asthma drugs

Question 1

What are the two main drug categories used for asthma treatment?

Answer 1

Anti-inflammatory drugs & Bronchodilators

Question 2

What are the four types of anti-inflammatory drugs for asthma?

Answer 2

Glucocorticoids, Leukotriene Modifiers, Cromolyn, IgE Antagonist

Question 3

What are the three types of bronchodilators for asthma?

Answer 3

Beta2 Agonists, Methylxanthines, Anticholinergics

Question 4

What are the two types of glucocorticoids used in asthma treatment?

Answer 4

Inhaled & Oral

Question 5

Name some inhaled glucocorticoids.

Answer 5

Beclomethasone, Budesonide + formoterol, Ciclesonide, Fluticasone + salmeterol, Mometasone + formoterol

Question 6

Name some oral glucocorticoids.

Answer 6

Methylprednisolone, Prednisolone, Prednisone

Question 7

What is the mechanism of glucocorticoids?

Answer 7

Suppress inflammation, reduce bronchial hyperreactivity, decrease mucus production

Question 8

How are glucocorticoids used in asthma treatment?

Answer 8

For chronic asthma, taken daily on a fixed schedule

Question 9

Are glucocorticoids used as rescue meds?

Answer 9

No

Question 10

What is the first-line treatment for asthma inflammation?

Answer 10

Inhaled glucocorticoids

Question 11

What are common adverse effects of inhaled glucocorticoids?

Answer 11

Dysphonia, hoarseness, oral candidiasis (thrush)

Question 12

What are common adverse effects of oral glucocorticoids?

Answer 12

Adrenal suppression, osteoporosis, hyperglycemia, peptic ulcers, infection, weight gain, insomnia

Question 13

What are contraindications/cautions for glucocorticoids?

Answer 13

Pregnancy/lactation, live virus vaccines, diabetes, HTN, heart failure, kidney dysfunction

Question 14

What drug interactions occur with prednisone?

Answer 14

Potassium-depleting diuretics, NSAIDs, hypoglycemic agents

Question 15

What order should Beta2 agonists & inhaled steroids be taken in?

Answer 15

Use Beta2 agonist first, then steroid

Question 16

Name three leukotriene modifiers.

Answer 16

Zafirlukast, Zileuton, Montelukast

Question 17

Are leukotriene modifiers rescue meds?

Answer 17

No

Question 18

What are the adverse effects of leukotriene modifiers?

Answer 18

Depression, suicidal ideation, liver injury

Question 19

What drug interactions occur with leukotriene modifiers?

Answer 19

Inhibit metabolism of warfarin & theophylline, phenytoin inhibits montelukast

Question 20

What is the only mast cell stabilizer used for asthma?

Answer 20

Cromolyn

Question 21

How is cromolyn administered?

Answer 21

Nebulizer

Question 22

What are the adverse effects of cromolyn?

Answer 22

Very safe; rare cough/bronchospasm

Question 23

What is the IgE antagonist used for asthma?

Answer 23

Omalizumab

Question 24

Who can use omalizumab?

Answer 24

Patients ≥12 years old with moderate-severe allergy-related asthma uncontrolled with corticosteroids

Question 25

How is omalizumab administered?

Answer 25

SubQ injection

Question 26

What are the adverse effects of omalizumab?

Answer 26

Injection-site reactions, viral infections, cardiovascular events, malignancy, anaphylaxis

Question 27

What are the two types of Beta2-adrenergic agonists?

Answer 27

SABAs & LABAs

Question 28

What are SABAs used for?

Answer 28

Rescue medication for acute bronchospasm

Question 29

Name some inhaled SABAs.

Answer 29

Albuterol + budesonide/ipratropium, Levalbuterol

Question 30

Name some oral SABAs.

Answer 30

Albuterol, Terbutaline

Question 31

What are LABAs used for?

Answer 31

Long-term asthma control, used with glucocorticoids

Question 32

Name some inhaled LABAs.

Answer 32

Arformoterol, Formoterol + budesonide/aclidinium/mometasone, Salmeterol + fluticasone, Olodaterol + tiotropium

Question 33

What are common adverse effects of Beta2 agonists?

Answer 33

Tachycardia, angina (oral), tremors

Question 34

What are contraindications/precautions for Beta2 agonists?

Answer 34

Tachydysrhythmias, caution in DM, hyperthyroidism, heart disease, HTN, angina

Question 35

What drug interactions occur with Beta2 agonists?

Answer 35

Beta blockers (counteract each other), MAOIs/TCAs

Question 36

What is the difference between SABA & LABA use?

Answer 36

SABAs are for immediate relief (PRN), LABAs are scheduled & always used with steroids

Question 37

What is the methylxanthine used for asthma?

Answer 37

Theophylline

Question 38

What is the therapeutic range for theophylline?

Answer 38

10–20 mcg/mL

Question 39

What happens at different theophylline toxicity levels?

Answer 39

<20 mcg/mL: uncommon AEs, 20–25 mcg/mL: N/V/D, insomnia, >30 mcg/mL: severe dysrhythmias, seizures, death

Question 40

What should be done for theophylline toxicity?

Answer 40

Stop theophylline, give activated charcoal, lidocaine (dysrhythmias), IV diazepam (seizures)

Question 41

What substances interact with theophylline?

Answer 41

Caffeine, tobacco/marijuana (increase clearance), cimetidine/fluoroquinolones (increase levels)

Question 42

Name a cousin of theophylline.

Answer 42

Aminophylline

Question 43

What are the two types of inhaled anticholinergics?

Answer 43

SAMA (Short-acting) & LAMA (Long-acting)

Question 44

Name a SAMA.

Answer 44

Ipratropium + albuterol

Question 45

Name some LAMAs.

Answer 45

Tiotropium + olodaterol, Aclidinium + formoterol, Umeclidinium + vilanterol

Question 46

What are common adverse effects of inhaled anticholinergics?

Answer 46

Dry mouth, hoarseness

Question 47

What are contraindications for inhaled anticholinergics?

Answer 47

Soy/peanut allergy (some contain soy lecithin), narrow-angle glaucoma, BPH

Question 48

How should inhaled anticholinergics be taken?

Answer 48

2 puffs, rinse mouth, 5 min between different inhalers