Respiratory Drugs

Question 1

T or F: Patients undergoing a “Status Asthmaticus” episode will be fully responsive to Bronchodilator treatments alone.

Answer 1

FALSE! Actually unresponsive to just Bronchodilator treatments.

Question 2

1st line rescue medication for Asthmatics?

Answer 2

SABA’s

Question 3

What are some SABA drugs?

Answer 3

Salbutamol
Terbutaline
Epinephrine

Question 4

How do SABA’s work?

Answer 4

-Bind Beta 2 Receptors in lungs, thus hyperpolarizing Ca2+ Activated K+ Channels & stimulates release of Ca2+ from Smooth Muscles of the airways.

Question 5

Major s/e’s of SABA’s?

Answer 5

Cardiovascular Stimulation (Tachycardia, Palpitations, Tremors)

Question 6

Model SAMA drug?

Answer 6

Ipratropium

Question 7

How do SAMA’s work?

Answer 7

-Antagonize ACh at Muscarinic Receptors of the airways, thus preventing smooth muscle contraction & inhibiting mucosal secretion.

Question 8

SAMA’s only work via what delivery system?

Answer 8

Topically

Question 9

S/E’s of SAMA’s?

Answer 9

Anti-Cholinergic (Cough, Dry Mouth, Headache)

Question 10

1st line “Controller” meds for Asthmatics?

Answer 10

Inhaled Corticosteroids

Question 11

Examples of ICS’s?

Answer 11

Beclomethasone
Fluticasone
Mometasone
Budesonide
Ciclesonide

Question 12

How do ICS’s work?

Answer 12

-Bind GC Receptors, translocate to nucleus, inhibit HAT proteins & upregulate HDAC2 proteins.

Question 13

S/E’s of ICS’s?

Answer 13

-Oral Thrush
-Hoarse Voice
-Osteoporosis
-Increased Glucose
-Pneumonia

Question 14

Model LABA’s?

Answer 14

Salmeterol
Formoterol

Question 15

Leukotriene Receptor Antagonists (ie. Montelukast) have potential therapeutic usefulness with what patient scenario?

Answer 15

Exercise-Induced Asthma

Question 16

How do LTRA’s work?

Answer 16

-Antagonize Cysteinyl-LT Receptors, which prevents mucous secretion, bronchoconstriction & eosinophil recruitment.

Question 17

What patients should we avoid giving Theophylline to?

Answer 17

-CV or GI Disease pt.’s (as drug demonstrates significant CV & GI toxicities).

-CYP3A4 / CYP1A2 Inhibitor drugs (as this drug is a substrate for those enzymes & will increase in circulation if co-administered with those drugs).

Question 18

Model Biologics?

Answer 18

Omalizumab
Mepolizumab
Reslizumab
Benralizumab
Dupilumab

Question 19

How do drug therapy regimens for COPD pt.’s differ from those of Asthmatic pt.’s?

Answer 19

-SABA’s & LABA’s are scheduled therapies (rather than taken prn).

-ICS’s reserved for End Stages of disease.

Question 20

Most effective agents for COPD?

Answer 20

SABA’s & LABA’s (slightly more effective than SAMA’s & LAMA’s)

Question 21

Model Long-Acting Muscarinic Antagonists (LAMA’s) used in the treatment of COPD?

Answer 21

Tiotropium
Glycopyrronium
Umeclidinium
Aclidinium