Drugs for asthma and COPD

Question 1

Non-selective adrenergic agonists that can be used for asthma and COPD

Answer 1

Epinephrine
Ephedrine
Isoproterenol

Question 2

Adverse effects of Epinephrine

Answer 2

Tachycardia
Arrhythmias
Angina pectoris - worsen

Question 3

Treatment of acute vasodilation and bronchospasm of anaphylaxis

Answer 3

Epinephrine

Question 4

Drug with a similar mechanism to epinephrine, but with a longer activity

Answer 4

Ephedrine

Question 5

Mechanism of epinephrine

Answer 5

Stimulates alpha, beta-1, and beta-2 receptors

Question 6

Mechanism of isoproterenol

Answer 6

Stimulates beta-1 and beta-2

Question 7

Side effect of isoproterenol

Answer 7

Arrhythmias

Question 8

Short acting beta-2 agonists used for asthma and COPD

Answer 8

Albuterol
Terbutaline
Levalbuterol

Question 9

Most widely used sympathomimetics for the treatment of acute bronchoconstriction

Answer 9

Albuterol
Terbutaline

Question 10

Long acting beta-2 agonists used for asthma and COPD

Answer 10

Salmeterol
Formoterol
Bambuterol

Question 11

Used only in combination with inhaled corticosteroid for asthma, offering complementary synergistic actions

Answer 11

LABAs

Question 12

May be used alone in COPD or with anticholinergics or inhaled corticosteroids

Answer 12

LABAs

Question 13

Risk with high dose or prolonged use of LABAs

Answer 13

Hypokalemia

Question 14

Methylxanthine drugs used as add on therapy in pts with severe asthma or COPD

Answer 14

Theophylline
Theobromine
Aminophylline

Question 15

Drug class that inhibits PDE enzymes to increase concentrations of IC cAMP. Used in asthma and COPD

Answer 15

Methylxanthine drugs

Question 16

Asthma and COPD drug class the enhances histone deacetylation to inhibit inflammatory gene transcription

Answer 16

Methylxanthine drugs

Question 17

Drug class that improves contractility of skeletal muscle and reverses diaphragm fatigue in COPD

Answer 17

Methylxanthine drugs

Question 18

Adverse effects of methylxanthine drugs

Answer 18

Nervousness and tremor
Medullary stimulation, convulsions, and death
Tachycardia and arrhythmias
Increase CO and TPR

Question 19

Contraindications of methylxanthine drugs

Answer 19

Metabolized by CYP450 and narrow therapeutic index

Question 20

Selective phosphodiesterase 4 inhibitor used in severe COPD

Answer 20

Roflumilast

Question 21

Antimuscarinic agents used mostly in COPD

Answer 21

Ipratropium
Tiotropium

Question 22

Used in COPD for pts intolerant of beta-agonists

Answer 22

Antimuscarinic agents

Question 23

Added in combination to inhaled corticosteroid/LABA to provide additional bronchodilation in pts with persistent airflow obstruction

Answer 23

Tiotropium

Question 24

Adverse effects of antimuscarinic agents

Answer 24

Dry mouth
Urinary retention
Increased risk of dementia in elderly

Question 25

Inhaled corticosteroids

Answer 25

Mometasone Fluticasone Budesonide Beclomethasone Triamcinolone

Question 26

Adverse effects of inhaled corticosteroids

Answer 26

Oral candidiasis Vocal cord changes

Question 27

Mechanism of inhaled corticosteroids

Answer 27

Alters gene expression and reduces inflammatory mediators

Question 28

Systemic corticosteroids used for asthma and COPD

Answer 28

Prednisone Methylprednisolone Hydrocortisone

Question 29

Drug class that upregulates expression of beta-adrenergic receptors

Answer 29

Corticosteroids

Question 30

Risk with chronic use of steroids

Answer 30

Osteoporosis Cataracts

Question 31

Leukotriene pathway inhibitors

Answer 31

Zileuton Zarfirlukast Montelukast

Question 32

5-lipoxygenase inhibitor used for aspirin induced asthma

Answer 32

Zileuton

Question 33

Asthma medication that requires monitoring of LFTs

Answer 33

Zileuton

Question 34

LTD4 receptor (CysLT1) antagonists used in mild asthma and aspirin induced asthma

Answer 34

Zarfirlukast Montelukast

Question 35

Humanized monoclonal antibody to human IgE that inhibits its binding to mast cells

Answer 35

Omalizumab

Question 36

Mast cell stabilizers used in asthma and allergic rhinitis

Answer 36

Cromolyn Nedocromil