Respiratory Disorders

Question 0

Asthma: Sympathomimetic action

Answer 0

Increase in cAMP

Question 1

Asthma: Drugs

Answer 1

Increase cAMP (beta2 sympathomimetics, methyl xanthines) or decrease cGMP (muscarinic  antagonists)
Glucocorticoids relieve inflammation and act through multiple mechanisms

Question 2

Asthma: Sympathomimetic Agents

Answer 2

Non-selective (beta-1, beta-2)
   - Isoproterenol
   - Epinephrine
Beta-2 selective agonists
   - Metaproterenol
   - Albuterol
        - Short acting

Question 3

Asthma: Methyl Xanthines Action

Answer 3

Block adenosine receptors to prevent adenosine-mediated constriction of bronchioles and mast cell degranulation
Increases cAMP by inhibiting phosphodiesterase, the enzyme that converts cAMP to 5’-AMP

Question 4

Asthma: Methyl Xanthines Agents

Answer 4

Theophylline

Question 5

Asthma: Methyl Xanthines Adverse Effects

Answer 5

CNS stimulation
Similar effects to sympathomimetics
Cardiovascular effects
   - stimulation
Diuretic effects
GI irritation nausea and vomiting
Small difference between therapeutic and toxic levels
Individual differences in metabolism

Question 6

Asthma: Muscarinic Antagonsits (Atropine) Mechanism

Answer 6

Blocks muscarinic receptors in bronchial smooth muscle, leads to decreased concentrations of cGMP
cGMP has opposing effects to those of cAMP
May also prevent mast cell degranulation through decrease cGMP

Question 7

Muscarinic Antagonists: Agents

Answer 7

Atropine
- Blocks the vagal components of asthma
Ipratropium (Atrovent)

Question 8

Atropine: cautions

Answer 8

Drying effects of the bronchiole secretions

Question 9

Cromoly: Selectivity

Answer 9

Very selective

Question 10

Cromolyn: Action

Answer 10

Prevents degranulation of mast cells and decreases release of chemical mediators such as histamine, chemotactic factors, and leukotrienes

Question 11

Cromoly: Results of solubility

Answer 11

Insoluble

• Would inhale the powder
• Now a nasal spray

Question 12

Corticosteroids: Use

Answer 12

First line drug in treating COPD and asthma

Question 13

Corticosteroids: Adverse Effects

Answer 13

Cataracts

Redistribution of fat

Question 14

Corticosteroids: Preferred use

Answer 14

Inhalers

Question 15

Leukotriene Modifiers: Mechanism

Answer 15

Suppress the effects of leukotrienes, which cause bronchoconstriction, infiltration of eosinophils, infiltration of inflammatory cells, decrease edema of the airway

Question 16

Leukotriene Modifiers: Agents

Answer 16

Zileuton
Zafirlukast
Montelukast

Question 17

Leukotriene Modifiers: Adverse effects

Answer 17

Zileuton can cause hepatotoxicity and an increase in levels of other drugs that are hepatically metabolized