08.18 - Pharmacotherapy of Asthma, COPD (Malik) - Questions

Question 1

Toxicities of Cromolyns

Answer 1

No systemic tox; Irritation of Trachea

Question 1

Interaction between Glucocorticoids and B2-agonists

Answer 1

Glucocorticoids increase transcription of B2AR’s

Question 1

Omalizumab

Answer 1

Anti-IgE mAb

Question 3

Anti-cholinergics

Answer 3

Atropine, Ipratropium

Question 3

Leukotriene Receptor Blockers

Answer 3

Monteleukast, Zafirlukast

Question 4

Anti-IgE mAb

Answer 4

Omalizumab

Question 4

Zileuton inhibits __ formation by blocking __-

Answer 4

Leukotriene formation, FLAP

Question 5

Systemic effects of Ipratropium

Answer 5

No significant

Question 5

2 Notable adverse effects of Monteleukast

Answer 5

Laryngitis/Pharyngitis; Viral infections

Question 6

Main effect of Beta agonists

Answer 6

Incr levels of cAMP

Question 7

Action of cAMP in B2 agonist effects

Answer 7

Stimulates EPAC –> Decr Prolifer; Stim PKA –> Inhibit MLCK –> Relaxation

Question 7

Interaction between Zileuton and Theophylline

Answer 7

CYP1A2

Question 8

2 ways in which Glucocorticoids decrease inflammatory gene translation

Answer 8

Decrease transcription thru CBP; Destabilize mRNA thru TTP

Question 9

2 main actions of Cromolyn Sodium

Answer 9

Inhibit mast cell degranulation; Reduce bronchial hyperactivity

Question 10

Beta-2-specific: Slow onset, long-acting

Answer 10

Salmeterol, Formoterol (use with steroids)

Question 11

Glucocorticoid with best pharmacokinetics and -dynamics

Answer 11

Ciclesonide

Question 12

When is Theophylline used?

Answer 12

Adjuvant to beta-2 agonist and anti-muscarinic

Question 12

Theophylline serum levesl 5-10 can cause

Answer 12

nervousness and insomnia

Question 12

Zafirlukast and Monteleukast specifically antagonize ___

Answer 12

LTD4 receptors

Question 13

Ligand for beta2 receptors in lung

Answer 13

Epinephrine

Question 14

AA is metabolized by __

Answer 14

5-LO

Question 15

Which GC has lowest oropharyngeal candidiasis

Answer 15

Ciclosenide

Question 16

Interaction between Anti-muscarinics and B2-agonist

Answer 16

Anti-muscarinics enhance b2-mediated bronchodilation

Question 17

Leukotriene Synthesis Inhibitor

Answer 17

Zileuton

Question 19

G protein that mediates good B2 agonist effects

Answer 19

Gs

Question 20

Response to corticosteroids in Asthma vs COPD

Answer 20

Good in Asthma, Poor in COPD

Question 21

T/F: Beta-adrinergic receptors in lungs can be de-sensitized

Answer 21

False, only in heart

Question 22

2 notable adverse effects of prolonged Oral Corticosteroids

Answer 22

Glucose intolerance; Incr BP and weight

Question 23

If you have to use beta-blocker in airway disease, use

Answer 23

beta1-selective

Question 25

Adverse effects of Anti-muscarinics

Answer 25

Pupillary dilation and cycloplegia

Question 26

LABA's

Answer 26

Salmeterol, Formeterol (use with steroids)

Question 27

3 notable features of Cushingoid Syndrome

Answer 27

Muscle weakness; Ruddy complexion; High BP

Question 29

Where is highest density of beta2-adrenergic receptors

Answer 29

Lung

Question 30

2 Notable adverse effects of Zafirlukast

Answer 30

Liver enzymes elevated; GIT disturbances

Question 32

2 main actions of Theophylline

Answer 32

Inhibits PDE; Inhibits Adenosine

Question 33

LABA's are only used

Answer 33

In combo with inhaled steroids

Question 34

Selectivity of Isoproterenol

Answer 34

B1 and B2

Question 35

Notable adverse effect of Zileuton

Answer 35

Liver enzymes elevated

Question 37

Selectivity of Ephedrine

Answer 37

B1 and B2 and some Alpha

Question 38

AA is metabolized by 5-LO, but ___ is what is inhibited by Zileutin

Answer 38

FLAP

Question 39

Why not use ACEi's in airway disease

Answer 39

Increased levels of Bradykinin, which causes PGE2-mediated sensitization of nerve endings (cough)

Question 40

What combined tx is indicated for COPD

Answer 40

Anti-muscarinic + beta2 agonist

Question 42

3 Minor effects of Beta agonists

Answer 42

Inhibit mast cell degran; Inhibit microvascular perm; Promote mucociliary transport

Question 43

LTB4 is a ___ chemoattractant

Answer 43

Neutrophil

Question 44

GC action that suppresses TH2 cell cytokine synthesis

Answer 44

Competes with GATA-3, which is TF for IL-4, -5, and -13

Question 46

2 Notable Adverse Effects of Omalizumab

Answer 46

Serious Allergic Reactions; CV complications

Question 47

Methylxanthines

Answer 47

Aminophylline, Theophylline

Question 48

3 main Adverse Effects of B2 agonists

Answer 48

Incr HR and Arrythmias; PaCO2 may decrease; CNS toxicities

Question 49

G protein that mediates inflammatory B2 agonist effects

Answer 49

Gq