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Pharmacology > Unit 4-Asthma > Flashcards

Unit 4-Asthma Flashcards

1
Q

Albuterol; Terbutaline; Metoproterenol; Pirbutal

Drug class

A

Bronchodilator - short-acting β2 agonist)

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2
Q

Albuterol; Terbutaline; Metoproterenol; Pirbutal

Mechanism

A

Relax bronchial smooth muscle, inhibit mediator release (mast cells, basophils), increase mucociliary clearance, suppression of microvascular permeability

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3
Q

Albuterol; Terbutaline; Metoproterenol; Pirbutal

Uses

A

Prevent or reduce exercise-induced bronhospasms; mild asthma & acute exacerbations

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4
Q

Albuterol; Terbutaline; Metoproterenol; Pirbutal

Side effects

A

Musculoskeletal tremor, Tachycardia, hyperglycemia, hypokalemia, hypomagnesemia

Tolerance with chronic use, Prolonged QTc, lactic acidosis, paradoxical bronchospasm

5 minutes to take action, 4-6 hours duration; nebulizer delivers more, but greater side effects. Note: Levalbuterol is R-isomer of albuterol.

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5
Q

Salmeterol (Serevent); Formoterol; Indacaterol

Drug class

A

Bronchodilator - long-acting β2 agonist

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6
Q

Salmeterol (Serevent); Formoterol; Indacaterol

Uses

A

used for long-term control of asthma symptoms (always in comination with inhaled steroids)

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7
Q

Salmeterol (Serevent); Formoterol; Indacaterol

Side effects

A
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8
Q

Salmeterol (Serevent); Formoterol; Indacaterol

Mechanism

A

Relax bronchial smooth muscle, inhibit mediator release (mast cells, basophils), increase mucociliary clearance, suppression of microvascular permeability

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9
Q

Salmeterol (Serevent); Formoterol; Indacaterol

Side effects

A

Musculoskeletal tremor, Tachycardia, hyperglycemia, hypokalemia, hypomagnesemia

Tolerance with chronic use, Prolonged QTc, lactic acidosis, paradoxical bronchospasm

10-15 minutes to take action, 6-12 hours (max) of duration; nebulizer delivers more, but greater side effects; oral is least effective (requires more dose –> side effects); can be used night symptoms, but not ideal

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10
Q

Theophylline (Theolair); Theobromine; Caffeine

Drug class

A

Bronchodilator (Methylxanthine)

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11
Q

Theophylline (Theolair); Theobromine; Caffeine

Mechanism

A

Phosphodiesterase inhibition and enhanced signalling via increased cAMP and cGMP; relax bronchial smooth muscle

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12
Q

Theophylline (Theolair); Theobromine; Caffeine

Uses

A

Reduce inflammation and bronchospasm in moderate to severe asthma, night symptoms

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13
Q

Theophylline (Theolair); Theobromine; Caffeine

Side effects

A

CNS stimulation or seizures, tachycardia/arrythmias, anorexia, nausea

Low therapeutic index! Metabolized by liver; cimetidine and quinoline increase blood levels

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14
Q

Roflumilast

Drug class

A

Methylxanthine

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15
Q

Roflumilast

Mechanism

A

Selective PDE4 inhibitor; more of an anti-inflammatory agent than bronchodilator

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16
Q

Roflumilast

Uses

A

COPD

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17
Q

Roflumilast

Side effects

A

CNS stimulation or seizures, tachycardia/arrythmias, anorexia, nausea

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18
Q

Ipratropium (Atrovent); Tiotropium; Atropine

Drug class

A

Quarternary amine antimuscarinic

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19
Q

Ipratropium (Atrovent); Tiotropium; Atropine

Mechanism

A

Blocks vagal pathways and decreases vagal tone to bronchial smooth muscle; also blocks the reflex bronchoconstriction caused by inhaled irritants

Note: tiotropium has anti-inflammatory properties and decreases mucus secretion.

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20
Q

Ipratropium (Atrovent); Tiotropium; Atropine

Uses

A

First-line agent for chronic COPD; status asthmaticus (w/ nebulized β2-agonists); no role in chronic stable asthma

21
Q

Ipratropium (Atrovent); Tiotropium; Atropine

Side effects

A

Typical antimuscarinic effects; acute angle glaucoma; paradoxical bronchospasm

22
Q

Aclidinium Bromide

Drug class

A

Quarternary amine antimuscarinic

23
Q

Aclidinium Bromide

Mechanism

A

Blocks vagal pathways and decreases vagal tone to bronchial smooth muscle; also blocks the reflex bronchoconstriction caused by inhaled irritants

24
Q

Aclidinium Bromide

Uses

A

Functionally similar to tiotropium

25
Q

Aclidinium Bromide

Side effects

A

Less systemic & CNS side effects than other antimuscarinics due to extremely short circulation half-life.

26
Q

Budesonide; Fluticasone propionate; beclomethasone

Drug class

A

Corticosteroid - anti-inflammatory agent

27
Q

Budesonide; Fluticasone propionate; beclomethasone

Mechanism

A

Anti-inflammatory effects: inhibition of growth factor secretion, inhibition of arachidonic acid metabolites and platelet activation factor, inhibition of leukocyte accumulation, decreased vascular permeability, inhibition of neuropeptide-mediated responses, inhibition of mucous glycoprotein secretion

28
Q

Budesonide; Fluticasone propionate; beclomethasone

Uses

A

Cornerstone treatment of persistent asthma; beneficial combination with beta-2 agonist; limited role in COPD

29
Q

Budesonide; Fluticasone propionate; beclomethasone

Side effects

A

Inhaled has thrush, hoarseness, dry cough, mild adrenal suppression (higher doses); oral has mood-swings, increased appetite, and suppression of adrenocorticotropic hormone secretion (Cushing’s Syndrome)

30
Q

Ciclesonide

Drug class

A

Corticosteroid - anti-inflammatory agent

31
Q

Ciclesonide

Mechanism

A

Same as other corticosteroids, but is a prodrug and only activated by airway esterase.

32
Q

Ciclesonide

Uses

A

Cornerstone treatment of persistent asthma; beneficial combination with beta-2 agonist; limited role in COPD

33
Q

Ciclesonide

Side effects

A

Less side effects than other corticosteroids (on site activation required)

34
Q

Sodium cromoglycate; Nedocromil sodium

Drug class

A

Anti-inflammatory agent

35
Q

Sodium cromoglycate; Nedocromil sodium

Mechanism

A

Prevent mast cell degranulation and mediator release from mast cells

36
Q

Sodium cromoglycate; Nedocromil sodium

Uses

A

Prophylaxis for inhibiting both early and late phase reactions; best results in mild and allergic asthma

37
Q

Sodium cromoglycate; Nedocromil sodium

Side effects

A

Minimal local side effect (cough & throat irritation)

38
Q

Montelukast (Singulair); Pranlukast (Azlaire); Zafirlukast (Accolate)

Drug class

A

Leukotriene inhibitor

39
Q

Montelukast (Singulair); Pranlukast (Azlaire); Zafirlukast (Accolate)

Mechanism

A

Leukotriene receptor antagonist

40
Q

Montelukast (Singulair); Pranlukast (Azlaire); Zafirlukast (Accolate)

Uses

A

Add-on therapy in mild persistent asthma; aspirin-induced asthma; prophylaxis for exercise-induced bronchospasm

41
Q

Montelukast (Singulair); Pranlukast (Azlaire); Zafirlukast (Accolate)

Side effects

A

Well tolerated

Must monitor liver function test.

42
Q

Zileuton

Drug class

A

Leukotriene inhibitor

43
Q

Zileuton

Mechanism

A

Inhibits 5-lipoxygenase and blocks leukotriene synthesis

44
Q

Zileuton

Uses

A

Add-on therapy in mild persistent asthma; aspirin-induced asthma; prophylaxis for exercise-induced bronchospasm

45
Q

Zileuton

Side effects

A

Liver toxicity

46
Q

Omalizumab

Drug class

A

Anti-IgE mAB

47
Q

Omalizumab

Mechanism

A

Blocks IgE function.

48
Q

Omalizumab

Uses

A

Poorly controlled severe asthma

Administered by subQ injection every 3 weeks

Pharmacology (26 decks)

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