Asthma And COPD

Question 1

What is the major route of inhaled drugs?

Answer 1

80% is swallowed, but the inhaled portion still does most the work

Question 2

What is the drug treatment plan for asthma? For COPD?

Answer 2

1. ICS - LABA - LAMA
2. LAMA - LABA - ICS

Question 3

What are the common B2 agonists (5)

Answer 3

Albuterol, terbutaline, metaprotetenol, pirbuterol, levalbuterol

Question 4

What is the only b2 drug avaliable for sub q injection

Answer 4

Terbutaline

Question 5

Which B 2 agonist is used for bronchial asthma and reversible bronchospasm

Answer 5

Metaproterenol

Question 6

What is the major risk factor for metaproterenol

Answer 6

Production of paradoxical bronchospasm

Question 7

Which B2 agonist produces significant cardiovascular effects in patients

Answer 7

Pirbuterol

Question 8

Which drug can be used in patients as young as 4 with asthma’s

Answer 8

Levabuterol. Prevents bronchospasm

Question 9

Name the inhaled corticosteroids (7)

Answer 9

Beclomethasone, budesonide, ciclesonide, fluticasone, mometasone, triamcinolone, prednisone

Question 10

What is a risk when comming off of systemically active corticosteroids in favor of inhaled ones

Answer 10

Adrenal insufficiency. Particularly with beclomethasone.

Question 11

What cell line is reduced with ICS

Answer 11

Eosinophils, t lymphocytes and mast cells

Question 12

What ICS drug can only be used as maintenance

Answer 12

Budesonide

Question 13

In which patients is budesonide and mometasone contraindicated in

Answer 13

People w milk sensitivity

Question 14

Which drug should not be given during canida infection but reduces its risk

Answer 14

Ciclesonide

Question 15

Which ICS (2) can reduce the need for oral corticosteroids

Answer 15

Flunisolide and Triamcinole

Question 16

What warning is given with fluticasone

Answer 16

Candida infection can occur during this ICS, rinse mouth after inhalation

Question 17

Which CS can be used to treat certain endocrine conditions and severe asthma flair ups

Answer 17

Prednisone

Question 18

What is the warning associated with prednisone

Answer 18

May cause pituitary adrenal axis supression

Question 19

Name the LABA (5)

Answer 19

Fomoterol, Salmeterol, indacaterol and vinanterol, oloaterol

Question 20

Why are LABAs only used last in asthma

Answer 20

Causes asthma related death and hospitalizations. Mostly used for COPD

Question 21

What is the main use of Olodaterol

Answer 21

Long term daily maintenance treatment for airway obstruction. Always use with ICS

Question 22

Name the anticholenergic drugs used in asthma and COPD

Answer 22

Atropine, ipratropium, Tiotropium, Aclinium

Question 23

What should the dose of atropine be restricted to in recurrent use

Answer 23

2-3 mg

Question 24

Which drug is relatively free if systemic atropine effects

Answer 24

Ipratropium

Question 25

How do methylxanthines work?

Answer 25

Smooth muscle relaxation and suppression of airway response to stimuli

Question 26

Name the Leukotriene R antagonist/Lipoxygenase Inhibitor (2)

Answer 26

Zafirlukast and montelukast

Question 27

What are the main effects of zafirlukast and montelukast

Answer 27

Anti inflammatory and glucocorticoid sparing

Question 28

What is the purpose of leukotryine antagonists

Answer 28

Treat and prevent acute asthma attacks by blocking cysteinyl leukotriene receptors

Question 29

What is the MOA of montelukast

Answer 29

Inhibits LTD4 at the CysLT1 receptor without agonist activity

Question 30

What is the warnings associated with zileutron

Answer 30

Immediate release withdrawn from market. Controlled release is not recommended in active liver disease. Used for chronic asthma Leukotryine antagonist

Question 31

What is the monoclonal antibody for asthma

Answer 31

Omizumab

Question 32

What is omalizumab indicated to treat

Answer 32

Severe persistent asthma, chronic idiopathic urticaria (antibody)

Question 33

What are the warnings of Omalizumab

Answer 33

Can cause anaphylaxis, (life threatening) monitor closely directly after administration

Question 34

What do you treat asthma patients with symptoms of COPD with

Answer 34

Triple therapy (ICS, LABA, LAMA)