Asthma/COPD Drugs

Question 1

what is the important parasympathetic receptors in the lungs?

Answer 1

M3

Question 2

what is the important sympathetic receptors in the lungs?

Answer 2

B2

Question 3

what does a B2 agonist cause in airway smooth muscle?

Answer 3

relaxation

Question 4

what does an M3 antagonist cause in airway smooth muscle?

Answer 4

relaxation

Question 5

what class of autonomic drugs is used for rescue therapy?

Answer 5

short acting beta agonists

Question 6

name the two short acting beta agonist drugs for respiratory ?

Answer 6

albuterol and epinephrine

Question 7

what is the issue associated with over use of albuterol?

Answer 7

can lead to desensitization of the B2 receptors in the lungs

Question 8

name the three short acting beta agonists for asthma/COPD

Answer 8

Salmeterol
Formoterol
Indacaterol

Question 9

what is the issue with beta agonists that leads to many of its toxicities?

Answer 9

it is not specific in binding and can bind other beta receptors like B1 receptors

Question 10

due to beta agonists lack of specificity…what are common toxicities?

Answer 10

tachycardia
a fib
angina
hypertension

Question 11

since beta agonists for respiratory diseases is inhaled…how much is systemically available? why is this?

Answer 11

actually about 95% because a lot of the drug is swallowed instead of inhaled

Question 12

which two beta agonist have the highest risk of cardiac toxicities?

Answer 12

epinephrine and indacaterol

Question 13

name the short acting M3 antagonist for respiratory disease

Answer 13

ipratropium

Question 14

name the four long acting M3 antagonists for respiratoyr disease

Answer 14

tiotrpium
aclidinium
umeclidinium
glycopyrronium

Question 15

name the five common toxicities with M3 antagonists

Answer 15

xerostomia
dry nasal membranes
constipation
urinary retention
tachycardia

Question 16

describe the two mechanisms of corticosteroids

Answer 16

inhibit inflammatory protein production

induce anti inflammatory protein production

Question 17

what is the main protein that corticosteroids induces for anti inflammation?

Answer 17

lipocortin

Question 18

how is lipocortin antiinflammatory?

Answer 18

it blocks phospholipase A and prevents arachidonic acid from being turned into cyclooxygenase or leukotrienes

Question 19

why are long acting beta agonists not used alone in treatment of asthma?

Answer 19

associated with premature death

Question 20

what two drugs is Advair a combo of?

Answer 20

fluticasone and salmeterol

Question 21

what two drugs is Symbicort a combo of?

Answer 21

Budesonide and formoterol

Question 22

what two drugs is Dulera a combo of?

Answer 22

Mometasone and Formoterol

Question 23

what is a side effect of inhaled corticosteroids?

Answer 23

immunosupression…so more oral and lung infections

Question 24

what two cells are in charge of production of leukotrienes? what is the role of leukotrienes in asthma?

Answer 24

mast cells and eosinophils

smooth muscle contraction

Question 25

name the three leukotriene inhibitors

Answer 25

Zileuton Montelukast Zafirlukast

Question 26

which leukotriene inhibitors target the leukotriene receptor on smooth muscle?

Answer 26

Montelukast and Zafirlukast

Question 27

which leukotriene inhibitor targets lipoxygenases or the molecules that make leukotrienes?

Answer 27

Zileuton

Question 28

name the drug that targets the IgE antibodies? what asthma can it treat?

Answer 28

Omalizumab | allergic

Question 29

name the drug that targets IL-5? what asthma can it treat?

Answer 29

Mepolizumab | any eosinophilic asthma

Question 30

name the drug that targets the IL-4Receptor? what asthma can it treat?

Answer 30

Dupilumab...asthma add on

Question 31

name the PDE4 inhibitor

Answer 31

Roflumilast

Question 32

what is the role of PDE4? why is it a target in asthma treatment?

Answer 32

PDE4 decreases the amounts of cAMP in the smooth muscle cells of the airway...cAMP is usually a bronchodilating chemical so by inhibiting PDE4 you get more cAMP available to bronchodilate

Question 33

what is the mechanism of theophylline?

Answer 33

inhibits adenosine and PDE4 in smooth muscle cells

Question 34

adenosine plays what role in smooth muscle cells of the airway?

Answer 34

it leads to smooth muscle contraction

Question 35

is theophylline classified as solely a bronchodilator or an anti inflammatory too?

Answer 35

it has effects on both bronchodilation and anti inflammation

Question 36

name two important toxicities of theophylline

Answer 36

seizures and arrhythmias

Question 37

what is the mechanism of cromolyn?

Answer 37

it inhibits mast cell degranulation

Question 38

what is the name of the drug that stabilizes mast cells?

Answer 38

cromolyn

Question 39

what is step 1 asthma treatment called? what drug to give?

Answer 39

intermittent asthma...give rescue albuterol

Question 40

what drugs are indicated in step 2 of asthma treatment?

Answer 40

low dose inhaled corticosteroid

Question 41

what drugs are indicated in step 3-5 of asthma treatment?

Answer 41

low to high dose of inhaled corticosteroids with a LABA

Question 42

what drugs are indicated in step 6 of asthma treatment?

Answer 42

high dose inhaled corticosteroid LABA and oral systemic corticosteroid

Question 43

what class of drugs is usually used in COPD?

Answer 43

anticholinergic drugs...M3 antagonist