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Pharmacology > Respiratory Pharm > Flashcards

Respiratory Pharm Flashcards

1
Q

describe asthma

A
  • Chronic inflammation of the airways
  • Bronchial hyperresponsiveness
  • Airflow obstruction
  • reversible
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2
Q

inflammation in airway secretion from asthma results in

A
  • Bronchiolar Smooth Muscle Spasm
  • Airway Hyperresponsiveness
  • Airway Edema
  • Increased Mucus Secretion
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3
Q

classify asthma based on severity

A
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4
Q

overview of drugs for asthma management

A
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5
Q

list the inhaled short-acting β2 adrenergic agonists (SABAs)

A

Albuterol
Terbutaline
Pirbuterol

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6
Q

list the Inhaled long-acting β2 adrenergic agonists (LABAs)

A

Salmeterol
Formoterol

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7
Q

describe the MOA of β2 Adrenergic Agonists

A
  • Binds/activates β2 adrenergic receptors on airway smooth muscle cells
  • Activation of β2 receptors stimulates adenylyl cyclase and increases formation of cAMP
  • cAMP activates protein kinase A which phosphorylates and inactivates myosin light chain kinase → relaxation of the airway smooth muscle cells and bronchodilation
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8
Q

___ are the DOC for relief of acute asthma symptoms and prevention of exercise-induced bronchospasm

A

SABAs are the DOC for relief of acute asthma symptoms and prevention of exercise-induced bronchospasm

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9
Q

LABAs are combined with ____ for long-term control in moderate and severe persistent asthma

LABAs shouldn’t be used as ___ for long-term control of asthma as they have no _____

Are LABAs used for treating acute asthma symptoms?

A

LABAs are combined with inhaled corticosteroids (ICS) for long-term control in moderate and severe persistent asthma

LABAs shouldn’t be used as monotherapy for long-term control of asthma as they have no anti-inflammatory action

LABAs are NOT used for acute astham symptoms

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10
Q

list AEs of β2 Adrenergic Agonists

A
  • tachycardia, tremor, and hypokalemia
    • ​reduced via inhalation administration
  • LABAs increase risk of serious asthma- related events (hospitalization, intubation, and death)
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11
Q

list the Inhaled Short-Acting Muscarinic Antagonists (SAMAs)

A

Ipratropium

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12
Q

list the Inhaled Long-Acting Muscarinic Antagonists (LAMAs)

A

Tiotropium

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13
Q

what is the MOA of ipratropium and tiotropium

A

block muscarinic receptors on the airways causing bronchodilation and reduction of respiratory secretions

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14
Q

Ipratropium is less effective than ____

but provides additive benefit to SABAs in the management of moderate to severe exacerbations of asthma

A

Ipratropium is less effective than SABAs

but provides additive benefit to SABAs in the management of moderate to severe exacerbations of asthma

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15
Q

____ is the DOC for β-blocker-induced bronchospasm

A

Ipratropium is the DOC for β-blocker-induced bronchospasm

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16
Q

____ may be added to ICS for long-term control of severe persistent asthma

A

Tiotropium may be added to ICS for long-term control of severe persistent asthma

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17
Q

list the Anticholinergic AEs

A
  • quaternary ammonium compounds
  • minor anticholinergic effects, e.g. xerostomia
  • may be safer than SABAs in patients with cardiovascular disease
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18
Q

Methylxanthines

A

Theophylline

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19
Q

Theophylline inhibits ____, increasing ____ evoking bronchodilation

A

Theophylline inhibits phosphodiesterase, increasing cAMP evoking bronchodilation

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20
Q

____ can be given orally or IV and is ___ therapy for patients with persistent asthma

A

Theophylline can be given orally or IV and is alternate therapy for patients with persistent asthma

21
Q

list the AEs of Theophylline

A
  • Largely replaced by β2 agonists and corticosteroids due to narrow therapeutic window, adverse effects, and potential for drug interactions
  • most common: headache, nausea, vomiting, abdominal discomfort, and restlessness
  • At high concentrations: cardiac arrhythmias and seizures
22
Q

list the inhaled corticosteroids (ICS)

A

Beclomethasone
Fluticasone
Flunisolide
Budesonide

23
Q

list the systemic corticosteroids

A

Prednisolone
Dexamethasone

24
Q

Glucocorticoids inhibit ____ and ____, resulting in reduced formation of leukotrienes and prostaglandins

A

Glucocorticoids inhibit phospholipase A2 and COX-2, resulting in reduced formation of leukotrienes and prostaglandins

25
Prolonged use of SABAs results in β2 receptors desensitization... ## Footnote **\_\_\_\_ prevent or reverse this desensitization**
Prolonged use of SABAs results in β2 receptors desensitization... ## Footnote **corticosteroids prevent or reverse this desensitization**
26
\_\_\_\_ are the most effective long-term control medication in the management of persistent asthma.
**corticosteroids** are the most effective long-term control medication in the management of persistent asthma.
27
Oral \_\_\_\_may be added to ICS for long-term control of severe persistent asthma
Oral **prednisolone** may be added to ICS for long-term control of severe persistent asthma
28
A short course of _____ is used for moderate and severe acute exacerbations of asthma to speed recovery and to prevent recurrence of exacerbations
A short course of **systemic corticosteroids** is used for moderate and severe acute exacerbations of asthma to speed recovery and to prevent recurrence of exacerbations
29
list the AEs of **inhaled** ICS
* Inhaled CS = lower bioavailability than systemic CS → less adverse effects * Local AEs: * **oropharyngeal candidiasis** * **dysphonia, reflex cough and bronchospasm** * Long-term use: * **osteoporosis and cataracts** * **may cause deceleration of vertical growth in children**
30
Long term use of **systemic** glucocorticoids may result in ____ and \_\_\_\_\_
Long term use of **systemic** glucocorticoids may result in **hypercortisolism** and **Cushing's syndrome**
31
list the anti-inflammatory drugs: Release Inhibitors
**Cromolyn Nedocromil**
32
Cromolyn and Nedocromil act by inhibiting \_\_\_\_\_, and prevent both antigen- and exercise-induced bronchospasm in asthmatic patients Are they useful in managing acute asthma attack?
Cromolyn and Nedocromil act by inhibiting **mast cell degranulation**, and prevent both antigen- and exercise-induced bronchospasm in asthmatic patients **NO-** not useful for acute asthma attack! because they are **not bronchodilators**
33
list AEs for release inhibitors: Cromolyn and Nedocromil
* Throat irritation, cough, mouth dryness. * Rarely, chest tightness and wheezing * reversible dermatitis, myositis, or gastroenteritis, pulmonary infiltration with eosinophilia and anaphylaxis.
34
\_\_\_\_ is a monoclonal antibody and prevents binding of ____ to basophils and mast cells. It is used for patients with ____ persistent asthma with evidence of allergy
**Omalizumab** is a monoclonal antibody and prevents binding of **IgE** to basophils and mast cells. It is used for patients with **severe** persistent asthma with evidence of allergy
35
Omalizumab AE?
Anaphylaxis
36
list the: 1. Leukotriene Receptor Antagonists (LTRAs) 2. 5-Lipoxygenase inhibitors
* LTRA: Monte**lukast,** Zafir**lukast** * 5-LOX inhibitor: **Zileuton** * all taken orally
37
what is the use for leukotriene-modifying agents?
* Alternative therapy * prevention of exercise-induced bronchospasm * **management of NSAID-exacerbated respiratory disease (NERD)**
38
list the AEs for leukotrine-modifying agents
* **Montelukast:** * insomnia, anxiety, depression, suicidal thinking * **Zileuton:** * Hepatotoxicity
39
describe ways to manage acute exacerbations of asthma
* Inhaled SABAs * Inhaled SAMAs * Systemic corticosteroids
40
describe long term management of asthma
41
describe COPD
* chronic, progressive * irreversible obstruction of the airflow * **most important risk factor: Smoking** * 3 cardinal symptoms of COPD: * dyspnea * chronic cough * sputum production
42
overview of drugs to manage COPD
43
drugs used for symptomatic relief and in management of acute exacerbations of COPD?
* short acting bronchodilators: * SABAs * SAMAs * systemic cortisoids * Oral prednisolone
44
drugs used for long-term control of COPD
* long acting bronchodilators * LABAs * LAMAs * Inhaled corticosteroids: * Fluticasone and budesonide
45
the mucolytic agent used in COPD ____ → breaks ___ linkages in mucus and lowers viscosity.
the mucolytic agent used in COPD **N-Acetylcysteine** → breaks **disulfide** linkages in mucus and lowers viscosity
46
drugs for treating allergic rhinitis
* **Glucocorticoid nasal sprays (1st line)** * Oral antihistamines * Cromolyn sodium * Montelukast * Nasal Decongestants- α adrenergic agonists * Phenylephrine * Pseudoephedrine
47
list AEs of Glucocorticoids
* local irritation of the nasal mucosa * **nosebleed** * nasal septal perforation * **nasopharyngeal candidiasis**
48
oral antihistamines
49
describe the drugs used for **coughing**
**Codeine and dextromethorphan** * Suppress cough reflex via a direct action on the cough center in the medulla of the brain * Adverse effects: constipation and drowsiness * **Dextromethorphan** = safer, lower abuse potential than codeine

Pharmacology (19 decks)

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