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

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Flashcards in 08.18 - Pharmacotherapy of Asthma, COPD (Malik) - Questions Deck (49):
1

Toxicities of Cromolyns

No systemic tox; Irritation of Trachea

1

Interaction between Glucocorticoids and B2-agonists

Glucocorticoids increase transcription of B2AR's

1

Omalizumab

Anti-IgE mAb

3

Anti-cholinergics

Atropine, Ipratropium

3

Leukotriene Receptor Blockers

Monteleukast, Zafirlukast

4

Anti-IgE mAb

Omalizumab

4

Zileuton inhibits __ formation by blocking __-

Leukotriene formation, FLAP

5

Systemic effects of Ipratropium

No significant

5

2 Notable adverse effects of Monteleukast

Laryngitis/Pharyngitis; Viral infections

6

Main effect of Beta agonists

Incr levels of cAMP

7

Action of cAMP in B2 agonist effects

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

7

Interaction between Zileuton and Theophylline

CYP1A2

8

2 ways in which Glucocorticoids decrease inflammatory gene translation

Decrease transcription thru CBP; Destabilize mRNA thru TTP

9

2 main actions of Cromolyn Sodium

Inhibit mast cell degranulation; Reduce bronchial hyperactivity

10

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

Salmeterol, Formoterol (use with steroids)

11

Glucocorticoid with best pharmacokinetics and -dynamics

Ciclesonide

12

When is Theophylline used?

Adjuvant to beta-2 agonist and anti-muscarinic

12

Theophylline serum levesl 5-10 can cause

nervousness and insomnia

12

Zafirlukast and Monteleukast specifically antagonize ___

LTD4 receptors

13

Ligand for beta2 receptors in lung

Epinephrine

14

AA is metabolized by __

5-LO

15

Which GC has lowest oropharyngeal candidiasis

Ciclosenide

16

Interaction between Anti-muscarinics and B2-agonist

Anti-muscarinics enhance b2-mediated bronchodilation

17

Leukotriene Synthesis Inhibitor

Zileuton

19

G protein that mediates good B2 agonist effects

Gs

20

Response to corticosteroids in Asthma vs COPD

Good in Asthma, Poor in COPD

21

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

False, only in heart

22

2 notable adverse effects of prolonged Oral Corticosteroids

Glucose intolerance; Incr BP and weight

23

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

beta1-selective

25

Adverse effects of Anti-muscarinics

Pupillary dilation and cycloplegia

26

LABA's

Salmeterol, Formeterol (use with steroids)

27

3 notable features of Cushingoid Syndrome

Muscle weakness; Ruddy complexion; High BP

29

Where is highest density of beta2-adrenergic receptors

Lung

30

2 Notable adverse effects of Zafirlukast

Liver enzymes elevated; GIT disturbances

32

2 main actions of Theophylline

Inhibits PDE; Inhibits Adenosine

33

LABA's are only used

In combo with inhaled steroids

34

Selectivity of Isoproterenol

B1 and B2

35

Notable adverse effect of Zileuton

Liver enzymes elevated

37

Selectivity of Ephedrine

B1 and B2 and some Alpha

38

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

FLAP

39

Why not use ACEi's in airway disease

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

40

What combined tx is indicated for COPD

Anti-muscarinic + beta2 agonist

42

3 Minor effects of Beta agonists

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

43

LTB4 is a ___ chemoattractant

Neutrophil

44

GC action that suppresses TH2 cell cytokine synthesis

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

46

2 Notable Adverse Effects of Omalizumab

Serious Allergic Reactions; CV complications

47

Methylxanthines

Aminophylline, Theophylline

48

3 main Adverse Effects of B2 agonists

Incr HR and Arrythmias; PaCO2 may decrease; CNS toxicities

49

G protein that mediates inflammatory B2 agonist effects

Gq