Asthma Drugs

Question 1

Salmeterol (Serevent) Class

Answer 1

Bronchodilator (beta 2 agonist)

Question 2

Theophylline (Theolair) Class

Answer 2

Bronchodilator (Methylxanthine)

Question 3

Ipratropium (Atrovent) Class

Answer 3

Quarternary amine antimuscarinic

Question 4

Asthma corticosteroids Class

Answer 4

Anti-inflammatory agent

Question 5

Cromolyn sodium (Intal) Class

Answer 5

Anti-inflammatory agent

Question 6

Montelukast (Singulair) Class

Answer 6

Anti-inflammatory agent (leukotriene modifier)

Question 7

Pranlukast (Azlaire) Class

Answer 7

Anti-inflammatory agent (leukotriene modifier)

Question 8

Zafirlukast (Accolate) Class

Answer 8

Anti-inflammatory agent (leukotriene modifier)

Question 9

Zileuton (Zyflo) Class

Answer 9

Anti-inflammatory agent (leukotriene modifier)

Question 10

Salmeterol (Serevent) MOA

Answer 10

Relax bronchial smooth muscle, inhibit mediator release (mast cells, basophils), increase mucociliary clearance, suppression of microvascular permeability

Question 11

Theophylline (Theolair) MOA

Answer 11

Phosphodiesterase inhibition and enhanced signalling via increased cAMP and cGMP; relax bronchial smooth muscle

Question 12

Ipratropium (Atrovent) MOA

Answer 12

Blocks vagal pathways and decreases vagal tone to bronchial smooth muscle; also blocks the reflex bronchoconstriction caused by inhaled irritants

Question 13

Asthma corticosteroids MOA

Answer 13

Anti-inflammatory effects: inhibition of growth factor secretion, inhibition of arachidonic acid metabolites and platelet activation factor, inhibition of leukocyte accumulation, decreased vascular permeability, inhibition of neuropeptide-mediated responses, inhibition of mucous glycoprotein secretion

Question 14

Cromolyn sodium (Intal) MOA

Answer 14

Not clear, may stabilize and prevent mediator release from mast cells

Question 15

Montelukast (Singulair) MOA

Answer 15

Leukotriene receptor antagonist

Question 16

Pranlukast (Azlaire)MOA

Answer 16

Leukotriene receptor antagonist

Question 17

Zafirlukast (Accolate) MOA

Answer 17

Leukotriene receptor antagonist

Question 18

Zileuton (Zyflo) MOA

Answer 18

Inhibits 5-lipoxygenase and blocks leukotriene synthesis

Question 19

Salmeterol (Serevent) Therapy

Answer 19

Prevent or reduce exercise-induced bronhospasms; mild asthma & acute exacerbations

Question 20

Theophylline (Theolair) Therapy

Answer 20

Reduce inflammation and bronchospasm in moderate to severe asthma, night symptoms; NOT as diuretic

Question 21

Ipratropium (Atrovent) Therapy

Answer 21

Status asthmaticus (w/ nebulized beta 2-agonists); partially reverse obstruction in COPD

Question 22

Asthma corticosteroids Therapy

Answer 22

Inhaled are a preventer of asthma attacks (not reliever); oral are used for uncontrolled moderate to severe asthma (10-14 day “burst”)

Question 23

Cromolyn sodium (Intal)Therapy

Answer 23

Prophylaxis for inhibiting both early and late phase reactions; best results in mild and allergic asthma

Question 24

Montelukast (Singulair) Therapy

Answer 24

Long-term asthma control and prevention of symptoms in mild persistent asthma

Question 25

Pranlukast (Azlaire)Therapy

Answer 25

Long-term asthma control and prevention of symptoms in mild persistent asthma

Question 26

Zafirlukast (Accolate) Therapy

Answer 26

Long-term asthma control and prevention of symptoms in mild persistent asthma

Question 27

Zileuton (Zyflo) Therapy

Answer 27

Long-term asthma control and prevention of symptoms in mild persistent asthma

Question 28

Salmeterol (Serevent) SE

Answer 28

Can mask progressively severe inflammation; overuse down-regulates b-receptor (become refractory). Tachycardia, muscle tremor

Question 29

Theophylline (Theolair) SE

Answer 29

Larger doses give nausea, vomiting, CNS stimulation or seizures, tachycardia/arrythmias

Question 30

Ipratropium (Atrovent) SE

Answer 30

Typically none

Question 31

Asthma corticosteroids SE

Answer 31

Inhaled has thrush, hoarseness, dry cough, mild adrenal suppression (higher doses); oral has mood-swings, increased appetite, and suppression of adrenocorticotropic hormone secretion (Cushing's Syndrome)

Question 32

Cromolyn sodium (Intal) SE

Answer 32

Minimal local side effect (cough)

Question 33

Salmeterol (Serevent) misc

Answer 33

10-15 minutes to take action, 6-12 hours (max) of duration; nebulizer delivers more, but greater side effects; oral is least effective (requires more dose --> side effects); can be used night symptoms, but not ideal

Question 34

Theophylline (Theolair) misc

Answer 34

FeNa = 5%; aminophylline = theophylline + ethyelenediamine (solubility agent); metabolized by liver; cimetidine and quinoline increase blood levels

Question 35

Ipratropium (Atrovent) misc

Answer 35

Typically used when there is a severe bronchitic component, unrelated to inflammation; inhaled, slower onset of action; restricted to lung (quarternary)

Question 36

Asthma corticosteroids misc

Answer 36

Prednisone, prednisolone, methyl prednisolone, dexamethasone, betamethasone

Question 37

Asthma corticosteroids misc

Answer 37

Prednisone, prednisolone, methyl prednisolone, dexamethasone, betamethasone