Exam 3 - Random info Flashcards by Rehman Hameed

inhaled corticosteroids (ICS) adverse effects (3)

oral thrush, cough, dysphonia

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ICS’s may increase the risk of _________ in patients with COPD

pneumonia

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LABA adverse effects (4)

tachycardia, headache, tremor, hypokalemia

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boxed warnings for LABAs (2 of them)

-LABAs should not be used for monotherapy, increased risk of asthma related death
-increasing hospitalizations in pediatric and adolescent patients

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adverse effects for LAMAs (5)

-dry mouth
-dizziness
-blurred vision
-upper respiratory infections
-paradoxical bronchospasms (unanticipated smooth muscle contraction)

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adverse effects of cromolyn (6)

-high incidence of unpleasant taste in mouth (>10%)
-rare cardiac arrythmias
-coughing
-dyspnea (shortness of breath)
-sore throat
-N/V/D (nausea, vomiting, diarrhea) if absorbed systemically

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cromolyn prevents _________ in bronchial hyperactivity seen in allergy season

a. increase
b. decrease

a. increase

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adverse effects of leukotriene modifiers (3)

-neuropsychiatric events (agitation, anxiety, abnormal dreams, hallucinations, depression, suicidal thinking)
-Churg-Strauss syndrome (rare)
-increased hepatic transaminases (zafirlukast and zileuton)

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montelukast is a minor substrate of which CYPs? (2)

CYP2C8/9 and CYP3A4

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boxed warning for montelukast

neuropsychiatric events

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zafirlukast is a major substrate, minor inhibitor of which CYP?

CYP2C9

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how long before or after meals should you take zafirlukast?

1 hour before or 2 hours after meals

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zileuton is a weak __________ inhibitor

a. CYP3A4
b. CYP2C9
c. CYP2C8
d. CYP1A2

d. CYP1A2

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true or false: zileuton can be taken with or without food

false

(take with food)

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adverse effects of methylxanthines (5)

-insomnia
-GI upset
-hyperactivity
-hypotension
-tremor

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contraindications for methylxanthines (3)

peptic ulcer disease
arrhythmias
seizure disorders

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theophylline is a major substrate of what 3 CYPs?

CYP3A4
CYP1A2
CYP2E1

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theophylline drug interactions: what drugs increase concentration? (5 of them, from chart)

cimetidine
erythromycin
clarithromycin
ciprofloxacin
ticlopidine

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theophylline drug interactions: what drugs decrease concentration? (4)

phenobarbital
phenytoin
carbamazepine
rifampin

(smoking as well)

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boxed warning for xolair

anaphylaxis

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adverse effects of xolair (7)

-headache
-injection site rxns
-arthralgias
-thrombocytopenia
-pharyngitis
-sinusitis
-upper respiratory tract infections

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adverse effects of mepolizumab (4)

-headache
-injection site reactions
-arthalgias (joint stiffness)
-Herpes Zoster infection

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adverse effects of reslizumab (3)

-injection site rxns
-myalgias
-increased creatinine phosphokinase

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boxed warnings for reslizumab (2)

anaphylaxis
malignancies

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how is the mechanism of action of benralizumab different than the other anti-IL5 drugs?

acts on IL-5 receptors while others act on IL-5 receptors

dupixent adverse effects (4)

-injection site rxns -antibody development -arthralgias -conjuctivitis

roflumilast adverse effects (4)

-heart attack -weight loss -diarrhea -nausea

what monitoring must be done for patients on roflumilast? (2)

liver function test weight monitoring

roflumilast has major drug interactions with which CYP? a. CYP1A2 b. CYP3A4 c. CYP2E1 d. CYP2C9

b. CYP3A4

roflumilast has minor drug interactions with which CYP? a. CYP1A2 b. CYP3A4 c. CYP2E1 d. CYP2C9

a. CYP1A2

is roflumilast for asthma or COPD? a. asthma only b. COPD only c. both

b. COPD only

contraindications for roflumilast

Child-Pugh class B or C

adverse effects of SABAs (4)

tachycardia tremor hypokalemia irritability

adverse effects of SAMAs (5)

dry mouth urinary retention infection sinusitis bronchitis

adverse effects of systemic corticosteroids - short term use (5 of them)

-hyperglycemia -increased appetite -fluid retention -demargination of WBCs -psychiatric disturbances

contraindications of systemic corticosteroids (2)

systemic fungal infections live vaccines if immunocompromised

drug interactions of systemic corticosteroids (2)

-warfarin INR inc -dec efficacy of inactivated vaccines

adverse effects of magnesium sulfate IV (3)

flushing hypotension vasodilation

contraindications of magnesium sulfate IV (2)

heart block caution in renal dysfunction

hydrocortisone equivalent dose

20 mg

cortisone equivalent dose

25 mg

prednisone equivalent dose

5 mg

prednisolone equivalent dose

5 mg

methylprednisolone equivalent dose

4 mg

triamcinolone equivalent dose

4 mg

betamethasone equivalent dose

0.75 mg

dexamethasone equivalent dose

0.75 mg

fludrocortisone equivalent dose

2 mg

which drug on the steroid potency table has the largest mineralocorticoid activity?

fludrocortisone

Which of these drugs is not for relief of acute bronchial spasm, and is also not usually for patients under 12 years of age, but a lower formulation for 5-12 years is available? (slide 21, asthma med chem) a. symbicort b. dulera c. QVAR d. mometasone e. pulmicort

b. dulera

two mechanisms for anti-inflammatory actions of theophylline

-HDAC activation (histone deacetylase) -enhanced apoptosis of inflammatory cells

mechanism of mast cell degranulation requires what 4 things?

1. binding of IgE antibodies to Fc epsilon receptor 2. binding of antigen to IgE antibodies 3. clustering of Fc epsilon receptors 4. influx of Ca2+ via Ca2+ release activated channels (CRAC)

type 2 low inflammation: neutrophilic or eosinophilic?

neutrophilic

type 2 high inflammation: neutrophilic or eosinophilic?

eosinophilic

type 2 low inflammation: which ILs? (3)

IL-6, IL-8 and IL-17

type 2 high inflammation: which ILs? (3)

IL-4, IL-5 and IL-13

which drug blocks TSLP (thymic stromal lymphopoietin?

tezepelumab

______ was the first drug approved to treat excessive sweating (2018)

Seebri

remodeling in COPD (4)

-fibrosis of small airways -hyperinflation of lungs: alveolar enlargement and alveolar wall destruction -mucus hypersecretion

what is the function of elastase?

elastase breaks down elastin, which is a needed structural component of lung tissue. Alpha1- antitrypsin normally protects the lung from elastase

what drug is a CFTR regulator for cystic fibrosis patients 4 months or older with Gating mutations in CFTR?

Ivacaftor (Kalydeco)

small molecule chaperones of delta F508 CFTR (3)

lumaftor tezacaftor elexacaftor

how does pancreatic enzyme replacement therapy (PERT) treat CF?

PERT helps the body digest and absorb nutrients from foods and fluids by breaking down carbs, fats and proteins. Without PERT, children are at high risk of poor nutrient absorption

how does Pulmozyme work?

cuts up DNA strands outside the cell that can make CF mucus thick and sticky (acts like scissors in the mucus)

antibiotics that treat cystic fibrosis (2)

tobramycin (Tobi) azithromycin

how does N-acetylcysteine (Mucomyst) work for CF?

it opens disulfide linkages in mucus thereby lowering the viscosity

true or false: dehydration of ASL (airway surface lipid) causes thickening of mucus

true

mechanism of histamine release: binding of antigen to antibody molecules causes an increase in cytoplasmic ___ concentration a. Na+ b. Ca2+ c. K+

b. Ca2+

H1 antagonists are predominantly _____ _____

inverse agonists

what class of first gen antihistamines is brompheniramine in? a. alkylamines b. ethanolamines c. ethylenediamines d. phenothiazines e. piperidines f. piperazines

a. alkylamines

cyproheptadine chemical class a. alkylamines b. ethanolamines c. ethylenediamines d. phenothiazines e. piperidines f. piperazines

e. piperidines

diphenhydramine chemical class a. alkylamines b. ethanolamines c. ethylenediamines d. phenothiazines e. piperidines f. piperazines

b. ethanolamines

promethazine chemical class a. alkylamines b. ethanolamines c. ethylenediamines d. phenothiazines e. piperidines f. piperazines

d. phenothiazines

hydroxyzine chemical class a. alkylamines b. ethanolamines c. ethylenediamines d. phenothiazines e. piperidines f. piperazines

f. piperazines

pyrilamine chemical class a. alkylamines b. ethanolamines c. ethylenediamines d. phenothiazines e. piperidines f. piperazines

c. ethylenediamines

examples of 2nd gen H1 antagonists

claritin allegra zyrtec xyzal clarinex

H1 antagonists topical (3 examples)

olopatadine (Patanol) azelastine (Astelin) ketotifen (Zaditor)