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Pcol2 > Anti-Asthma > Flashcards

Anti-Asthma Flashcards

1
Q

Responsible for processing
the oxygen into the blood
system and exhaling
carbon dioxide

A

Respiratory System

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2
Q

2 major parts of respiratory system

A

Upper and Lower

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3
Q

Upper respiratory system comprises of

A

pharynx to trachea

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4
Q

lower respiratory system includes

A

lungs to alveoli

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5
Q

Common Respiratory Disorders

A

-Asthma
-Chronic Obstructive Pulmonary Disorder (COPD)
-Cystic Fibrosis
-Tuberculosis

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6
Q

Episodic narrowing and inflammation of the airway caused by stimuli

A

Asthma

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7
Q

Chronic bronchitis
Emphysema

A

Chronic Obstructive Pulmonary Disorder (COPD)

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8
Q

Thick secretion are excreted into the lung

A

Cystic Fibrosis

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9
Q

Infection caused by Mycobacterium tuberculosis

A

Tuberculosis

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10
Q

one of its manifestation is having barrel shoulders

A

COPD

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11
Q

T/F: COPD is irreversible and progressive

A

T

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12
Q

T/F: We don’t give NSAIDS to
asthmatic patients , We give
inhaled corticosteroid (ICS):

A

T

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13
Q

prevent asthma episodes

A

Controller

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14
Q

specifically for asthma attack

A

Reliever

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15
Q

Drugs used in Asthma

A

Bronchodilators
Anti-inflammatory agents
Leukotriene antagonist

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16
Q

Beta 2 - agonist
Methylxanthines
Muscarinic
antagonist

A

Bronchodilators

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17
Q

Release inhibitors
Antibodies
Steroids

A

Anti-inflammatory agents

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18
Q

Lipoxygenase inhibitor (Zileuton)
Receptor inhibitor (Zafirlukast, Montelukast)

A

Leukotriene antagonist

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19
Q
  • Inflammation of the airways
  • Constrictions
A

Asthma

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20
Q

Treatment of asthma involves:

A
  • Dilation of airway
  • Reduction of inflammation
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21
Q

Asthma manifestations

A

-tightness of chest
-shortness of breath
-wheezing

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22
Q

T/F: Asthma is always a reaction to allergen

A

T

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23
Q

can cause bronchodilation

A

B2 agonist

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24
Q

T/F: you should not give non-selective to asthmatic patients, give selective instead

A

T

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25
Q

Sympathomimetic Agents

A

Adrenoreceptor agonist

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26
Q

Sympathomimetic Agents stimulates ______________________
and ____________ the formation of
intracellular cAMP

A

adenylyl cyclase (AC); increases

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27
Q

Sympathomimetic Agents Binds to __________________, stimulating
the cAMP in the smooth muscle,
causing it to __________ and inhibiting
the release of bronchoconstricting
mediators from mast cells.

A

Binds to beta-receptor; relax

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28
Q

Dilation of the bronchioles

A

Sympathomimetic Agents

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29
Q

Best delivered by inhalation

A

Sympathomimetic Agents

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30
Q

more cAMP = _______ bronchodilation

A

more

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31
Q

Can you give B2 and Theophylline at the same time?

A

Yes

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32
Q

Rapid-acting bronchodilator when injected subcutaneously or as
inhaled as micro aerosol

A

Epinephrine

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33
Q

Maximal bronchodilation of epinephrine is achieved __________ minutes after inhalation and
last for ___________ minutes

A

15; 60 – 90

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34
Q

Epinephrine may cause

A

Tachycardia
Arrhythmia
Worsening of angina pectoris

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35
Q

May also be used for treating acute vasodilation, shock, and
bronchospasm of anaphylactic shock

A

Epinephrine

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36
Q

Longer duration of action compared to epinephrine

A

Ephedrine

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37
Q

A more pronounced central activity and a much lower potency

A

Ephedrine

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38
Q

Infrequently used in the management of asthma

A

Ephedrine

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39
Q

Potential non-selective B1 and B2 bronchodilator

A

Isoproterenol

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40
Q

Micro aerosol from pressurized canister

A

Isoproterenol

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41
Q

Isoproterenol at ____________ causes bronchodilation within 5 minutes

A

– 80 – 120 mcg

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42
Q

Rarely used for asthma

A

Isoproterenol

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43
Q

Albuterol, Terbutaline, Metaproterenol and Pirbuterol

A

Short Acting Beta -2 Agonist (SABA)

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44
Q

Available as a metered dose inhaler

A

SABA

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45
Q

Albuterol and Terbutaline are also available in ________ form

A

oral

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46
Q

Bronchodilation caused by SABA is maximal within ____________ and persistent for _______

A

15 minutes; 3 – 4
hours

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47
Q

SABA can be diluted in _________ for administration from a hand-held nebulizer

A

saline

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48
Q

Terbutaline is also available as ______ injection

A

SQ

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49
Q

Large doses of ____________ may sometimes be used to inhibit uterine
contraction

A

terbutaline

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50
Q

Salmeterol and Formeterol

A

LABA

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51
Q

LABA’s Duration of action 12 or more hours as a result of ___________

A

high lipid solubility

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52
Q
  • Need to be taken once daily
  • Used for treatment of COPD
A

Ultra Long-Acting Beta 2 Agonist

53
Q

Purine derivatives

A

Methylxanthine

54
Q

Caffeine, theophylline, theobromine

A

Methylxanthine

55
Q

once a mainstay of asthma treatment

A

Theophylline

56
Q

Inhibits phosphodiesterase → _________________ concentration of
intracellular cAMP and in some tissues cGMP

A

increasing

57
Q

stimulates cardiac function, relaxation of smooth
muscles and reduction in the immune and inflammatory activity

A

cAMP

58
Q

Methylxanthine that is;
-Absorbed well in the GI
-Metabolized in the liver

A

Theophylline

59
Q

Theophylline dosing iv therapy

A

3 – 4 mg/kg q 6

60
Q

Theophylline plasma concentration:

A

5
– 20 mg/L

61
Q

Methylxanthine SE:

A
  • Gastrointestinal distress
  • Tremor
  • Insomnia
62
Q

MEthylxanthine Toxicities:

A
  • Arrythmia
  • Hypotension
  • Vomiting
63
Q

Antidote for methylxanthine

A

Beta blocker

64
Q

Datura stramonium

A

Antimuscarinic Agents

65
Q

Competitively inhibits the action of acetylcholine at the
muscarinic receptor

A

Antimuscarinic Agents

65
Q

Antimuscarinic Agents _____________ (competitively/partially) inhibits the action of acetylcholine at the
muscarinic receptor

A

competitively

66
Q

Blocks the contraction of airway smooth muscle and the
increased secretion of mucus

A

Antimuscarinic Agents

67
Q

Very high concentrations are required to inhibit the response of
airway smooth muscle to non-muscarinic stimulation.

A

Antimuscarinic Agents

68
Q

prototypic muscarinic antagonis

A

Atropine

69
Q

SAMA

A

Ipratropium

70
Q

Selective quaternary ammonium derivative of atropine

A

SAMA

71
Q

Greater bronchodilation with less toxicity from systemic absorption

A

SAMA

72
Q

Can be delivered into the circulation and does not readily enter the
CNS

A

SAMA

73
Q

T/F: SAMA is as effective as albuterol in patients with COPD

A

T

74
Q

Tiotropium, Aclidinium

A

LAMA

75
Q

Binds to the M1, M2, and M3 receptors with equal affinity, but
dissociates most rapidly from M2 receptor

A

LAMA

76
Q

LAMA dissociates most rapidly from ___________ receptor

A

M2

77
Q

LAMA is taken by

A

inhalation

78
Q

A single dose of 18 mcg of __________ – 24 hours duration,

A

Tiotropium

79
Q

400
mcg of _________ – 12 hours duration thus taken 2x daily

A

aclidinium

80
Q

Daily inhalation of ____________ has been shown to improve the
functional capacity of patients with COPD as well as reduce
_____________

A

Tiotropium; exacerbation frequency

81
Q

T/F: LAMA is not part of maintenance
medications for patients with Asthma but only given as add ons

A

T

82
Q

frequently used corticosteroids

A

Inhaled corticosteroids

83
Q

Inhibit phospholipase A2 and COX-2 expression

A

Corticosteroids

84
Q

effect of Corticosteroids

A

Reduce inflammatory cytokines
* The thickness of the respiratory mucosa is reduced
* Does not have an effect on dilation

85
Q

Used routinely in combination with β agonist

A

Corticosteroids

86
Q

Urgent treatment corticosteroid

A

Prednisolone (oral) - 30 – 60 mg per day or
Methylprednisolone (IV) - 1mg/kg every 6 – 12 hours

87
Q

Beclomethasone, Budesonide, Ciclesonide, Flunisolide, Fluticasone,
Mometasone, Triamcinolone

A

Inhalational Corticosteroid (ICS)

88
Q

minimal systemic absorption

A

Inhalational Corticosteroid (ICS)

89
Q

An Average daily dose of ___________________ is equivalent to
10 – 15mg/day of oral prednisolone

A

800 mcg of Beclomethasone

90
Q

__________ oral therapy slowly before switching from oral to ICS to avoid
adrenal insufficienc

A

Taper

91
Q

commonly occurs in patients using inhaled
topical corticosteroid

A

Oropharyngeal candidiasis

92
Q

it inhibits early and later
response to antigen on mast cells and eosinophil

A

Release Inhibitor

93
Q

Block bronchoconstriction caused by allergen inhalation,
exercise, sulfur dioxide and variety of causes of occupational
asthma

A

Release Inhibitor

94
Q

When taken regularly (2-4 puffs 2-4x daily) it significantly
reduces sympathomimetic severity and the need for
bronchodilator medications particularly in young patients with
allergic asthma

A

Release Inhibitor

95
Q

Useful in reducing allergic rhinnoconjunctivitis

A

Release Inhibitor

96
Q

Side effects are minor and localized to the site of deposition

A

Release Inhibitor

97
Q

Release inhibitor se

A
  • Throat irritation, cough, and mouth dryness
  • Rarely, chest tightness and wheezing
  • Administering B2 agonist before Cromolyn or Nedocromil treatment
    prevents these symptoms
98
Q

Cromolyn, Nedocromil

A

Release Inhibitors

99
Q
  • Inhibiting the mast cell and have no direct bronchodilator effect
A

Cromolyn, Nedocromil

100
Q

Low solubility and poorly absorbed from the GI tract thus, it must be
inhaled as microfine powder or microfine suspension

A

Cromolyn, Nedocromil

101
Q

Has no effect on the airway’s smooth muscle tone and is thus
ineffective in reversing asthmatic bronchospasm but effective in
inhibiting both antigen and exercise-induced asthma

A

Cromolyn, Nedocromil

102
Q

from the action of 5-lipoxygenase on arachidonic
acid is synthesized by various inflammatory cells in the airways.

A

Leukotriene

103
Q

potent neutrophil chemoattractan

A

LTB4

104
Q

exert many effects known to occur in asthma,
including bronchoconstriction, increased bronchial reactivity,
mucosal edema, and mucus hypersecretion

A

LTC4 and LTD4

105
Q

Leukotriene Pathway Inhibitor approaches

A
  • Inhibition of 5-lipoxygenase thereby preventing leukotriene synthesis
  • Inhibition of the binding of LTD4 to its receptor on target tissue
106
Q

– lipoxygenase inhibitor

A

Zileuton

107
Q

– LTD4 receptor antagonist

A

Zafrilukast and Montelukast

108
Q

Leukotriene inhibitor is usually taken

A

orally

109
Q

Leukotriene inhibitor that is Approved for children as young as 12 months

A
  • Montelukast
110
Q

most prescribed leukotriene inhibitor

A

Montelukast

111
Q

T/F: Montelukast can be taken without regard to meals

A

T

112
Q

Montelukast is taken ______ daily

A

once

113
Q

Least prescribed due to liver toxicity

A

Zileuton

114
Q

Not as effective as an inhaled steroid

A

Leukotriene inhibitor

115
Q

Not recommended for acute asthma

A

Leukotriene inhibitor

116
Q

Leukotriene inhibitor is effective in

A
  • Exercise-induced bronchospasm
  • Antigen 2induced bronchospasm and aspirin allergy
  • Aspirin-induced bronchospasm
117
Q

Leukotriene inhibitor Toxicity

A

Generally low

118
Q

occasional elevation of liver enzyme

A

Zileuton

119
Q

Anti-IgE Monoclonal Antibodies

A

Omalizumab

120
Q

Humanized murine monoclonal antibody

A

Omalizumab

121
Q

Prevents the activation by asthma trigger antigens

A

Omalizumab

122
Q

Inhibits the binding of IgE but does not activate IgE already bound to
the mast cells and thus does not provoke mast cell degranulation

A

Omalizumab

123
Q

Omalizumab is given ___________ every 2- 4 weeks to asthmatic patients

A

subcutaneously

124
Q

Mepolizumab & Reslizumab

A

Anti-IL5 Therapy

125
Q

targeting IL- 5 receptor

A

Benralizumab

126
Q

T2 cells secrete IL 5 as pro-eosinophilic cytokine, resulting in
_________

A

eosinophilic airway inflammation

127
Q

Prevent exacerbation in asthmatic patients with peripheral
eosinophilia, add on maintenance therapy of severe asthma in
patient with an eosinophilic asthma.

A

Anti-IL5 Therapy

Pcol2 (20 decks)

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