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Pharmacology III > Asthma & COPD > Flashcards

Asthma & COPD Flashcards

(65 cards)

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1
Q

SABAs… (2)

A

Albuterol

Levalbuterol

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2
Q

LABA (1)

A

Salmeterol

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3
Q

Leukotriene inhibitors

A

montelukast/zafirlukast

Zileuton

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4
Q

Inhaled CS (5)

A 
Fluticasone
Flunisolide
Beclomethasone
Budesonide
Triamcinolone
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5
Q

a LABA should always be combined with…

A

inhaled CS

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6
Q

3 features of asthma…

A

reversible obstruction

airway inflammation

Increased airway responsiveness

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7
Q

What substances released from inflammatory cells cause bronchoconstriction and edema?

A

Leukotrienes

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8
Q

What substances released from inflammatory cells cause bronchoconstriction, sustained airway hyperreactivity, edema, chemotaxis of eosinophils?

A

platelet-activitating factor

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9
Q

Prostaglandins cause…

A

inflammation

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10
Q

These chemicals attract and activate eosinophils and stimulate IgE production in B-lymphocytes

A

Interleukins

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11
Q

What is the only drug that is used PRN to treat acute asthma attack/exacerbation

A

SABA

albuterol/levalbuterol

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12
Q

These drugs for asthma decrease the likelihood of bronchospasm and prevent attacks

A

LABA (salmeterol)

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13
Q

These are used to produce bronchodilation in COPD

A

cholinergic antagonists

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14
Q

Which three asthma drug classes can reduce inflammation

A

CS, Leukotriene inhibitors, Monoclonal Ab

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15
Q

This decreases the release of histamine from mast cells…

A

cromolyn

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16
Q

This is a CNS stimulant that can produce long-lasting bronchodilation

A

theophyline

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17
Q

What happens to cilia and goblet cells in COPD?

A

immobilized cilia

excess mucous production

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18
Q

Generally, COPD is treated with _______ or _______

A

LABA or inhaled anticholinergics

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19
Q

what two drugs can be used for acute COPD exacerbations?

A

ipratropium

albuterol

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20
Q

Mechanism for beta 2 agonists…

A

activate adenylate cyclase

increase cAMP

relax SM, bronchioles, stabilize mast cells

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21
Q

What class of drugs are the most effective bronchodilators?

A

beta-2 agonists

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22
Q

Where are beta 1 located?

A

heart

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23
Q

onset and duration of action for albuterol/levalbuterol…

A

fast onset

4-8 hours

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24
Q

onset and duration of action for salmeterol?

A

onset 20 minutes

duration 12 hours

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25
In addition to a LABA and ICS, what should always be prescribed to asthma patients?
SABA
26
4 common beta 2 agonist S/Es?
tachy nervousness dizziness tremor
27
What is responsible for tolerance to beta 2 agonists?
chronic use = receptor downregulation
28
Tolerance to beta 2 agonists occurs more/less in the lungs than other tissues
less
29
Tolerance to beta 2 agonists has more an effect on _______
side effects
30
2 muscarinic antagonists...
ipratropium tiotropium
31
Use of ipratropium/tiotropium
COPD
32
When could you consider ipratropium/tiotropium (M antagonists) in asthma patients?
if B2 agonist alone isn't sufficient
33
What are the advantages of Tiotropium?
longer duration of action QD admin
34
Combivent is a rescue inhaler that contains...
albuterol + ipratropium
35
Mechanism for Theophylline
Blocks adenosine receptor AND PDE inhibitor --> increased cAMP + epi mimetic
36
When should theophylline be considered? Why?
insufficient beta 2 agonist response low therapeutic index (easy to OD)
37
route of admin for theophylline?
PO
38
Is it safe to switch between brands of theophylline once a dose has been established?
no
39
What 4 things increase the clearance of theophylline in the liver?
Phenytoin, TOBB, rifampin, OCs
40
What two drugs decrease the clearance of theophylline?
cimetidine, erythromycin (P450 inhibitor)
41
Major, serious side effect of theophylline?
arrhythmia
42
mild SE of theophylline
nervousness, insomnia
43
_______ improve sxs and decrease the requirement for _______ in asthma patients w. in 1 week.
ICS Beta agonists
44
When should PO CS be considered?
short course for exacerbation taper to ICS
45
Does short term use of PO CS carry risk of serious SEs?
no
46
These drug has the following effects: - decrease inflammatory cell number - decrease cytokines and cytokine mediators - decrease capillary permeability - decrease mucus secretion - increase beta 2 receptors on airway smooth muscle
CS
47
3 major side effects of ICS?
OP Candidiasis Hoarseness Decreased bone Density
48
What can be used to limit the SEs of ICS?
spacer
49
Two PO steroids used for asthma/COPD?
methylprednisolone, prednisone
50
4 major SEs of chronic systemic CS therapy?
osteoporosis, thin skin, hyperglycemia, truncal obesity
51
Short term SEs of systemic CS?
hyperactivity, insomnia, restlessness
52
Which drug class will decrease the asthmatic response to exercise or cold air, and decreases the need for steroids?
leukotriene inhibitors
53
Which leukotriene inhibitors block the receptor?
Zafirlukast + Montelukast
54
Which leukotriene inhibitor blocks 5-LOX, and therefore decreases synthesis?
Zileuton
55
Which drug may decrease asthmatic reaction to ASA?
Zileuton (blocks 5-lox)
56
4 SEs of leukotriene inhibitors?
increased URI ST Sleepiness Psych sxs
57
Mechanism for Omalizumab?
Ab targeted to IgE Prevents binding/activation of mast-cells/basophils
58
Omalizumab should be considered for what reason?
decrease CS need Reduce exacerbation adjunct to therapy
59
Route for omalizumab
SC Injection q 2--4 weeks
60
Mechanism for Benralizumab, mepolizumab, reslizumab...
Ab targeting IL-5... reduces eosinophil function
61
Indication for Benralizumab, mepolizumab, reslizumab
severe, eosinophilic asthma | decreases CS need
62
route for Benralizumab, mepolizumab, reslizumab
SC injection q 4 weeks
63
this drug inhibits the release of histamine from mast cells...
cromolyn
64
Describe the dosing for cromolyn...
several times daily, chronically
65
Cromolyn is effective as a _____ agent for asthma...
prophylactic

Pharmacology III (15 decks)

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