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RES Biweekly 1 > Treatment for Asthma and COPD > Flashcards

Treatment for Asthma and COPD Flashcards

1
Q

what are the main 2 pharmacologic targets in asthma

A

tone of bronchial smooth muscle
inflammation of airways

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2
Q

Short-acting beta 2 agonists
Short-acting anti-cholinergic agents
Oral corticosteroids

A

rescue medications for asthma

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3
Q

Inhaled corticosteroids
Long-acting Beta 2 agonists
Long-acting muscarinic antagonists
Mast cell inhibitors
Leukotriene inhibitors
Phosphodiesterase inhibitors
Antibodies against IgE

A

controller medications for asthma

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4
Q

MoA of beta2 adrenergic agonists

A

-K+ out of cell (hyperpolarization; smooth m relaxation)
-increases cAMP and decreases PLC/IP3/Ca2+; smooth muscle relaxation

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5
Q

short acting beta2 agonist (SABA) used in mild intermittent asthma and mild COPD

A

Albuterol

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6
Q

long acting beta2 agonists (LABA) used in moderate-severe asthma and >mild COPD

A

Salmeterol
Formoterol

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7
Q

classic non-selective beta agonist

A

Isoproterenol

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8
Q

key drug to use in mild-intermittent asthma

A

SABA (Albuterol)

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9
Q

this drug is added to ICS in patients with poorly controlled mild-persistent asthma

A

LABA (Salmeterol or Formoterol)

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10
Q

SE’s of this type of drug include:
muscle tremor
tachycardia
hypokalemia
restlessness

A

Beta2 agonists

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11
Q

in asthma, ____ should only be used with ICS, never alone

A

LABA

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12
Q

-sones and budesonide are what type of drug

A

corticosteroids

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13
Q

moa of corticosteroids

A

anti-inflammatory (goes into nucleus and stops inflammatory gene expression)
eosinophil apoptosis

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14
Q

____ can cause oral candidiasis (rinse after using this)

A

inhaled corticosteroids

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15
Q

1st line therapy for all patients with persistent asthma

A

ICS

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16
Q

hair loss
bone loss
mood changes
infections

A

systemic SE’s of corticosteroids

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17
Q

prolonged use of ____ causes HPA axis suppression

A

oral corticosteroids

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18
Q

use lowest dose of ____ to control asthma

A

ICS

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19
Q

combination inhalers (LABA + ICS) used for persistent asthma

A

Advair
Symbicort

20
Q

salmeterol/fluticasone

A

Advair

21
Q

formoterol/budesonide

A

Symbicort

22
Q

small changes in airway ______ have important impacts in changing airflow resistance

A

radius

23
Q

this drug is used to reduce airway constriction and first line in COPD

A

muscarinic antagonist

24
Q

this drug competitively inhibits Ach pathway of bronchoconstriction

A

muscarinic antagonist

25
Q

short acting muscarinic antagonist

A

Ipratropium

26
Q

long acting muscarinic antagonist

A

Tiotropium

27
Q

this drug is generally well-tolerated

A

muscarinic antagonist

28
Q

little evidence that ______ are helpful in asthma

A

anti-histamines

29
Q

used as an add-on to treat bronchoconstriction and inflammation in asthma

A

anti-leukotrienes

30
Q

LOX inhibitor

A

Zileuton

31
Q

leukotriene receptor inhibitors

A

Monteleukast
-lukasts
zaprinast

32
Q

no benefit in using these in COPD, used as an add-on maybe in asthma

A

anti-leukotrienes

33
Q

used in both asthma and COPD but not as common
PDE inhibitor (allows cAMP to function)

A

Theophylline

34
Q

has small therapeutic window and toxicity w/ other meds that block CYP function

A

Theophylline

35
Q

not used often to treat asthma but stabilizes mast cells

A

Cromolyn

36
Q

-mab against _____ can be used to treat all 3 types of asthma

A

TSLP

37
Q

Rx mild intermittent asthma

A

SABA prn

38
Q

Rx mild-persistent asthma

A

low dose ICS

39
Q

Rx moderate-persistent asthma

A

medium dose ICS + LABA

40
Q

Rx severe-persistent asthma

A

high dose ICS + LABA (+ oral corticosteroid)
consider: Omalizumab for patients who have allergies

41
Q

_____ causes epithelial cell injury and stimulation of macrophages

A

cigarette smoking, air pollutants, indoor wood cooking

42
Q

fibrosis
increase in proteases that lead to alveolar wall destruction (emphysema) and mucus hypersecretion (chronic bronchitis)

A

pathogenesis of COPD

43
Q

first line drug for COPD

A

anti-cholinergic/muscarinic antagonist

44
Q

can use LABA by itself here, but do not use ICS by itself, only as an add on

A

COPD

45
Q

most important thing to do for COPD

A

stop smoking

46
Q

Rx mild COPD

A

SABA (Albuterol)

47
Q

Rx >mild COPD

A

long acting muscarinic antagonists
LABA
(ICS if above do not work)

RES Biweekly 1 (11 decks)

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