Respiratory Pharmacology-2 (1) Flashcards
What type of antibiotics can be used for patients with uncomplicated COPD?
- Advanced Macrolide (azithromycin, clarithromycin)
- Ketolide (telithromycin)
- Cephalosporin (cefuroxime, cefpodoxime, cefdinir)
- Doxycycline
- Trimethoprim/sulfamethoxazole
Concern over resistance with chronic use
Why are asthma patients not treated with antibiotics?
Bacteria is not the cause of the inflammation of the airways
Antibiotics may be beneficial in COPD patients during acute exacerbation
What is the mechanism of action for mucolytics?
Break up mucus by reducing viscosity and elasticity
Examples include N-acetylcysteine (NAC)
What is the only PDE-4 inhibitor currently approved for severe COPD treatment?
Roflumilast
Administered orally with systemic side effects
What are the two groups of leukotrienes?
- Leukotriene B4 (LTB4)
- Cysteinyl leukotrienes (LTC4, LTD4, LTE4)
LTB4 binds to BLT receptors; Cysteinyl leukotrienes bind to CysLT1 and CysLT2 receptors
What is the role of Zileuton in asthma treatment?
Inhibits 5-Lipoxygenase, used for prophylaxis and treatment of chronic asthma
Not effective for managing acute asthma attacks
What are leukotriene receptor antagonists used for?
Asthma prophylaxis and chronic treatment
Prototype: Montelukast
What are the advantages of monoclonal antibodies (MAbs)?
- Greater selectivity
- Better efficacy (possibly)
- Less toxicity (possibly)
Limitations include high cost and administration methods
What is the prototype IgE inhibitor monoclonal antibody?
Omalizumab
Prevents interaction of allergen with IgE
What is the function of IL-5 inhibitors in asthma treatment?
Reduce eosinophil production and survival
Example: Mepolizumab
What is the genetic basis of Cystic Fibrosis (CF)?
Defective CF transmembrane conductance regulator (CFTR) gene
CFTR is an ion channel affecting ion and fluid transport
What is the main issue with CFTR gene defects in Cystic Fibrosis?
- Misfolding of CFTR
- Dysfunctional CFTR that reaches the cell membrane
Results in impaired chloride secretion and sodium reabsorption
What are the two pharmacological approaches needed for Cystic Fibrosis?
- Correctors (correct misfolded protein)
- Activators (activate CFTR in cell membrane)
Triple therapy includes Elexacaftor, Tezacaftor, and Ivacaftor
What is the mechanism of action of cough suppressants like Dextromethorphan?
Antagonists of NMDA-type glutamate receptors
Inhibits the cough reflex in the CNS
What is the mechanism of action for expectorants like Guaifenesin?
Reduces viscosity of mucus in the upper respiratory tract
Helps clear irritants/microbes
What are common side effects of Guaifenesin?
- Dizziness
- Nausea
- Vomiting
- Allergic reaction
- Rash itching
- Swelling
Side effects can vary among individuals
What are the side effects of Dupilumab?
- Elevated eosinophils
- Eye disorders (conjunctivitis, keratitis)
Dupilumab blocks both IL-4 and IL-13
