Anti-Asthma Flashcards
(128 cards)
1
Q
Responsible for processing
the oxygen into the blood
system and exhaling
carbon dioxide
A
Respiratory System
2
Q
2 major parts of respiratory system
A
Upper and Lower
3
Q
Upper respiratory system comprises of
A
pharynx to trachea
4
Q
lower respiratory system includes
A
lungs to alveoli
5
Q
Common Respiratory Disorders
A
-Asthma
-Chronic Obstructive Pulmonary Disorder (COPD)
-Cystic Fibrosis
-Tuberculosis
6
Q
Episodic narrowing and inflammation of the airway caused by stimuli
A
Asthma
7
Q
Chronic bronchitis
Emphysema
A
Chronic Obstructive Pulmonary Disorder (COPD)
8
Q
Thick secretion are excreted into the lung
A
Cystic Fibrosis
9
Q
Infection caused by Mycobacterium tuberculosis
A
Tuberculosis
10
Q
one of its manifestation is having barrel shoulders
A
COPD
11
Q
T/F: COPD is irreversible and progressive
A
T
12
Q
T/F: We don’t give NSAIDS to
asthmatic patients , We give
inhaled corticosteroid (ICS):
A
T
13
Q
prevent asthma episodes
A
Controller
14
Q
specifically for asthma attack
A
Reliever
15
Q
Drugs used in Asthma
A
Bronchodilators
Anti-inflammatory agents
Leukotriene antagonist
16
Q
Beta 2 - agonist
Methylxanthines
Muscarinic
antagonist
A
Bronchodilators
17
Q
Release inhibitors
Antibodies
Steroids
A
Anti-inflammatory agents
18
Q
Lipoxygenase inhibitor (Zileuton)
Receptor inhibitor (Zafirlukast, Montelukast)
A
Leukotriene antagonist
19
Q
- Inflammation of the airways
- Constrictions
A
Asthma
20
Q
Treatment of asthma involves:
A
- Dilation of airway
- Reduction of inflammation
21
Q
Asthma manifestations
A
-tightness of chest
-shortness of breath
-wheezing
22
Q
T/F: Asthma is always a reaction to allergen
A
T
23
Q
can cause bronchodilation
A
B2 agonist
24
Q
T/F: you should not give non-selective to asthmatic patients, give selective instead
A
T
25
Sympathomimetic Agents
Adrenoreceptor agonist
26
Sympathomimetic Agents stimulates ______________________
and ____________ the formation of
intracellular cAMP
adenylyl cyclase (AC); increases
27
Sympathomimetic Agents Binds to __________________, stimulating
the cAMP in the smooth muscle,
causing it to __________ and inhibiting
the release of bronchoconstricting
mediators from mast cells.
Binds to beta-receptor; relax
28
Dilation of the bronchioles
Sympathomimetic Agents
29
Best delivered by inhalation
Sympathomimetic Agents
30
more cAMP = _______ bronchodilation
more
31
Can you give B2 and Theophylline at the same time?
Yes
32
Rapid-acting bronchodilator when injected subcutaneously or as
inhaled as micro aerosol
Epinephrine
33
Maximal bronchodilation of epinephrine is achieved __________ minutes after inhalation and
last for ___________ minutes
15; 60 – 90
34
Epinephrine may cause
Tachycardia
Arrhythmia
Worsening of angina pectoris
35
May also be used for treating acute vasodilation, shock, and
bronchospasm of anaphylactic shock
Epinephrine
36
Longer duration of action compared to epinephrine
Ephedrine
37
A more pronounced central activity and a much lower potency
Ephedrine
38
Infrequently used in the management of asthma
Ephedrine
39
Potential non-selective B1 and B2 bronchodilator
Isoproterenol
40
Micro aerosol from pressurized canister
Isoproterenol
41
Isoproterenol at ____________ causes bronchodilation within 5 minutes
– 80 – 120 mcg
42
Rarely used for asthma
Isoproterenol
43
Albuterol, Terbutaline, Metaproterenol and Pirbuterol
Short Acting Beta -2 Agonist (SABA)
44
Available as a metered dose inhaler
SABA
45
Albuterol and Terbutaline are also available in ________ form
oral
46
Bronchodilation caused by SABA is maximal within ____________ and persistent for _______
15 minutes; 3 – 4
hours
47
SABA can be diluted in _________ for administration from a hand-held nebulizer
saline
48
Terbutaline is also available as ______ injection
SQ
49
Large doses of ____________ may sometimes be used to inhibit uterine
contraction
terbutaline
50
Salmeterol and Formeterol
LABA
51
LABA's Duration of action 12 or more hours as a result of ___________
high lipid solubility
52
* Need to be taken once daily
* Used for treatment of COPD
Ultra Long-Acting Beta 2 Agonist
53
Purine derivatives
Methylxanthine
54
Caffeine, theophylline, theobromine
Methylxanthine
55
once a mainstay of asthma treatment
Theophylline
56
Inhibits phosphodiesterase → _________________ concentration of
intracellular cAMP and in some tissues cGMP
increasing
57
stimulates cardiac function, relaxation of smooth
muscles and reduction in the immune and inflammatory activity
cAMP
58
Methylxanthine that is;
-Absorbed well in the GI
-Metabolized in the liver
Theophylline
59
Theophylline dosing iv therapy
3 – 4 mg/kg q 6
60
Theophylline plasma concentration:
5
– 20 mg/L
61
Methylxanthine SE:
* Gastrointestinal distress
* Tremor
* Insomnia
62
MEthylxanthine Toxicities:
* Arrythmia
* Hypotension
* Vomiting
63
Antidote for methylxanthine
Beta blocker
64
Datura stramonium
Antimuscarinic Agents
65
Competitively inhibits the action of acetylcholine at the
muscarinic receptor
Antimuscarinic Agents
65
Antimuscarinic Agents _____________ (competitively/partially) inhibits the action of acetylcholine at the
muscarinic receptor
competitively
66
Blocks the contraction of airway smooth muscle and the
increased secretion of mucus
Antimuscarinic Agents
67
Very high concentrations are required to inhibit the response of
airway smooth muscle to non-muscarinic stimulation.
Antimuscarinic Agents
68
prototypic muscarinic antagonis
Atropine
69
SAMA
Ipratropium
70
Selective quaternary ammonium derivative of atropine
SAMA
71
Greater bronchodilation with less toxicity from systemic absorption
SAMA
72
Can be delivered into the circulation and does not readily enter the
CNS
SAMA
73
T/F: SAMA is as effective as albuterol in patients with COPD
T
74
Tiotropium, Aclidinium
LAMA
75
Binds to the M1, M2, and M3 receptors with equal affinity, but
dissociates most rapidly from M2 receptor
LAMA
76
LAMA dissociates most rapidly from ___________ receptor
M2
77
LAMA is taken by
inhalation
78
A single dose of 18 mcg of __________ – 24 hours duration,
Tiotropium
79
400
mcg of _________ – 12 hours duration thus taken 2x daily
aclidinium
80
Daily inhalation of ____________ has been shown to improve the
functional capacity of patients with COPD as well as reduce
_____________
Tiotropium; exacerbation frequency
81
T/F: LAMA is not part of maintenance
medications for patients with Asthma but only given as add ons
T
82
frequently used corticosteroids
Inhaled corticosteroids
83
Inhibit phospholipase A2 and COX-2 expression
Corticosteroids
84
effect of Corticosteroids
Reduce inflammatory cytokines
* The thickness of the respiratory mucosa is reduced
* Does not have an effect on dilation
85
Used routinely in combination with β agonist
Corticosteroids
86
Urgent treatment corticosteroid
Prednisolone (oral) - 30 – 60 mg per day or
Methylprednisolone (IV) - 1mg/kg every 6 – 12 hours
87
Beclomethasone, Budesonide, Ciclesonide, Flunisolide, Fluticasone,
Mometasone, Triamcinolone
Inhalational Corticosteroid (ICS)
88
minimal systemic absorption
Inhalational Corticosteroid (ICS)
89
An Average daily dose of ___________________ is equivalent to
10 – 15mg/day of oral prednisolone
800 mcg of Beclomethasone
90
__________ oral therapy slowly before switching from oral to ICS to avoid
adrenal insufficienc
Taper
91
commonly occurs in patients using inhaled
topical corticosteroid
Oropharyngeal candidiasis
92
it inhibits early and later
response to antigen on mast cells and eosinophil
Release Inhibitor
93
Block bronchoconstriction caused by allergen inhalation,
exercise, sulfur dioxide and variety of causes of occupational
asthma
Release Inhibitor
94
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
Release Inhibitor
95
Useful in reducing allergic rhinnoconjunctivitis
Release Inhibitor
96
Side effects are minor and localized to the site of deposition
Release Inhibitor
97
Release inhibitor se
* Throat irritation, cough, and mouth dryness
* Rarely, chest tightness and wheezing
* Administering B2 agonist before Cromolyn or Nedocromil treatment
prevents these symptoms
98
Cromolyn, Nedocromil
Release Inhibitors
99
* Inhibiting the mast cell and have no direct bronchodilator effect
Cromolyn, Nedocromil
100
Low solubility and poorly absorbed from the GI tract thus, it must be
inhaled as microfine powder or microfine suspension
Cromolyn, Nedocromil
101
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
Cromolyn, Nedocromil
102
from the action of 5-lipoxygenase on arachidonic
acid is synthesized by various inflammatory cells in the airways.
Leukotriene
103
potent neutrophil chemoattractan
LTB4
104
exert many effects known to occur in asthma,
including bronchoconstriction, increased bronchial reactivity,
mucosal edema, and mucus hypersecretion
LTC4 and LTD4
105
Leukotriene Pathway Inhibitor approaches
* Inhibition of 5-lipoxygenase thereby preventing leukotriene synthesis
* Inhibition of the binding of LTD4 to its receptor on target tissue
106
– lipoxygenase inhibitor
Zileuton
107
– LTD4 receptor antagonist
Zafrilukast and Montelukast
108
Leukotriene inhibitor is usually taken
orally
109
Leukotriene inhibitor that is Approved for children as young as 12 months
* Montelukast
110
most prescribed leukotriene inhibitor
Montelukast
111
T/F: Montelukast can be taken without regard to meals
T
112
Montelukast is taken ______ daily
once
113
Least prescribed due to liver toxicity
Zileuton
114
Not as effective as an inhaled steroid
Leukotriene inhibitor
115
Not recommended for acute asthma
Leukotriene inhibitor
116
Leukotriene inhibitor is effective in
* Exercise-induced bronchospasm
* Antigen 2induced bronchospasm and aspirin allergy
* Aspirin-induced bronchospasm
117
Leukotriene inhibitor Toxicity
Generally low
118
occasional elevation of liver enzyme
Zileuton
119
Anti-IgE Monoclonal Antibodies
Omalizumab
120
Humanized murine monoclonal antibody
Omalizumab
121
Prevents the activation by asthma trigger antigens
Omalizumab
122
Inhibits the binding of IgE but does not activate IgE already bound to
the mast cells and thus does not provoke mast cell degranulation
Omalizumab
123
Omalizumab is given ___________ every 2- 4 weeks to asthmatic patients
subcutaneously
124
Mepolizumab & Reslizumab
Anti-IL5 Therapy
125
targeting IL- 5 receptor
Benralizumab
126
T2 cells secrete IL 5 as pro-eosinophilic cytokine, resulting in
_________
eosinophilic airway inflammation
127
Prevent exacerbation in asthmatic patients with peripheral
eosinophilia, add on maintenance therapy of severe asthma in
patient with an eosinophilic asthma.
Anti-IL5 Therapy
