Respiratory Tract Disorders

Question 1

Meaning of COPD

Answer 1

Chronic Obstructive Pulmonary Disease

Question 2

Characterized by airway inflammation and hyperresponsiveness to stimuli that produce brochoconstriction

Answer 2

Asthma

Question 3

Reasons of narrowing of airways in COPD

Answer 3

Inflammation
Mucus Secretion

Question 4

Triggers of Asthma

Answer 4

Allergens
Air pollution
Cigarette smoking
Upper Respiratory tract infections
Drugs (NSAIDs & Beta-blockers)
Cold Air
Exercise

Question 5

A substance that is released during inflammation

Answer 5

Protease

Question 6

Surface in between the sacs of the alveoli, this is also directly connected to the capillaries

Answer 6

Parenchyma

Question 7

A condition wherein the partition in between every alveoli collapses (alveolar collapse)

Destruction of Parenchyma

Answer 7

Emphysema

Question 8

Why do NSAIDs cause Asthma

Answer 8

Since they inhibit cox resulting to increase of LOX thus increasing leukotrienes causing constriction

Question 9

Why do beta-blockers cause Asthma attack

Answer 9

Since Beta 2 causes bronchodilation, antagonize it then no bronchodilation

Question 10

Two factors for Asthma

Answer 10

Genetic & Environmental

Question 11

Examples of Beta Agonist Bronchodilators (SABA)

Answer 11

Salbutamol
Terbutaline
Levalbuterol
Fenoterol
Pirbuterol

Question 12

Examples of Beta Agonist Bronchodilators (LABA)

Answer 12

Salmeterol
Formeterol
Indacaterol

Question 13

SABAs are used for

Answer 13

Treating acute bronchospasms since it is fast acting

Question 14

LABAs are used for

Answer 14

Prevention of asthma attacks

Most of them are given twice daily by INHALATION except for Indacaterol (once daily)

Question 15

Example Muscarinic Antagonist Bronchodilators

Answer 15

Ipratropium
Tiotropium

Both are administered by oral inhalation to produce few side effects

Question 16

1+1 = 3 (synergistic)

Answer 16

when muscarinic receptor antagonists are given on its own it is weaker than beta agonists HOWEVER when given together with beta 2 agonist they are more effective

Question 17

MOA of Theophylline

Answer 17

Inhibition of PDE isozymes and Blockade of adenosine receptors thus increasing camp

Inhibition of calcium influx

Enhancement of catecholamine secretion

Question 18

Indications of Theophylline

Answer 18

COPD and Asthma whose symptoms are not controlled with Beta 2 agonists and muscarinic antagonists

Question 19

Adverse effects of Theophylline

Answer 19

Gastrointestinal distress

CNS stimulation (HA, anxiety, restlessness, seizure) caffeine like effects

Cardiac stimulation

Question 20

What do Corticosteroids or steroids do

Answer 20

Inhibit the immune system thus lessening immune response

Question 21

Indications of Corticosteroids

Answer 21

Long-term prevention of asthma attacks

Question 22

Adverse effects of Corticosteroids(Budesonide, Fluticasone, Beclomethasone, Triamcinolone)

Answer 22

Oral Thrush

Risk of suppressing growth in children

Question 23

Examples of Corticosteroid drugs

Answer 23

Budesonide
Fluticasone
Beclomethasone
Triamcinolone

Question 24

MOA of Leukotriene antagonists (zafirlukast and montelukast)

Answer 24

Antagonize Leukotriene receptor

Inhibit Lipoxygenase (enzyme responsible for producing leukotrienes)

Question 25

Examples of leukotriene antagonists

Answer 25

Montelukast - can be given to patients as young as 6 months old Zafirlukast - for patients with age greater than 5 years old

Question 26

Indications of leukotriene antagonists (zafirlukast and montelukast)

Answer 26

Preferred initial anti-inflammatory therapy since it has minimal side effects, orally administered, and it can be used for patients that are unwilling/contraindicated to use steroids

Question 27

Example of Lipoxygenase 5 inhibitor

Answer 27

Zileuton

Question 28

MOA of Zilueton

Answer 28

Block the formation of leukotriene

Question 29

Indications of Lipoxygenase 5 inhibitor (zileuton)

Answer 29

Prophylaxis of asthma in adults and children (12 years and above)

Question 30

Adverse effects of Lipoxygenase 5 inhibitor (zileuton)

Answer 30

Flu-like syndrome Elevation of liver enzymes

Question 31

Adverse effects of leukotriene receptor antagonists (montelukast and zafirlukast)

Answer 31

Rarely, Churg-Strauss Syndrome - treated with corticosteroids, this is developed in patients being withdrawn from glucocorticoid therapy while a leukotriene antagonist is substituted

Question 32

Example of mast cell stabilizers

Answer 32

Cromolyn Sodium Nedocromil Lodoxamide

Question 33

MOA of mast cell stabilizers (Cromolyn Sodium, Nedocromil, Lodoxamide)

Answer 33

stabilize the plasma membranes of mast cells and prevent granulation and release of histamine, leukotrienes and other substances that cause airway inflammation Block calcium

Question 34

Indications of mast cell stabilizers (Cromolyn Sodium, Nedocromil, Lodoxamide)

Answer 34

used as a prophylactic agent for asthma (inhaled)

Question 35

Example of PDE-4 Inhibitor

Answer 35

Roflumilast

Question 36

MOA of PDE-4 Inhibitor (roflumilast)

Answer 36

Increase cAMP levels

Question 37

Indications of PDE-4 Inhibitor (roflumilast)

Answer 37

used to reduce the risk of COPD exacerbations in patients with chronic bronchitis who have a history of exacerbations

Question 38

MOA of Antitussives (Dextromethorphan, Noscapine, Propoxyphene Codeine, Butamirate Citrate, Levodroproprizine)

Answer 38

Inhibit the cough center in the brain: elevating cough threshold

Question 39

Examples of Antitussives

Answer 39

Dextromethorphan Noscapine Propoxyphene Codeine Butamirate Citrate Levodroproprizine

Question 40

MOA of Expectorants (Guaifenesin, Sodium Citrate, Potassium Citrate, Ammonium Chloride)

Answer 40

Facilitate the coughing up of mucus and other materials from the lungs Reduce adhesiveness and surface tension of respiratory tract secretions and thereby facilitate their expectoration

Question 41

Examples of Expectorants

Answer 41

Guaifenesin Sodium Citrate Potassium Citrate Ammonium Chloride

Question 42

MOA of Mucolytics (Acetylcysteine, Bromhexine, Carbocisteine, Ambroxol)

Answer 42

Breaks down the bonds holding together mucus thus making the mucus less sticky and thick

Question 43

Examples of Mucolytics

Answer 43

Acetylcysteine Bromhexine Carbocisteine Ambroxol