Respiratory Drugs

Question 1

Short-acting Beta Agonists (SABA)

Answer 1

Albuterol and Levalbuterol

Question 2

SABA - MoA

Answer 2

Incr. cAMP > PKA > Phos. MLCK > decr. contraction

Question 3

Long-acting Beta Agonists (LABA)

Answer 3

Salmeterol

Formoterol

Question 4

LABA - adverse effects

Answer 4

headache, throat irritation,

death, if used without a corticosteroid

Question 5

Muscarinic antagonists

Answer 5

Ipratropium (short-acting)

Tiotropium, Aclidinium (long-acting)

Question 6

Muscarinic antagonist - MoA

Answer 6

Block M3 receptors, bronchocontriction is inhibited

Question 7

Musc. antagonists - adverse

Answer 7

Dry mouth, headache

Caution: glaucoma, prostate hypertrophy, myasthenia gravis

Question 8

Corticosteroids

Answer 8

-one

Question 9

Steroids - MoA

Answer 9

alter gene transcription, leading to less inflammation

Question 10

Steroids - adverse effects

Answer 10

pneumonia, oral thrush, voice change, osteoporosis, cataracts

interaction w/ ritonavir - leads to cushing syndrome

Question 11

Leukotriene inhibitors

Answer 11

Montelukast (LTE receptors)

Zileuton (blk leukotriene synth)

Question 12

Leukotriene inhibitors - adverse effects

Answer 12

Churg-strauss, liver dysfunction

Question 13

Methylxanthines

Answer 13

Theophylline

Caffeine

Question 14

Methylxanthines - MoA

Answer 14

PDE inhibition, inhibits adenosine binding, activates histone deacetylase

Question 15

Methylxanthines - adverse

Answer 15

Significant tachycardias, nausea/vomiting, and seizures

Question 16

Anti-IgE - anti-Ab

Answer 16

Omalizumab

Question 17

Anti-IL5 receptor

Answer 17

Mepolizumab

Question 18

Anti-IgE - indications

Answer 18

moderate-severe asthma, high IgE levels, allergies

Question 19

Anti-IL5 - indications

Answer 19

moderate-severe asthma, high eosinophil count

Question 20

Anti-IgE, Anti-IL5 - adverse

Answer 20

local site rxns, anaphylaxis

Question 21

COPD - treatment

Answer 21

Same except no leukotriene inhibitors

Also, PDE4 inhibitors

Question 22

PDE4 inhib (COPD)

Answer 22

Roflumilast

Question 23

PDE4 inhib- MoA

Answer 23

increase cAMP, leading to anti-inflammatory effects

Question 24

PDE4 inhib- adverse

Answer 24

GI upset, diarrhea, weight loss

Question 25

Idiopathic Pulmonary fibrosis treatment

Answer 25

Pirfenidone - antioxidant, blocks fibrosis

Nintedanib - kinase inhibitor, blocks fibrosis

Question 26

Pirfenidone/Nintedanib - adverse effects

Answer 26

GI side effects

Question 27

Pulmonary hypertension treatment

Answer 27

Prostacyclin analogs
Endothelin receptor antagonists
PDE5 inhibs
Soluble guanylate cyclase stimulator

Question 28

Prostacyclin analogs

Answer 28

“Prost” drugs

Question 29

IP receptor agonist (prostacyclin receptor)

Answer 29

Selexipag

Question 30

Prostacyclin analog - adverse effects

Answer 30

Hypotension
Flushing
Jaw pain*
Thrombocytopenia
Sepsis (IV), Pain (SC), Cough (inhaled)

Question 31

Endothelin receptor antagonists

Answer 31

Bosentan
Ambrisentan
Macitentan

Question 32

Endothelin receptor antagonist - MoA

Answer 32

Block receptors to endothelin-1, leading to vasodilation and preventing SMC proliferation

Question 33

Endothelin - adverses

Answer 33

Peripheral edema*
Liver function abdnormalities
Anemia

Question 34

PDE5 inhibiors

Answer 34

Sildenafil

Tadalafil

Question 35

PDE5 - MoA

Answer 35

increase cGMP, leading to vasodilation and inhbits smooth muscle cell proliferation

Question 36

PDE5 - adverse

Answer 36

headache
flushing
rhinitis
caution: nitrates will cause severe hypotension

Question 37

Soluble guanylate cyclase stimulators

Answer 37

Riociguat

Question 38

Guanylate cyclase stims - MoA

Answer 38

stimulates guanylate cyclase to make more cGMP leading to vasorelaxation