HY pharm

Question 1

SABA

examples

Answer 1

albuterol

Question 2

LABA

examples

Answer 2

salmeterol and formoterol

Question 3

short-acting anti-muscarinics

examples

Answer 3

ipratropium

Question 4

long-acting anti-muscarinics

examples

Answer 4

tiotropium

Question 5

inhaled corticosteroids

examples

Answer 5

fluticasone, budesonide, dexamethasone

Question 6

albuterol MOA

Answer 6

stim adenylate cyclase → incr cAMP (→ incr Ca2+ efflux → relax airway smc →) BRONCHODILATION.

Question 7

black box warning of LABAs

Answer 7

use of LABAs (without concomitant inhaled steroids) may be associated with increased asthma and cardiac mortality when used without an anti-inflammatory in asthma

→ LABAs not to be used as monotherapy in asthma.

Question 8

anticholinergics MOA

Answer 8

Atropine-like activity - block muscarinic (parasympathetic) receptors

Question 9

anticholinergics are more effective in ______ due to _____

Answer 9

anticholinergics are more effective in COPD due to INCREASED MUSCARINIC TONE IN COPD

Question 10

What feature of anticholinergics reduces systemic absorption?

Answer 10

Quaternary structure

Question 11

anticholinergics AE

Answer 11

dry mouth, urinary retention (older men with prostatic hypertrophy)

Question 12

Which drug both increases bronchodilation and decreases bronchoconstriction?

Answer 12

Theophylline

Question 13

Theophylline MOA

Answer 13

1. Phosphodiesterase inhibitor leading to incr cAMP due to decr cAMP hydrolysis (→ incr bronchodilation).
2. Adenosine inhibitor (→ decr bronchoconstriction)

Question 14

Theophylline AE

Answer 14

cardiotoxicity, neurotoxicity (seizures, tachyarrhythmia, nausea)

(caffeine AF)

Question 15

Leukotriene antagonists MOA

Answer 15

1. inhibit 5-lipooxygenase

2. block LT receptors

Question 16

Zileuteon MOA

Answer 16

inhibit 5-lipooxygenase

Question 17

Montelukast MOA

Answer 17

block LT receptors

Question 18

Zafirlukast MOA

Answer 18

block LT receptors

Question 19

_____ are effective in aspirin and exercise-induced bronchospasm

Answer 19

Leukotriene antagonists

Question 20

Which leukotriene antagonist is characterized by hepatotoxicity?

Answer 20

Zileuton

Question 21

Which ICS has high GC activity (inc potency, smaller dose req)?

Answer 21

dexmathasone

Question 22

Inhaled corticosteroids MOA (general)

Answer 22

Principally anti-inflammatory agents (decr the numbers of lymphocytes, mast cells and eosinophils and their associated cytokines)

Question 23

Inhaled corticosteroids MOA (specific)

Answer 23

Inactivate NF-κB, the tfac that induces production of TNF-α and other inflammatory agents.

Question 24

Inhaled corticosteroids AE

Answer 24

oral –> thrush, dysphonia

systemic –> weight gain, hyperglycemia, cataracts, osteoporosis, less frequently adrenal suppression

Question 25

1st line tx asthma

Answer 25

inhaled corticosteroids (fluticasone)

Question 26

Roflumilast

Answer 26

PDE-4 inhibitor (increases cAMP) Weak bronchodilator, effective for reducing COPD exacerbation

Question 27

Mast cell stabilizers Use

Answer 27

prophylactic for bronchospasm, NOT for acute bronchodilation

Question 28

Mast cell stabilizers examples

Answer 28

Cromolyn | Nedocromil

Question 29

cromolyn MOA and use

Answer 29

blocks histamine and leukotriene release from mast cells Use in PEDS and EXERCISE-INDUCED

Question 30

nedocromil MOA

Answer 30

blocks release of inflammatory mediators from mast cells AND blocks release from other cells (eos, macrophages, platelets)

Question 31

inhaled mucolytics examples

Answer 31

N-acetylcysteine

Question 32

N-acetylcysteine MOA

Answer 32

liquifies mucus in chronic bronchopulmonary diseases (COPD, CF) by disrupting disulfide bonds

Question 33

______ is also an antidote for acetaminophen OD

Answer 33

N-acetylcysteine

Question 34

Antihistamines MOA

Answer 34

reversible inhibitors of H-1 receptors

Question 35

1st generation anti-histamines examples

Answer 35

Diphenhydramine, dimenhydrinate, cholorpheniramine | “-en/ine”, “-en/-ate.”

Question 36

1st generation anti-histamines uses/AE

Answer 36

allergy, motion sickness, sleep aid AE: MORE anticholinergic effects

Question 37

2nd generation anti-histamines examples

Answer 37

Loratadine, fexofenadine, desloratadine, cetirizine | “-adine.”

Question 38

2nd generation anti-histamines uses/AE

Answer 38

allergy AE: LESS anticholinergic effect and LESS sedating

Question 39

Antitussives examples

Answer 39

Dextromethorphan | Benzonatate

Question 40

Expectorant examples

Answer 40

Guaifenesin

Question 41

codeine MOA

Answer 41

opiate, mu receptor antitussive

Question 42

Dextromethorphan MOA

Answer 42

non-opiate but binds mu Antagonizes NMDA glutamate receptors antitussive

Question 43

which drug may cause serotonin syndrome if combined w/ other serotonergic agents?

Answer 43

Dextromethorphan (antitussive)

Question 44

Anti-IgE monoclonal therapy example

Answer 44

omalizumab

Question 45

omalizumab MOA/use

Answer 45

Anti-IgE monoclonal Ab binds unbound serum IgE and blocks binding to FcεRI on mast cells use: allergic asthma with incr IgE levels resistant to inhaled steroids/long-acting B-2 agonists

Question 46

Which ILD does not improve with corticosteroids?

Answer 46

ASBESTOSIS

Question 47

which drug is cryptogenic organizing pneumonia EXQUISITELY sensitive to?`

Answer 47

CORTICOSTEROIDS

Question 48

tx for pulmonary arterial hypertension (PAH) | group 1 pulmonary HTN

Answer 48

-anticoagulants -vasodilators (Ca chan blockers, prostacyclins) -endothelin antagonists -PDE-5 inhibitors (cGMP) guanylate cyclase stimulant (cGMP)

Question 49

PDE-5 inhibitors MOA in PAH

Answer 49

inc cGMP to promote vasodilation; sildenafil [Viagra]

Question 50

heparin MOA

Answer 50

anticoagulant indirect thrombin inhibitor, binds anti-thrombin-3 and inactivates thrombin

Question 51

avoid using ____ in CF

Answer 51

anticholinergics

Question 52

order of drugs for AECOPD w infection + hypercapnia

Answer 52

abx, iprotropium (antimusc), beta agonists, SYSTEMIC steroids, dec suppl O2

Question 53

which drugs reduce the resistive work of breathing (by reducing airways resistance) and may also reduce hyperinflation

Answer 53

bronchodilators

Question 54

aspirin-induced asthma MOA

Answer 54

aspirin blocks cyclooxygenase thereby shunting the products of arachidonic acid metabolism toward the lipoxygenase pathway

Question 55

Quit rates with counseling and nicotine replacement are on the order of

Answer 55

10-20%

Question 56

T/F Inhaled corticosteroids have no benefit in CF patients

Answer 56

TRUE, no benefit with inhaled CS

Question 57

______-inhibitors frequently cause cough

Answer 57

ACE-inhibitors

Question 58

drugs that improve FEV1 and exercise capacity in COPD

Answer 58

nintedanib and pirfenidone