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Pharma > Treatmment Bronchial Asthma > Flashcards

Treatmment Bronchial Asthma Flashcards

1
Q

Drug delivery

A

Topically to nasal mucosa
 Inhaled into lungs ( most effective)
 Orally
 Parenterally faster action
Local delivery methods preferred to minimize systemic side effects

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2
Q

Most used drug for asthma

A

1-sympathomimetic agents (used as “relievers” or
bronchodilators)
2-inhaled corticosteroids (used as “controllers” or anti-
inflammatory agents)

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3
Q

Anticholinergics

A

Ipratropium, tiotropium

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4
Q

Methylxanthines

A

Theophylline, aminophylline

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5
Q

Monoclonal antibodies

A

Omalizumab

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6
Q

 Mast cell stabilizers

A

Sodium cromoglycate

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7
Q

Leukotriene inhibitors

A

Zileuton, montelukast

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8
Q

β2-adrenergic agonists

A

β2-adrenergic agonists relax airway smooth muscle,
quick relief

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9
Q

β2 agonists have inflammatory effect true /false ¿

A

False • β2 agonists have no anti-inflammatory effects

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10
Q

β2 agonists • not be used as monotherapy for patients with persistent asthma

A

True

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11
Q

Short-acting β2 agonists:

A

a rapid onset of action (5-15min)

best delivered by inhalation

local effect on airway smooth muscle with least systemic
toxicity 80–90% of total dose of aerosol is deposited in the
mouth or pharynx

symptomatic treatment of bronchospasm

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12
Q

Chronic use of β2-agonists - leads to tachyphylaxis
due to receptor down regulation

A

True

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13
Q

Adverse effect of short b2 agonists

A

tachycardia, hyperglycemia, hypokalemia

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14
Q

Example for short b2agnists

A

Salbutamol

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15
Q

Example for Long-acting β2 agonists

A
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16
Q

Duration of Long-acting β2 agonists

A

ong duration of action (12 hours)

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17
Q

Long acting used for acute attack ¿

A

False  should NOT be used for acute attack

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18
Q

Long acting used only in combination with an asthma controller
medication

A

ICS

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19
Q

Example for Ultra LABA

A

vilanterol) has a 24-hour bronchodilator duration
of effect

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20
Q

Vilanterol combian ……….for daily asthma

A

fluticasone

21
Q

Mechanism of Action Corticosteroids

A

inhibit arachidonic acid by phospholipase A2 inhibition
 producing anti-inflammatory effect

22
Q

Inhalational route ICS most commonly used ¿

A

True

23
Q

ICSs
Examples-

A

Beclomethasone, budesonide, fluticasone

24
Q

Systemic corticosteroids indicated in acute severe
asthma

A

prednisone/ prednisolone

25
Q

Adverse effects and cautions Corticosteroids

A

Sudden discontinuation of oral/parenteral therapy  acute adrenal insufficiency — can be fatal

26
Q

When the Systemic adverse effects may occur Corticosteroids

A

high dose ICSs

27
Q

Where the ICS deposit

A

oral and laryngeal mucosa

28
Q

Corticosteroids  can cause candidiasis and dysphonia

A

True Prevented by rinsing mouth with water, use of spacer

29
Q

Ciclesonide associated with less frequent candidiasis

A

True

30
Q

Zafirlukast Food impairs absorptio

A

True

31
Q

Zileuton and its metabolites excreted in urine

A

True

32
Q

Zafirlukast, montelukast, and metabolites liver

A

False Zafirlukast, montelukast, and metabolites undergo
biliary excretion

33
Q

Not useful in an acute asthma attack, because it is not
a bronchodilator

A

Cromolyn sodium

34
Q

alternative therapy for mild persistent asthma
prophylactic anti-inflammatory agent

A

Cromolyn sodium

35
Q

Ipratropium

A

nonselective M1, M2, and M3 antagonist
 poorly absorbed, minimal systemic effects
 adjunctive therapy in acute severe asthma not
completely responsive to β2-agonists
 not recommended for routine treatment of acute
asthma
 onset is much slower than inhaled SABAs
 multiple-dose ipratropium bromide added to initial
therapy in moderate to severe asthma

36
Q

Tiotropium

A

long-acting anticholinergic agent  can be used as an add-on treatment in severe asthma Adverse effects  Xerostomia

37
Q

Mechanism of Action Anticholinergics

A

Muscarinic antagonists reverse cholinergic
bronchoconstriction
 block vagally mediated contraction of airway smooth
muscle and mucus secretion

38
Q

X use has declined
 high risk of severe toxicity
 drug interactions
 less efficacy compared with ICSs and LABAs

A

Methyl Xanthines

39
Q

Nonselective phosphodiesterase inhibition
 They also inhibit adenosine receptors ( adenosine
contracts airways)

A

Theophylline

40
Q

Theophylline Toxicities include

A

nausea, vomiting
 tachycardia, cardiac arrhythmias
 Monitoring of serum concentrations essential for safe
use
• narrow therapeutic index
• Dose of theophylline should be decreased if enzyme
inhibitors like erythromycin and Ciprofloxacin are
prescribed with it

41
Q

Binds selectively to (IgE)

A

Omalizumab

42
Q

Omalizumab monoclonal antibody

A

True

43
Q

Decreases binding of IgE to its receptor on mast cells
and basophils.

A

Omalizumab

44
Q

 Is indicated for treatment of moderate to severe
persistent asthma in poorly controlled patients

A

Omalizumab

45
Q

Route of administration (subcutaneous)

A

Omalizumab

46
Q

Drugs used in treatment COPD

A
  1. Inhaled β2-agonists 2. Anticholinergic agents
     ipratropium and tiotropium
  2. Inhaled corticosteroids
  3. Other agents
     Roflumilast
     Oral phosphodiesterase-4 inhibitor
     Not indicated for relief of acute bronchospasm
47
Q

Two types of aerosols can be used.

A

• Aerosol using drugs in solution: These include
metered dose inhaler(MDI) and nebulizers
• Aerosols using drugs as dry powder (DPI)

48
Q

Spacers

A

large-volume chamber
attached to an MDI more likely to reach the
target airway tissue

49
Q

Delivers beta-adrenergic drugs
directly to the lungs

This is inhaled without having to
coordinate dosing with breathing

sound waves to
create a continuous mist of drug

A

Nebulizer

Pharma (3 decks)

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