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Pharm 3 Test 5 > Asthma > Flashcards

Asthma Flashcards

1
Q

What is known about the etiology of asthma?

A

Not a ton exactly. The etiology is far from completely understood. It does related to genes, environmental and biological triggers.

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2
Q

What are the characteristics of asthma?

A

Airway inflammation
Airway obstruciton-REVERSIBLE
Hyperresponsiveness

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3
Q

Define IAR and LAR

A

Immediate asthmatic response-Occurs over minutes

Late asthmatic response- Occurs over hours

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4
Q

What is the key cell involved in immediate asthmatic response?

A

Mast cells. They release histamines, also leukotrienes and other inflammatory responses

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5
Q

What triggers mast cell activation?

A

Antigen

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6
Q

What is getting activated in lat asthmatic responses?

A

Activation of other inflammatory mediators like eosinophils that is activated by mast cells and lymphocytes

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7
Q

How many levels are there of asthma classification?

A

Four

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8
Q

What is the definition of FEV1

A

Forced expiratory volume in 1 second

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9
Q

What is the definition of PEF

A

Peak expiratory flow, the speed of the air moving out of your lungs at the beginning of the expiration

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10
Q

What is COPD mediated by?

A

Neutrophils

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11
Q

What are the four components of treating and managing asthma?

A

1- Measures of asthma assessment and monitoring
2- Education
3- Control of environmental factors and other triggers
4- Meds

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12
Q

What is the main thing needed for component 2?

A

A written asthma action plan for daily management and how to recognize/handle worsening asthma symptoms

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13
Q

What is the key points of component 3?

A

Avoid non selective beta blockers
Reducing allergens
Avoid triggers

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14
Q

What are the SABAs? Short acting beta 2 agonists

A

Albuterol and levolbuterol

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15
Q

What changed in the mid 2020s for management of asthma?

A

Use inhaled corticosteroids instead of SABA for patients over 12

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16
Q

What are the LABAs for asthma? Long acting beta agonists

A

Salmeterol and formoterol

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17
Q

What are the LABAs for COPD?

A

Aformoterol, indacaterol, vilanterol (Can be used for asthma I guess), olodaterol,

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18
Q

Which LABA is highly selective for B2 over B1?

A

Olodaterol

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19
Q

What is the mnemonic for short acting beta agonists?

A

Effective, BUT short acting
alBUTerol
levalBUTerol

20
Q

What is the pneumonic for LABAs for COPD?

A

Airway-Arformoterol
Is- Indacaterol
Very- Vilanterol (can be used for asthma)
Obstructed- Olodaterol

21
Q

What is the MOA of Beta 2 agonists?

A

Stimulation of adenylyl cyclase, increasing cAMP and increasing bronchial dilation

22
Q

What are the potential problems with inhaled beta 2 agonists?

A

Regular use is associated with diminished control of asthma

23
Q

What medication should never be used with asthma without concurrent ICS use?

A

LABAs

24
Q

What is the MOA of antimuscarinic compounds?

A

Inhibit the action of ach at muscarinic receptors

-Basically prevents bronchoconstriction

25
Q

What is the pneumonic for long acting muscarinic antagonists?

A 
Is- Ipatropium- Only for asthma
That- Tiotropium- COPD for the rest
All- Aclindinium
Understood- Umeclidinium
Go- Glycopyrrolate
Roos- Revefenacin
26
Q

What serious side effects can aclidinium cause?

A

Diabetes, cardiac effects

27
Q

What is the MOA of theophylline?

A

Blocks adenosine, preventing bronchoconstriction. Also inhibits PDE, causing more cAMP to cause bronchodilation

28
Q

What are the inhaled corticosteroids?

A

Fluticasone, budesonide, beclomethasone, ciclesonide, and mometasone

29
Q

How large of a dose of theophyliline will cause vomiting, arrhythmias, or intractable seizures?

A

Greater than 20mcg/ml

30
Q

What is inhaled corticosteroids MOA?

A

Inhibit multiple cell types involved in process of inflammation.

31
Q

What is the age cut off for use of inhaled corticosteroids?

A

12 years and older CAN use it

32
Q

What is a situation to be cautious with when it comes to giving ICS?

A

When a patient has an infection like HIV

33
Q

What class of drug is cromolyn?

A

Mast cell stabalizer

34
Q

What is cromolyns MOA?

A

Prevents release of inflammatory chemicals, histamine from mast cells, but may do more

35
Q

What is cromolyn not good for?

A

Acute attacks

36
Q

What has cromolyn been replaced by predominately?

A

LTRA

37
Q

What is an LTRA?

A

Leukotriene receptor antagonist

38
Q

What are the LTRAs?

A

Motelukast and zafirlukast

39
Q

What is the MOA of LTRAs?

A

Block binding of leukotrienes to CysLT1 receptors

40
Q

What class is Zileuton?

A

Lipoxygenase inhibitor

41
Q

What drug class is Omalizumab?

A

Immunomodulator

Anti-Ige

42
Q

What scenario is Omalizumab ideal for?

A

Asthma of allergic etiology

43
Q

What are some other immunomodulators? The pneumonic?

A 
Mepolizumab
Reslizumab
Benralizumab
Dupilumab
MRBD- For eosinophillic

Only Omalizumab for allergic asthma

44
Q

What infection is contraindicated for use of biologics that treat eosinophillic asthma?

A

Helminth infection

45
Q

What are the treatment options for COPD?

A

SABA, LABA, ICS, theophylline
Phosphodiaterase 4 inhibitor- Roflumilast
Antibiotics- Azithromycin
Antimuscarinics- Tiotropium, aclidinium

Pharm 3 Test 5 (4 decks)

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