3

Bronchodilators and anticholinergics

Question 4

Codeine MOA

Answer 4

Opioids agonist that suppresses cough center in brain stem

Question 5

Bronchodilators- theophylline

Answer 5

Camp pde inhibitors.
Can use if unresponsive to albuterol

Question 6

Albuterol and terbulatine

Answer 6

Short acting beta 2 adrenergic agonist

Question 7

Salmeterol

Answer 7

Long acting beta 2 adrenergic agonist

Question 8

Mag sulfate

Answer 8

Bronchodilators- MOA not fully known but interfere with calcium channels and causes smooth muscle relaxation

Question 9

Is theophylline a good choice for people who experience seizures or insomnia

Answer 9

No it activates the sns because it’s non selective bronchodilator. Also interacts with seizure meds

Question 10

What are the types of asthma

Answer 10

Intermittent or persistent.
Persistent is mild/moderate/severe

Question 11

Goals of treatment for asthma

Answer 11

Minimize side effects, prevents progressive loss of pulmonary function and LDAS, ***3 more

Question 12

Intermittent treatment of asthma

Answer 12

Prn bronchodilators/rescue inhalers, short acting beta agonist (albuterol and terbutaline)

Question 13

Persistent (mild/mod/severe) asthma treatment

And severe

Answer 13

Daily inhalation of glucocorticoids first line and prn rescue inhaler

Severe- long acting beta2 agonist

Question 14

Acute severe asthma treatment

Answer 14

Oxygen, systemic dose glucocorticoid, nebulized form of short acting beta 2 agonist combined with ipathdium

Question 15

Alveolar type 2 cells

Answer 15

Produce surfactant.

Question 16

What happens when elastic fibers break down around alveoli

Answer 16

Copd

Question 17

Bronchial glands release water to ?

Answer 17

Keep airways moist

Question 18

Pns activated by

Answer 18

Bronchoconstriction by muscarinic cholinergic receptors

Question 19

Sns and epi cause

Answer 19

Bronchodilation mediated by beta 2 adrenergic receptors

Question 20

Elastic fibers surround alveoli are stretched during what part of breathing?

Answer 20

Inspiration

Question 21

Beractant moa/therapeutic use

Answer 21

Surfactant preparation administrated intratrachaelly. Reduces water surface tension in alveoli and makes inflation of alveoli easier

Used in preterm infants and events where dilution of surfactant like drowning/ards/pulmonary

Question 22

Alpha1 antityrpsin (type of antielastase ) deficiency moa/therapeutic use

Answer 22

Treat genetically linked form of emphysema (copd) that is associated with the absence of antilastases in leukocytes/without antielastase there is a breakdown of elastic around alveoli leading to copd. MOA replacement therapy of an alpha1 prolastin (alpha1 antityrpsin) iv infusion

Question 23

Expectorant/guaifenesin MOA / therapeutic use

Answer 23

Menthol containing. MOA mild irritant of bronchial glands. Stimulates secretion of water that dilutes mucous and makes it easier to dislodge

Question 24

Mucolytics MOA/therapeutic use

Answer 24

Acetylcysteine (mucomyst) MOA- breaks disulfide bonds with mucoproteins that are secreted by mucus glands. Reduces viscosity of mucus and makes it easier to dislodge from airways. Antidote to Tylenol overdose. Helps replace glutathione

Med is bronchospastic needs albuterol and beta 2 agonist before hand

Question 25

Cromolyn preparations (intal)

Answer 25

MOA- mast cell stabilizer. Reduces mast cell release of histamine in response to an allergen/ reduces mucus secretion and congestion. Uses prophylactic treatment of asthma attach, must be used before and not for an acute attack. Usually used before exercise induced asthma

Question 26

Omalizumab

Answer 26

Monoclonal anti igE antibody. 2 week injection. Increased risk of anaphylactic reaction must be done in dr office. MOA- selectively binds to Ige antibodies in blood which prevents them from attaching to mast cells and prevents release of histamine following antigen exposure Treat moderate/severe forms of allergic asthma and reduces treatment with glucocorticoids

Question 27

Anticholinergics - ipatropium

Answer 27

MOA- Muscarinic cholinergic receptor antagonist Therapeutic use- reduce cholinergic receptor mediated bronchoconstriction associated with respiratory disorders/ copd

Question 28

Leukotiene system inhibitors

Answer 28

zilueton/montelukast

Question 29

Inflammatory challenge chart

Question 30

Zilueton/ montelukast

Answer 30

MOA/ zileuton is lipooxygenase inhibitor which acts to block production of leukotines Montelukast is a selective leukotrienes receptor antagonist

Question 31

Glucocorticoids - steroid anti inflammatory

Answer 31

Prednisone- Intermed Dexamethasone - long acting MOA- steroid anti inflammatory drugs are cortisol receptor agonist. Stimulate production of lipocortin which is an inhibitor of phospholipase a2 and this reduces production of arachiodomic acid, prostaglandin and Leuko which results in reduced inflammation. Used for asthma, copd, allergies and immunosuppressant

Question 32

Dextromethorphan

Answer 32

Cough supressant. Increases the sensory threshold for airway obstruction that activates the cough center. Precise MOA unknown shown to be NMDA antagonist and signal receipt agonist