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CVPR > CVPR Week 5: Drugs used in the treatment of Asthma and COPD > Flashcards

CVPR Week 5: Drugs used in the treatment of Asthma and COPD Flashcards

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1
Q

β2 adrenergic agonists to know

3 listed

A
  • Albuterol
  • Terbutaline
  • Salmeterol
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2
Q

Muscarinic antagonists to know

2 listed

A
  • Ipratropium
  • Tiotropium
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3
Q

Phosphodiesterase inhibitors to know

2 listed

A
  • Theophylline
  • Roflumilast
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4
Q

Antileukotrienes to know

3 listed

A
  • Ziluteon
  • Zarfirlukast
  • Motelukast
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5
Q

Corticosteroids to know

2 listed

A
  • Beclomethasone
  • Fluticasone
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6
Q

Anti-IgE Antibodies to know

A

Omalizumab

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7
Q

Mast cell degranulation inhibitors to know

A

Cromolyn sodium

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8
Q

Anti-IL5 receptor antibody to know

A

Benralizumab

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9
Q

Hallmarks of asthma

9 listed

A
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10
Q

Hallmarks of COPD

8 listed

A
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11
Q

Hyperreactivity and hypersensitivity

A

sensitive to less stimulus

vs

the amount of smooth muscle contraction in response

Both are in asthma to cause Hyperresponsiveness

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12
Q

Normal control of bronchial tone

A
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13
Q

Treatment of asthma for hyperresponsiveness of the trachea and bronchi to stimuli and smooth muscle contraction

5 listed

A
  • β2-agonists
  • PDEi - Theophylline
  • Roflumilast
  • Antimuscarinics
  • Leukotriene modifiers
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14
Q

Treatment of asthma: Mucosal thickening from edema and mucus plug and cellular infiltration

6 listed

A
  • Corticosteroids
  • Leukotriene modulators
  • Mast cell stabilizer
  • Anti-IgE
  • Anti-IL5R
  • PDEi
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15
Q

Treatment of asthma: Short-term relief

A

bronchodilating agents to increase airway caliber by relaxing smooth muscles

  • β-adrenoreceptor agonists
  • Theophylline
  • Antimuscarinics
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16
Q

Treatment of asthma: Long-term control

A

Antiinflammatory agents to reduce edema, mucus and infiltration

  • Inhaled corticosteroids
  • Antileukotrienes
  • mast cell stabilizer (Cromolyn sodium)
  • Anti-IgE
  • β2 agonists
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17
Q

Bronchial tone

A
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18
Q

β2 adrenergic agonists properties

A
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19
Q

Effects of albuterol

A
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20
Q

Short-acting β2 agonists

A
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21
Q

Long-acting β2 agonists

A
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22
Q

What is the key to triggering the inflammatory cascade seen in asthma?

A
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23
Q

Anti-IL5 drugs

A

Benralizumab (Reslizumab and Mepolizumab bind IL-5

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24
Q

IL-5

Study These Flashcards
A

Anti-IL-5 alpha chain receptor mAB IL-5 is a key cytokine in eosinophil maturation, activation, survival and proliferation

25
Benralizumab in severe asthma
In severe eosinophilic asthma, Benralizumab decreased eosinophils in the airways, sputum, bone marrow and peripheral blood
26
Benralizumab adverse effects
allergic hypersensitivity reactions (including anaphylaxis)
27
Benralizumab clinical use
* Add-on maintenance therapy * approved in ages 12 and older
28
Antimuscarinics MOA in Asthma
29
Antimuscarinics MOA in Asthma
30
Antimuscarinic agents
Ipratropium bromide (Atrovent, atropine derivative) inhalation treatment for COPD Tiotropium (Spiriva) a longer-lasting agent
31
Antimuscarinic clinical uses
* Inhibits bronchoconstriction * Inhibits tracheobronchial secretions * A weak bronchodilator * Used in asthma patients intolerant to
32
Leukotriene antagonists and synthesis inhibitors
* CysLTX - a role in airway remodeling * LTD4 and LTE4 - bronchial smooth muscle constriction * LTD4 is 1000x more potent than histamine * Zafirlukast and Montelukast are competitive antagonists * Zileuton is an inhibitor of 5-Lipoxygenase * Controlling drugs
33
Leukotriene antagonists MOA
34
Leukotriene modifying agents
35
Zafirlukast toxicities
36
Ziluteon warnings/precautions
37
Methylxanthines MOA
38
Methylxanthines 2 listed
* Theophylline * Roflumilast
39
Methylxanthines clinical uses
40
Roflumilast MOA
41
Roflumilast specific MOA
PDE type 4 inhibitor
42
Roflumilast clinical uses
long acting PDE4 inhibitor (not considered a bronchodilator) For severe COPD - controller not a rescue drug
43
Roflumilast Interactions
Avoid in combination with CYP3A4/5 inhibitors or inducers (carbamazapine, cimetidine, erythromycin, fluvomoxamine, ketoconazole, phenytoin, rifampicin and some oral contraceptives)
44
Roflumilast adverse effects
* Can cause tachycardia like other PDE inhibitors * Some indication of depression * can cause muscle spasm and uncontrollable shaking
45
Bronchodilators MOA
46
Therapeutic treatment for the inflammatory side of asthma
47
Corticosteroids Hx of Tx asthma
Used to treat asthma since 1950
48
Corticosteroids for asthma 4 listed
* Methylprednisone * beclomethasone * Fluticasone * Mometasone
49
Corticosteroids clinical uses for asthma 5 listed
* reduces bronchial reactivity * increases airway caliber * Increases β2 receptors * Inhibit production of LTX, PGs and PAF * By repressing gene transcription - interferring with Nfkappa B transcriptional regulation of cytokine production, represses transcription of NOSi, COX-2, cytokine receptors
50
Corticosteroids MOA
51
Rate of death from Asthma to Corticosteroids used
52
Cromolyn sodium clinical uses
only valuable prophylactically Inhibit antigen (seasonal or situational) and exercise induced asthma No effect on airway smooth muscle tone Does not reverse bronchospasm Should not be used during an acute asthmatic episode
53
Cromolyn sodium MOA
* Cromolyn sodium alters chloride channel function which inhibits Ca2+ influx thus inhibiting mast cell function and airway nerves * In the mast cell this prevents the release of histamine and LTX * May also inhibit the function of other inflammatory cells
54
Omalizumab MOA
55
Omalizumab clinical use
* administered over 10 weeks for those with poorly controlled or severe asthma * Reduces magnitude of early and late bronchospasms responses
56
Omalizumab adverse effects
Anaphylaxis
57
Omalizumab malignancies
breast non-melanoma skin prostate melanoma parotid
58
Omalizumab infections
geohelminthic infections (roundworm, hookworm, whipworm, threadworm)
59
Cromolyn sodium, benralizumab, omalizumab MOA

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