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Pharmacyology 3 > COPD drugs > Flashcards

COPD drugs Flashcards

1
Q

Mast cell stabilizer

A

cromolyn sodium

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2
Q

cromyolyn sodium MOA

A
  • stabilize mast cells –> prevent histamine release

- decrease bronchial hyper-reactivity (not direct bronchodilator)

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3
Q

What is the only anti-asthmatic that blocks both early and late phase responses?

A

cromolyn sodium

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4
Q

Cromolyn uses

A
  • decrease hyper responsiveness
  • mild to moderate asthma with allergic component
  • limited overall use
  • NOT bronchodilating
  • NOT for acute asthma
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5
Q

Cromolyn adverse effects

A
  • cause bronchospasm, wheezing
  • throat irritation, cough, dry mouth
  • bad taste
  • joint swell, pain, HA
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6
Q

What is one of the safest anti-asthma meds?

A

cromolyn

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7
Q

Leukotriene modifiers

A

montelukast

zileuton

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8
Q

LTD4 leukotriene receptor antagonist

A

montelukast

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9
Q

leukotriene synthesis inhibitor

A

zileuton

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10
Q

Alternative to steroids for mild persistent asthma

A

leukotriene modifiers

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11
Q

leukotriene modifiers use

A
  • aspirin sensitive asthma
  • allergic rhinitis, chronic sinus
  • limited effects in acute attacks
  • may cause some bronchodilation
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12
Q

Leukotriene modifiers side effects

A
  • well tolerated

- mild HA, GI

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13
Q

zileuton side effects

A 
occasional reversible liver toxicity 
increase serum (warfarin and theophylline)
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14
Q

montelukast side effects

A

psychosis/depression risk

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15
Q

Biologic for airway

A

omalizumab

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16
Q

omalizumab MOA

A

prevent IgE from binding

- blocks all components of allergic response

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17
Q

omalizumab PK

A

onset 12 weeks

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18
Q

omalizumab use

A
  • moderate to severe disease not well controlled by inhaled steroids
  • allergic asthma –> non seasonal allergic
  • reduce frequency and severity of exacerbation
  • allow reduction of anti-inflammatory GC dose
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19
Q

omalizumab adverse effects

A
  • irritation at injection site

- CV and stroke risk

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20
Q

BBW omalizumab

A

analphylaxis

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21
Q

new subset of asthma

A

eosinophilic asthma

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22
Q

new biologic for asthma

A

IL-5 antagonist

23
Q

IL5

A

critical eosinophil promoting cytokine

24
Q

bronchial thermoplasty

A
  • recently approved

- non-pharmacologic to reduce bronchoconstriction

25
Q

bronchial thermoplastic MOA

A

destroy smooth muscle, not just dilating

- heat generating probe

26
Q

benefits of bronchial thermoplasty

A
  • decrease airway wall thickness
    increase airway diameter
  • eliminate bronchocinstriction capability
27
Q

COPD LABA

A

indacaterol
- once daily
COPD only

28
Q

indacaterol

A

COPD only

29
Q

T/F ICS drugs alone are not approved for use in COPD

A

true

30
Q

T/F adding ICS drugs to LABAs or other COPD drugs is not recommended

A

false

is recommended for severe disease and with frequent exacerbations

31
Q

anticholinergic for COPD

A

ipratropium

tiotropium

32
Q

target of anticholinergic agents for COPD

A

M3

- reduce bronchoconstriction due to airway nerve Ach release

33
Q

T/F anticholinergics are anti constrictors

A

true

34
Q

ipratropium

A

SAMA

35
Q

tiotropium

A

LAMA

36
Q

anticholinergics airways

A

only approved for COPD

- off label use in asthma

37
Q

first LAMA for long term asthma maintenance therapy

A

tiotropium

38
Q

anticholinergic adverse effects

A
  • few systemic
  • dry mouth
  • pharyngeal irritation
  • increase IOP
  • constipation
  • urinary retention
  • tachycardia
  • blurred vision
39
Q

PDE4 inhibitor

A

roflumilast

40
Q

roflumilast

A

reduce COPD exacerbations

  • reduce inflammation not bronchoconstrictions
  • not for bronchospasms: prevent exacerbation, not treat
41
Q

roflumilast adverse effects

A
  • D/N
  • CNS: suicide risk
  • weight loss
  • altered liver metabolism
42
Q

Mainstay of COPD therapy

A

bronchodilators

43
Q

Bronchodilators work

A

improve airflow
reduce hyperinflation
alleviate acute smyptoms

44
Q

For COPD a ____ combo is preferred over adding ICS

A

LABA-LAMA

45
Q

Tiotropium use

A

COPD and asthma

46
Q

T/F ICS should always be used in asthma

A

true

47
Q

When would you use an ICS to a LABA or LAMA

A
  • severe disease
  • frequent exacerbations
  • not for COPD alone
48
Q

theophylline can be used for added _____ effect

A

bronchodilator

49
Q

Roflumilast is not termed _____ and not used in ______

A

bronchodilator

asthma

50
Q

roflumilast specifically approved for ____

A

COPD

51
Q

Roflumilast used for

A
  • reduce/prevent exacerbations

- NOT treat acute exacerbations

52
Q

_____ are not major drug choice for COPD

A

inhaled steroids

53
Q

New ____ therapies are being developed

A

triple

Pharmacyology 3 (12 decks)

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