614 - Asthma drugs

Question 1

What two pathways are targeted in asthma therapy?

Answer 1

Those involved in bronchoconstriction: 1. inflammatory processes 2. parasympathetic tone

Question 2

What are three β2-agonists used to treat asthma?

Answer 2

albuterol, salmeterol, formoterol

Question 3

Which of the β2-agonists are used as long-acting agents for asthma prophylaxis? What are the adverse effects?

Answer 3

Salmeterol, formoterol; tremor and arrhythmia

Question 4

How do β2 agonists help in the treatment of asthma?

Answer 4

relax bronchial smooth muscle

Question 5

Which of the β2 agonists are useful for acute exacerbations of asthma?

Answer 5

Albuterol

Question 6

What is an example of a methylxanthine used for the treatment of asthma?

Answer 6

Theophylline

Question 7

How does theophylline work?

Answer 7

likely causes bronchodilation by inhibiting phosphodiesterase → ↑ cAMP levels due to ↓ cAMP hydrolysis

Question 8

Why is the usage of theophylline for the treatment of asthma limited?

Answer 8

Narrow therapeutic index (cardio- and neurotoxicity)

Question 9

What metabolizes theophylline?

Answer 9

cytochrome P-450

Question 10

How does theophylline relate to adenosine?

Answer 10

theophylline blocks the actions of adenosine

Question 11

What is a muscarinic antagonist used in the treatment of asthma?

Answer 11

Ipratropium

Question 12

How does ipratropium work as an asthma treatment?

Answer 12

competitive blockade of muscarinic receptors, preventing bronchoconstriction

Question 13

What is another form of ipratropium that is used as a long-acting muscarinic antagonist in the treatment of COPD?

Answer 13

tiotropium

Question 14

What are two corticosteroids used in asthma treatment?

Answer 14

beclomethasone, fluticasone

Question 15

How do beclomethasone and fluticasone work?

Answer 15

1. inhibit the synthesis of virtually all cytokines 2. inactivate NK-kB (transcription factor that induces the production of TNF-α and other inflammatory agents)

Question 16

Are corticosteroids used as a first line therapy for asthma?

Answer 16

yes, for chronic asthma treatment

Question 17

List 3 antileukotrienes used in asthma treatment:

Answer 17

1. Montelukast 2. Zafirlukast 3. Zileuton

Question 18

Which antileukotrienes block leukotriene receptors?

Answer 18

montelukast, zafirlukast

Question 19

What treatment especially good for asprin-induced asthma?

Answer 19

leukotriene receptor blockers montelukast and zafirlukast

Question 20

How does the antileukotriene zileuton work?

Answer 20

inhibits the 5-lipooxygenase pathway, blocking conversion of arachidonic acid to leukotrienes

Question 21

What is omalizumab?

Answer 21

a monoclonal anti-IgE antibody which binds mostly unbound serum IgE and blocks binding to FcϵRI.

Question 22

When would omalizumab be used in asthma treatment?

Answer 22

used in allergic asthma resistant to inhaled steroids and long-acting β2-agnoists

Question 23

What is methacholine?

Answer 23

a muscarinic receptor agonist used in bornchial provocation challenge to help diagnose asthma

Question 24

What is the treatment for pulmonary arterial hypertension? How does it work?

Answer 24

bosentan; competitively antagonizes endothelin-1 receptors, ↓ pulmonary vascular resistance

Question 25

Fill in the blank:

Answer 25

Beta agonists

Question 26

Answer 26

Muscarinic antagonists