Respiratory Drugs

Question 1

What are the Beta2-adrenergic agonists used to treat Asthma? What is the MOA?

Answer 1

Albuterol, Terbutaline, Salmeterol -

cause bronchodilation by activation of the beta2-adrenergic receptors on the bronchial smooth muscle.

Question 2

What is the drug of choice for acute bronchospasm and prevention of exercise-induced asthma?

Answer 2

Albuterol

Question 3

What is the use of Salmeterol?

Answer 3

long actinv beta2-agonist (at least 12 hours); used for long-term prevention of asthma Sx, nocturnal Sx and for prevention of exercise-induced bronchospasm. Not for acute exacerbations.

Question 4

What are the corticosteroids used to treat Asthma? What is the MOA?

Answer 4

Beclomethasone -
reduce inflammation by reversing mucosal edema, decreasing the permeability of capillaries and inhibiting the release of leukotriens. Also enhance activity of sympathomimetics in hypoxic and acidotic states.

Question 5

When are corticosteroids the drug of choice for Asthma?

Answer 5

Glucocorticoids are the drug of choice in patients who require beta2-agonists more than 2 times per week.

Question 6

What is the adverse effect of inhaled steroids?

Answer 6

they increase the risk of oral candidiasis infections (thrush).

Question 7

What are the Methylxanthines used to treat Asthma? What is the MOA?

Answer 7

Aminophyline -
provide mild bronchodilation - used as an adjuct therapy in patients with moderate or sever persistent asthma. NARROW THERAPEUTIC INDEX

Question 8

What is the caution needed when using Aminophyline?

Answer 8

Can cause HA, insomnia, tachycardia, dizziness, seizures. Low Therapeutic index.

Question 9

What are the Inflammatory Cell Stabilizers used to treat Asthma? What is the MOA?

Answer 9

Cromolyn -
Prevent the release of inflammatory mediators (eg histamine) from mast cells, macrophages, neutrophils and eosinophils. used as prophylaxis of asthma attacks.

Question 10

What are the Leukotriene Modifiers used to treat Asthma? What is the MOA?

Answer 10

Montelukast, Zileutin -
Leukotriens (a product of arachiodonic acid metabolism) increase eosinophil migration, mucus production and airway wall edema and cause bronchoconstriction.
Montelukast blocks binding of leukotriene D4 (LTD4) to its receptor.
Zileutin inhibits 5-lipoxygenase, an enzyme required for leukotriene synthesis.

Question 11

What are the Cholinergic Antagonists used to treat Asthma? What is the MOA?

Answer 11

Ipratropium -

block bronchoconstriction and secretions caused by activation of parasympathetic nervous system.

Question 12

When is Ipratropium used for asthma?

Answer 12

When a patient is unable to tolerate beta2-agonists.

Question 13

What are Anti-IgE Therapies used to treat Asthma? What is the MOA?

Answer 13

Omalizumab -
a monoclonal antibody specific for IgE is used for the treatment of asthma in patients who are allergic. It selectively binds to human IgE. This leads to decreased binding of IgE to the high-affinity IgE receptor on the surface of mast cells and basophils. This prevents activation and degranulation of these cells.

Question 14

What asthma drug as a narrow therapeutic index?

Answer 14

Aminophyline

Question 15

What is administered endotracheally in infant respiratory distress syndrome?

Answer 15

Surfactant

Question 16

What is Administered by inhalation to patients with cystic fibrosis to decrease the viscosity of bronchial secretions?

Answer 16

Dornase Alfa

Question 17

What is a mucolytic agent?

Answer 17

N-acetylcysteine

Question 18

What is targeted against respiratory syncytial virus (RSV) and provides passive immunity to high risk infants, such as premature, when given as monthly IM injections during winter and early spring?

Answer 18

Palivizumab

Question 19

What Intranasal Steroids are used to treat allergic rhinitis?

Answer 19

Budesonide, Flunisolide

Question 20

What are the u/e of intranasal steroids?

Answer 20

increased risk of thrush and poor healing of the nasal mucosa