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CPR II Exam #2 > Drugs for Asthma and COPD > Flashcards

Drugs for Asthma and COPD Flashcards

1
Q

Anti-inflammatory drug classes (3)

A

Corticosteroids
Antibodies
Leukotriene receptor modifiers

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2
Q

Bronchodilators (3)

A

Beta-2 agonists
Anti-cholinergic drugs
Methylxanthines

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3
Q

Absorption/deposition of beta-2 agonists

A

10-20% is inhaled and enters the lungs —> systemic circulation

80-90% is swallowed and enters the GI tract —> liver —> first-pass metabolism and systemic circulation

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4
Q

What is unique about Terbutaline (SABA)?

A

It is the only b-2 drug available by subQ injection

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5
Q

Avoid Terbutaline in patients with…

A

A sulfa allergy

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6
Q

Metaproterenol (SABA) is used for…

A

Bronchial asthma and reversible bronchospasm.

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7
Q

Major warning associated with Metaproterenol (SABA)

A

Paradoxical bronchospasm

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8
Q

Use of Pirbuterol (SABA) is…

A

Prevention and reversal of bronchospasm.

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9
Q

Major warning associated with Pirbuterol (SABA) is…

A

Cardiovascular effects

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10
Q

Levalbuterol (SABA) is used for…

A

Treatment and prevention of bronchospasm

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11
Q

What warning is associated with Levalbuterol (SABA)?

A

Paradoxical bronchospasm

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12
Q

Fomoterol (LABA) is given for the…

A

Maintenance treatment of patients with asthma/COPD, along with an additional control agent.

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13
Q

Salmeterol (LABA) is given for…

A

Prevention of exercise-induced bronchospasm.

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14
Q

Indacaterol and Vilanterol (LABA) are given to which patients?

A

Patients with COPD.

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15
Q

Oldaterol (LABA) is given as a…

A

One-daily maintenance bronchodilator for airway obstruction in COPD patients.

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16
Q

All LABAs share the following 2 characteristics:

A
  1. Must be given as concomitant treatment with another med, like an ICS.
  2. Increase the risk of asthma-related deaths and hospitalizations.
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17
Q

What class of drug is Atropine?

A

Anti-cholinergic drugs

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18
Q

Aside from Atropine, what suffix is associated with anti-cholinergic drugs?

A

-ium

Ipratropium, Tiotropium, Aclidinium

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19
Q

Ipratropium is an anti-choinergic and is an analog of…

A

Atropine, but does not produce the same atropine-like effects because it is poorly absorbed.

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20
Q

Tiotropium is indicated for…

A

Long-term, once-daily treatment of bronchospasm in COPD.

21
Q

Aclidinium is indicated for…

A

Long-term maintenance of bronchospasm in COPD

22
Q

Examples of Methylxanthines include…

A

Theophylline
Theobromide
Caffeine

23
Q

MOA of Theophylline…

A
  1. Inhibit PDE and slow cAMP degradation.
  2. Inhibit adenosine’s action of bronchoconstriction.

—> both lead to bronchodilation and suppression of response to airway stimuli.

24
Q

What are the contraindications for Methylxanthines?

A

Acid-peptic Dz
Seizures
Arrhythmias

25
Q

What is the most effective controllers and anti-inflammatory agents of Asthma?

A

Inhaled corticosteroids

26
Q

What is the MOA of ICS?

A
  • Switch off transcription of multiple genes encoding inflammatory proteins.
  • Reduce levels of eosinophils, T-cells and mast cells in airway mucosa.
27
Q

How often are ICS taken?

A

2x daily

28
Q

What should be given as first-line therapy in patients with persistent asthma?

A

ICS

29
Q

If symptoms are not controlled well with an ICS, what else could be added?

A

A LABA in addition to an ICS

30
Q

What are the suffixes of ICSs?

A
  • sone

- ide

31
Q

The major caution of giving Beclomethasone is…

A

In patients who have been on systemically active corticosteroids prior, it can cause adrenal insufficiency and death.

32
Q

Budesonide should not given during…

A

Should not be given in treatment of status asthmaticus or acute attacks.

33
Q

Ciclesonide should not be given in….

A

The treatment of acute bronchospasm AND in patients with a Thrush infection.

34
Q

Flunisolide might be able to….

A

Reduce or eliminate the need for OCS

35
Q

Major side effect of Fluticasone is…

A

Thrush

36
Q

Mometasone is contraindicated in patients with…

A

A known milk hypersensitivity

37
Q

Triamcinolone is given to patients who need…

A

Systemic corticosteroid therapy

38
Q

Triamcinolone does not relieve…

Deaths from…. have happened

A

Does not relieve acute bronchospasm.

Deaths from adrenal insufficiency has happened.

39
Q

Major OCS used is…

A

Prednisone

40
Q

Leukotriene antagonists are given for…

A

Treatment and prevention of acute asthma attacks

41
Q

The MOA of Leukotriene antagonists is…

A

Block activation nd cascade from CysLT receptors

42
Q

Montelukast inhibits…

It is given to…

A

Inhibits actions of LTD4 at the CysLT1 without agonist activity.

Given to prevents allergies and asthma attacks.

43
Q

Zariflukast inhibits…

It’s major toxicity is…

A

Inhibits LTD4 and LTE4.

Hepatotoxicity.

44
Q

Zileuton inhibits…

It should not be given to…

A

Inhibits LOX, therefore LTB4, LTC4, LTD4 and LTE4.

Not recommended in cases with active liver disease or elevated liver enzymes > 3x normal.

45
Q

Omalizumab is of what drug class?

A

Monoclonal antibody drugs

46
Q

Omalizumab MOA

A
  1. Binds to free IgE, thus decreasing cell-bound IgE.
  2. decrease expression of IgE receptors.
  3. Decreased mediator release.
  4. Decrease allergic inflammation AND prevents exacerbation.
47
Q

Omalizumab is given for…

What must the patient have in addition?

A

Moderate to severe persistent asthma.

Patients must have a positive skin test or in vitro reactivity to perennial aeroallergen and SX are not adequately controlled otherwise.

48
Q

Omalizumab, aside form asthma, can be used in the treatment of…

What is the major warning of its use?

A

Chronic idiopathic urticaria.

Anaphylaxis.

CPR II Exam #2 (20 decks)

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