Respiratory Pharm

Question 1

_____ generation antihistamines are LESS likely to block muscarinic receptors (minor anticholinergic adverse effects)

Answer 1

second

Question 2

______ is used to prevent exercise induced bronchospasm

Answer 2

nedocromil/cromolyn

Question 3

three cardinal signs of COPD are:

Answer 3

dyspnea, chronic cough, and sputum production

Question 4

what are the inhaled SHORT acting β2 adrenergic agonist?

Answer 4

• albuterol
• terbutaline
• pirbuterol

Question 5

what are the leukotriene receptor antagonists?

Answer 5

• montelukast

- zafirlukast

Question 6

inflammation in the airways ultimately results in ____

Answer 6

airflow obstruction

Question 7

ipatropium and triotropium block ______ receptors on the airways

Answer 7

M3

Question 8

what are some adverse effects of theophylline?

Answer 8

headache, nausea, vomiting, etc
high concentrations: cardiac arrhythmias and seizures
(theophylline is pretty obsolete and has been replaced by β2 agonists and corticosteroids)

Question 9

what is an adverse effect of zileuton?

Answer 9

hepatotoxicity

Question 10

pharmacotherapy agents used in allergic rhinitis (5)

Answer 10

• glucocorticoid nasal sprays
• oral antihistamines
• cromolyn sodium
• montelukast
• nasal decongestants

Question 11

long term use of systemic glucocortoics can result in ____ and _____

Answer 11

hypercortisolism and Cushing’s syndrome

Question 12

what are the inhaled LONG acting β2 adrenergic agonists?

Answer 12

• salmeterol

- formoterol

Question 13

_______ prevent or reverse the desensitization of β2 receptors due to the prolonged use of SABA’s

Answer 13

corticosteroids

Question 14

long acting β2 adrenergic agonists (salmeterol and formoterol) are combined with ______ for long term control in moderate and severe persistent asthma

Answer 14

corticosteroids

Question 15

______ is first line treatment of allergic rhinitis

Answer 15

glucocorticoid nasal sprays

Question 16

_________ is the DOC for β blocker induced bronchospasm

Answer 16

ipratropium

Question 17

what drug is a methylxanthine that is used to treat asthma? what is its MOA?

Answer 17

theophylline; inhibits phosphodiesterase → ↑ cAMP → bronchodilator

Question 18

_____ are drugs that act on the cough reflex in the __________

Answer 18

codeine and dextromethorphan;

medulla fo the brain

Question 19

systemic corticosteroids such as _____ and _____ are used in the ____ management of asthma

Answer 19

prednisone and dexamethasone;

ACUTE

Question 20

_____ may be added to the inhaled corticosteroid therapy for long term control of severe persistent asthma

Answer 20

prednisolone

Question 21

omalizumab prevents the binding of ____ to ________

Answer 21

IgE to basophils and mast cells

Question 22

what is the MOA of corticosteroids?

Answer 22

inhibits phospholipase A2 → inhibits transcription of COX 2 → ↓ formation of leukotrienes and prostaglandins

Question 23

what types of drugs are used to manage asthma?

Answer 23

• bronchodilators: β2 adrenergic agonists, anticholinergics, methylaxanthines
• anti-inflammatory drugs: corticosteroids, release inhibitors, immunomodulators, leukotriene modifying agents

Question 24

long term use of inhaled corticosteroids can result in ____ and ____

Answer 24

osteoporosis and cataracts; can cause deceleration of vertical growth in children

Question 25

zileuton MOA?

Answer 25

inhibitor of 5- lipoxygenase

Question 26

what are the uses of nedocromil/cromolyn?

Answer 26

they are used to prevent both antigen and exercise induced bronchospasm in asthmatic patients BUT NOT useful in managing an acute asthma attack because stye are not bronchodilators

Question 27

_____ and ______ is used to reduce the cough in COPD; what is the MOA?

Answer 27

codeine and dextromethorphan;

suppresses cough reflex via direct action on the cough center in the medulla of the brain

Question 28

iptratropium is what kind of bronchodilator?

Answer 28

inhaled short acting muscarinic antagonists

Question 29

what are some adverse effects of montelukast?

Answer 29

insomnia, anxiety, depression, suicidal thinking

Question 30

what is a mucolytic agent used for COPD and how does it work?

Answer 30

N-acetylcysteine which ↓ viscosity by breaking the disulfide linkages in mucus

Question 31

adding ipratopium to _______ provides additive benefit int hem anagemtn of moderate to severe exacerbations of asthma

Answer 31

short acting β2 adrenergic agonists

Question 32

what drugs are used for the ACUTE management of asthma?

Answer 32

• inhaled short acting β2 adrenergic agonist (SABA)
• inhaled short acting muscarinic antagonists (SAMA)
• systemic corticosteroids

Question 33

_______ and ______ are release inhibitors (anti-inflammatory)

Answer 33

nedocromil and cromolyn;

they inhibit mast cell degranulation

Question 34

anticholinergics (ipratropium and tiotropium) may be safer than SABA’s in patients with cardiovascular disease because _____

Answer 34

the anticholinergics are quaternary compounds and so they have low access to systemic circulation and so have minor adverse effects

Question 35

Omalizumab (immunomodulators) is used in the management of patients with __________

Answer 35

severe persistent asthma with evidence of allergy

Question 36

what are the anticholinergic bronchodilators?

Answer 36

• Ipratropium (short acting)

- tiotropium (long acting)

Question 37

nasal septal perforation and nasopharyngeal candidiasis and nose bleeds and an AE of ____

Answer 37

glucocorticoids

Question 38

what are the three classes of drugs used in the management of COPD?

Answer 38

• bronchodilators (β2 agonists and anticholinergics)
• corticosteroids
• mucolytic agents: N-acetylcysteine