Respiratory - Asthma

Question 1

Albuterol

Answer 1

b2 selective agonist

Oral & Oral inhalation

USE - alleviate acute bronchoconstriction in intermittent and persistent

Question 2

Leavlbuterol

Answer 2

b2 selective agonist

alleviate acute bronchoconstriction in intermittent and persistent asthma

Question 3

Terbutaline

Answer 3

b2 selective agonist

Oral & i.v.

alleviate acute bronchoconstriction in intermittent and persistent asthma

Question 4

Ipratopium Bromide

Answer 4

Antimuscarinic

Non selective, M3 muscarinic antagonist (mediate ACh induced airway smooth muscle contraction)

Short half life (2hrs), long acting (6hrs)

Quick relief, not 1st line.

Contraindicated in individuals with narrow-angle glaucoma, pre-existing bladder obstruction, and sensitivity to atropine.

Question 5

Budesonide

Answer 5

Corticosteroid

Question 6

Fluticasone

Answer 6

Corticosteroid

Question 7

Methylprednisolone

Answer 7

Corticosteroid

Question 8

Formoterol

Answer 8

Long acting b2 selective

Question 9

Salmeterol

Answer 9

long acting b2 selective

Question 10

Zileuton

Answer 10

Leukotriene synthesis inhibitor

Inhibiting the enzyme, 5-lipoxygenase.

treatment of mild and moderate persistent asthma.

Contraindications - previous HSR to drug, history of hepatic disease/ elevations in hepatic enzymes.

Zileuton interferes with the metabolism of theophylline, warfarin, and propranolol, neuropsychiatric events and hepatic injury.

Question 11

Montelukast

Answer 11

Leukotriene receptor antagonist

selective antagonist of the CysLT1 receptor

reduces leukotriene-induced bronchoconstriction, microvascular permeability, and mucus hypersecretion.

treatment of mild or moderate persistent asthma.

Contraindication - previous HSR to drug

Side effects - Churg-Strauss syndrome and neuropsychiatric events

Question 12

Theophylline / Aminophylline

Answer 12

Methylxantine

antagonist of adenosine receptors.

Theophylline -non-selective inhibitor of phosphodiesterase 4 (PDE4 - degrades cAMP)

Theophylline is used for the prophylactic treatment of mild and moderate persistent asthma. Aminophylline is given intravenously for the treatment of status asthmaticus.

Contraindications and Cautions – Potential cardiac arrhythmias and seizures , the use of theophylline is contraindicated in patients with heart disease and with a history of seizures.

theophylline is contraindicated in patients with liver disease. In addition, cimetidine, a histamine H2-receptor antagonist, increases the plasma levels of theophylline when co-administered.

Side Effects – Side effects to theophylline include nausea, vomiting, cardiac arrhythmias, hypotension, cardiac arrest, and seizures.

Question 13

Omalizumab

Answer 13

Monoclonal Ab

Omalizumab binds to IgE at the same site that IgE binds to its high affinity receptor (Fc􏰜-RI). Consequently, omalizumab prevents circulating IgE from binding to Fc􏰜- RI on mast cells and basophils and thereby prevents mast cell degranulation and the release of inflammatory mediators

Question 14

Magnesium Sulfate

Answer 14

Magnesium sulfate is often given as an intravenous bolus for status asthmaticus when both β2−selective agonists and ipratropium have failed.

Magnesium sulfate causes airway smooth muscle relaxation, inhibits acetylcholine release for efferent nerve terminals, and decreases histamine release from mast cells.

Question 15

DuoNeb

Answer 15

Albuterol + Ipratopium Bromide

Nebulization

Question 16

Combivent

Answer 16

Albuterol + Ipratopium Bromide

Metered dose inhaler