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Pharmacology- Test 2 > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

1
Q

Cromolyn Sodium: Mechanism of Action

A

Inhibits Mast cell degranulation

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2
Q

Theophylline: Mechanism of Action

A

Adenosine receptor antagonist, PDE inh

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3
Q

Albuterol: Mechanism of Action

A

Beta-2 adrenergic receptor agonist (short acting)

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4
Q

Salmeterol: Mechanism of Action

A

Beta-2 adrenergic receptor agonist (long acting)

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5
Q

Ipratropium: Mechanism of Action

A

Muscarinic antagonist

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6
Q

Fluticasone: Mechanism of Action

A

Inhaled corticosteroid

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7
Q

Prednisone: Mechanism of Action

A

Systemic corticosteroid

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8
Q

Montelukast: Mechanism of Action

A

Leukotriene receptor antagonist

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9
Q

Zileuton: Mechanism of Action

A

5-Lipoxygenase inhibitor

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10
Q

Which drugs are antiinflammatory?

A

(1) Fluticasone
(2) Prednisone
(3) Montelukast
(4) Zileuton

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11
Q

What drugs reverse bronchoconstriction?

A

(1) Theophylline
(2) Albuterol
(3) Salmeterol
(4) Ipratropium

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12
Q

What drugs inhibit mast cell degranulation (good as a phrophylaxis)?

A

(1) Cromolyn

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13
Q

What are the treatment goals of respiratory drugs?

A

(1) To reverse acute episodes
(2) To control recurrent episodes
(3) To reduce bronchial inflammation

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14
Q

What are released in asthma attacks? What do they do?

A

Autocoids; produce bronchoconstriction and increase vascular permeability in bronchi and cause mucosal edema (histamines, leukotrienes, adenosine)

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15
Q

What is bronchial tone innervated by?

A

Autonomic nervous system; Adrenergic(alpha-constriction; beta-dilation) and Cholinergic (muscarinic-constriction)

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16
Q

What types of drugs are bronchodilators? What do they do?

A

(1) Beta-adrenergic agonists- relax bronchial smooth muscle and decrease microvascular permeability
(2) Muscarinic antagonists- inhibit the effects of endogenous ACh
(3) Theophylline- reduces the frequency of recurrent bronchospasm

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17
Q

What types of drugs are non-bronchodilators?

A

(1) Corticosteroids- control mucus production and edema
(2) Cromolyn- controls mediator response
(3) Leukotriene modulators- antagonize mediator receptors or decrease their synthesis

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18
Q

What are the most effective bronchodilators?

A

Beta-adrenergic agonists

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19
Q

How are beta-adrenergic agonists given? Why?

A

Inhalation; to avoid systemic effects

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20
Q

What are the 2 beta-adrenergic agonists and which is slow/fast acting? Which is number 1 drug during acute asthma attack? Which is used for maintenance treatment?

A

(1) Albuterol- FAST (3-6 hr); ACUTE

(2) Salmeterol- LONG (>12 hr); MAINTENANCE

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21
Q

What drugs are useful in prevention of exercise-induced asthma?

A

Beta-adrenergic agonists

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22
Q

What may happen with continuous use of beta-adrenergic agonists? How can you combat this?

A

Patient may result in desensitization of adrenergic receptors; prevented or reversed by using corticosteroids

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23
Q

What may happen in high doses of beta-adrenergic agonists?

A

Tachycardia, palpitations, tremor (more systemic effects)

24
Q

<p>

| What type of drug is Ipratropium? What is it a synthetic analog of?</p>

A

<p>

| A muscarinic receptor antagonist; synthetic analog of atropine</p>

25
Q

T/F Ipratroprium has some anti-inflammatory activity.

A

FALSE

26
Q

When is Ipratroprium used?

A

(1) In COPD to decrease cholinergic tone

(2) In asthma in combination with beta-adrenergic agonists- Different mechanism of action!

27
Q

How is Ipratroprium given?

A

Inhaled (has negligible side effects)

28
Q

T/F Ipratroprium is a weak bronchodilator and inhibitor of airway secretory glands.

A

TRUE

29
Q

Why do you use Ipratroprium with Beta-adrenergic agonists?

A

The combination is more effective and less toxic than either drug alone (can use lower doses of each)

30
Q

What drug is a methylxanthine? What are some other examples of this?

A

Theophylline; Caffeine, theo bromine (found in chocolate)

31
Q

What does Theophylline do?

A

Relaxes smooth muscles of the body, especially if bronchi have been constricted by a spasmogen as in asthma

32
Q

How is Theophylline given?

A

Orally, it is ineffective by aerosol

33
Q

What are the 2 different mechanisms Theophylline works in?

A

(1) Adenoside receptor blockade

(2) Phosphodiesterase inhibition

34
Q

When is Theophylline used?

A

In chronic asthma

35
Q

Which drug is more effect and faster? Theophylline or beta-adrenergic agonists?

A

Beta-adrenergic agonists

36
Q

What are the mild, potentially serious, and severe toxicities within Theophylline?

A

(1) Mild (30mg/L)- nausea, vomiting, headache, insomnia, and nervousness
(2) Potentially serious- sinus tachycardia
(3) Severe- cardiac arrythmias, seizures

37
Q

Why does Theophylline need to be monitored?

A

It has a clearance variability with a narrow safety index (10-20 mg/L); clearance is influenced by smoking and other drugs metabolized in the liver

38
Q

What are Fluticasone’s 2 mechanisms of action?

A

(1) Block release of arachidonic acid and it’s metabolites (leukotrienes)
(2) Inhibits production of pro-inflammatory cytokines

39
Q

When is Fluticasone used?

A

In chronic asthma, lowers the frequency of acute episodes

40
Q

What is the most important part of the arachidonic acid synthesis?

A

Leukotrienes

41
Q

Fluticasone- Adverse effects?

A

Dysphonia and/or esophageal candidiasis

42
Q

What are the most effective drugs for asthma unresponsive to bronchodilators and inhaled steroids?

A

Oral or injected Prednisone

43
Q

How long do you want to continue Prednisone after recovery from exacerbation? How would you continue use?

A

8-10 days; every other day to decrease side effects

44
Q

Prednisone- Adverse Effects

A

glucose intolerance, sodium and water retention, increased BP, peptic ulcer, immunosuppression, etc.

45
Q

What is Cromolyn Sodium useful for?

A

Prophylaxis; it stabilizes mast cells and decreases airway responsiveness to spasmogens (if you’re having an asthma attack, the mast cells have already degranulated)

46
Q

What population is Cromolyn Sodium effective for?

A

Children and adolescents

47
Q

When does the Cromolyn become effective? (How long do you have to take it?)

A

After 4-6 weeks of treatment

48
Q

T/F Cromolyn Sodium does not have any bronchodilating activity.

A

TRUE

49
Q

Cromolyn Sodium- Adverse Effects

A

Virtually no toxicity!

50
Q

What are the 2 types of Leukotriene modulators? Which drugs go with each?

A

(1) Inhibitors of LT synthesis- block the production: Zileuton
(2) LT receptor (LTD4) antagonists- block the response to leukotrienes: Montelukast

51
Q

What are leukotriene modulators used for?

A

Maintenance therapy; they reduce frequency of acute episodes; useful in children in chronic treatment of mild to moderate asthma

52
Q

Zileuton: Drug Interactions

A
  • It can elevate liver enzymes and increases the concentrations of theophylline and warfarin because it inhibits P450 in the liver
53
Q

Which are more effective antiinflammatory agents? Corticosteroids, Leukotriene modulators?

A

Corticosteroids

54
Q

How are Leukotriene modulators given?

A

Orally

55
Q

Why do asthmatics have severe response to ASA sometimes?

A

because ASA inhibits cyclooxygenase which is part of the arachidonic pathway

Pharmacology- Test 2 (10 decks)

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