Unit 4-Asthma Flashcards by Akil Miah

Q

Albuterol; Terbutaline; Metoproterenol; Pirbutal

Drug class

A

Bronchodilator - short-acting β2 agonist)

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Albuterol; Terbutaline; Metoproterenol; Pirbutal

Mechanism

A

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

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Albuterol; Terbutaline; Metoproterenol; Pirbutal

Uses

A

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

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

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.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Salmeterol (Serevent); Formoterol; Indacaterol

Drug class

A

Bronchodilator - long-acting β2 agonist

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Salmeterol (Serevent); Formoterol; Indacaterol

Uses

A

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

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Salmeterol (Serevent); Formoterol; Indacaterol

Side effects

A

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Salmeterol (Serevent); Formoterol; Indacaterol

Mechanism

A

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

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

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

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Theophylline (Theolair); Theobromine; Caffeine

Drug class

A

Bronchodilator (Methylxanthine)

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Theophylline (Theolair); Theobromine; Caffeine

Mechanism

A

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

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Theophylline (Theolair); Theobromine; Caffeine

Uses

A

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

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

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

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Roflumilast

Drug class

A

Methylxanthine

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Roflumilast

Mechanism

A

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

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Roflumilast

Uses

A

COPD

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Roflumilast

Side effects

A

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

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Ipratropium (Atrovent); Tiotropium; Atropine

Drug class

A

Quarternary amine antimuscarinic

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

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.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

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

Q

Ipratropium (Atrovent); Tiotropium; Atropine

Side effects

A

Typical antimuscarinic effects; acute angle glaucoma; paradoxical bronchospasm

Q

Aclidinium Bromide

Drug class

A

Quarternary amine antimuscarinic

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

Q

Aclidinium Bromide

Uses

A

Functionally similar to tiotropium

Aclidinium Bromide Side effects

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

Budesonide; Fluticasone propionate; beclomethasone Drug class

Corticosteroid - anti-inflammatory agent

Budesonide; Fluticasone propionate; beclomethasone Mechanism

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

Budesonide; Fluticasone propionate; beclomethasone Uses

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

Budesonide; Fluticasone propionate; beclomethasone Side effects

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)

Ciclesonide Drug class

Corticosteroid - anti-inflammatory agent

Ciclesonide Mechanism

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

Ciclesonide Uses

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

Ciclesonide Side effects

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

Sodium cromoglycate; Nedocromil sodium Drug class

Anti-inflammatory agent

Sodium cromoglycate; Nedocromil sodium Mechanism

Prevent mast cell degranulation and mediator release from mast cells

Sodium cromoglycate; Nedocromil sodium Uses

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

Sodium cromoglycate; Nedocromil sodium Side effects

Minimal local side effect (cough & throat irritation)

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

Leukotriene inhibitor

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

Leukotriene receptor antagonist

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

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

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

Well tolerated Must monitor liver function test.

Zileuton Drug class

Leukotriene inhibitor

Zileuton Mechanism

Inhibits 5-lipoxygenase and blocks leukotriene synthesis

Zileuton Uses

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

Zileuton Side effects

Liver toxicity

Omalizumab Drug class

Anti-IgE mAB

Omalizumab Mechanism

Blocks IgE function.

Omalizumab Uses

Poorly controlled severe asthma Administered by subQ injection every 3 weeks