Asthma and COPD

Question 1

What are the 3 different delivery formulations for asthma

Answer 1

MDI, Dry powder inhalers (DPI), and nebulizers

Question 2

This inhaler technique reduces oropharngeal deposition, minimizes importance of timing, and improves distal delivery

Answer 2

MDI with spacer

Question 3

What is the difference of breathing technique with MDI and DPI

Answer 3

with MDI, you inhale slowly and deeply and with DPI you inhale deeply and quickly

Question 4

What should you do after you inhale a corticosteroid

Answer 4

Rinse your mouth (can lead to oral thrush)

Question 5

what is the pathogenesis of asthma

Answer 5

allergy mediated response (IgE)

Question 6

What are the goals for asthma treatment

Answer 6

relax the airways, reduce inflammation, and reduce mucus secretion

Question 7

This type of asthma medicine is short-acting medicine used to treat symptoms after they have started

Answer 7

Rescue medicine

Question 8

This type of asthma medicine is long-acting medicine used to prevent symptoms before they start

Answer 8

Controller medicine

Question 9

Can controller medicine be used as a rescue medicine

Answer 9

NO

Question 10

What do B2 agonist do

Answer 10

Relax the airway SM

Question 11

Besides relaxing the SM in the airways, what else do B2 agonists do (5 things)

Answer 11

Decrease plasma exudation, decrease cholinergic neurotransmission, increase mucocillary clearance, decrease neutrophil function, and decrease bacterial adherence

Question 12

What is the MOA for B2 Agonists

Answer 12

Work through adenylate cyclase to increase cyclic AMP, leading to SM relaxation

Question 13

What is the onset for Short-acing Beta agonist (SABA)

Answer 13

10 min

Question 14

What is the peak of SABA

Answer 14

30 min

Question 15

What is the duration of SABA

Answer 15

3-6 hours

Question 16

How can SABA be administered

Answer 16

MDI, HFA, or nebulizer

Question 17

What are the side effects of SABA

Answer 17

tremor, hypokalemia, and tachycardia

Question 18

Name the two SABA drugs

Answer 18

Albuterol and Levalbuterol

Question 19

What is the onset of Long-acting Beta agonist (LABA)

Answer 19

30 min

Question 20

What is the peak of LABA

Answer 20

3 hours

Question 21

What is the duration of LABA

Answer 21

12 hours

Question 22

How can LABA be administered

Answer 22

dry powder

Question 23

What are the side effects of LABA

Answer 23

headache and throat irritation

Question 24

Name the 4 LABA

Answer 24

salmeterol, Formoterol, Indaceterol, Olodaterol

Question 25

What type of asthma drug has a black box warning

Answer 25

LABA (not indicated for use as a single agent in asthma; increase risk of death if used alone)

Question 26

Why can't LABA be used alone as a controller medicine

Answer 26

BC it can lead to down regulation of B2 receptors

Question 27

What is the MOA of anticholinergics

Answer 27

Block M3 receptors on SM cells, inhibiting bronchoconstriction

Question 28

What is the onset of anticholinergics

Answer 28

15 min

Question 29

What is the peak of anticholinergics

Answer 29

1-2 hours

Question 30

what is the duration of a short acting anticholinergic

Answer 30

2-5 hrs

Question 31

what is the duration of a long acting anticholinergic

Answer 31

24 hours

Question 32

How can an anticholinergic be administered

Answer 32

MDI, nebulizer, Handihaler, Pressair

Question 33

What patients should you not used an anticholinergic on

Answer 33

COPD or older patients with glaucoma and prostate hypertrophy

Question 34

Ipratropium

Answer 34

Short acting anticholinergic

Question 35

Tiotropium

Answer 35

Long acting anticholinergic

Question 36

Aclidinium

Answer 36

long acting anticholinergic

Question 37

umeclidinium

Answer 37

long acting anticholinergic

Question 38

DuoNeb

Answer 38

combined anticholinergic and beta agonist

Question 39

What side effect will you see with duoneb

Answer 39

cotton mouth or urinary retention

Question 40

What is the MOA of corticosteroids

Answer 40

alter gene transcription leading to less inflammation

Question 41

what is the onset of corticosteroids

Answer 41

5-8 hrs

Question 42

what is the duration of corticosteroids

Answer 42

6-24 hours

Question 43

How can corticosteroids be administered

Answer 43

Inhaled, oral or IV

Question 44

What are the side effects of corticosteroids

Answer 44

pneumonia, oral thrush, osteoporosis, cataracts, voice change

Question 45

Fluticasone

Answer 45

Corticosteroid

Question 46

Budesonide

Answer 46

Corticosteroid

Question 47

Beclomethasone

Answer 47

Corticosteroid

Question 48

Mometasone

Answer 48

Corticosteroid

Question 49

What kind of patients are leukotriene inhibitors important for

Answer 49

allergic asthmatics

Question 50

What is the MOA of leukotriene inhibitors

Answer 50

either block LTE receptors or inhibit synthesis of leukotrienes

Question 51

What is the specific MOA of zileuton

Answer 51

inhibit synthesis of leukotrienes

Question 52

what is the specific MOA of montelukast

Answer 52

Block LTE receptors

Question 53

What is the MOA of methylxanthines

Answer 53

PDE inhibition (increase cAMP), inhibits adenosine, histone deacetylase activation

Question 54

What is an important side effect of methylxanthines

Answer 54

seizures (must follow levels)

Question 55

Omalizumab

Answer 55

Anti-IgE medications

Question 56

Mepolizumab

Answer 56

Anti-IL5

Question 57

What is the cornerstone of therapy for asthma

Answer 57

Inhaled corticosteroids

Question 58

What is the first line agent for control of COPD

Answer 58

LABA or anticholinergic

Question 59

PDE4 inhibitors MOA

Answer 59

increase cAMP leading to anti-inflammatory effects

Question 60

Roflumilast

Answer 60

PDE4 inhibitor (severe COPD)

Question 61

Anticholinergic drugs end in

Answer 61

ium (ipratropium, tiotropium)

Question 62

corticosteroid drugs end in

Answer 62

sone (prednisone, fluticasone)

Question 63

Which disease needs LABA in combination with inhaled corticosteroids

Answer 63

asthma

Question 64

Which drugs should be used with caution in those with glaucoma or prostate issues

Answer 64

inhaled anticholinergics

Question 65

Which drug has significant side effects and blood levels must be monitored

Answer 65

theophylline

Question 66

which drugs are the first line controller medication for COPD

Answer 66

Long acting anticholinergics or LABA