Pharm-asthma

Question 1

Ciclesonide + budesonide drug class?

Answer 1

inhaled corticosteriods

Question 2

Salbutamol, salmeterol + formoterol drug class?

Answer 2

Inhaled B2 agonists

Question 3

Ipratropium + tiotropium drug class?

Answer 3

Anticholinergics

Question 4

Montelukast drug class?

Answer 4

Leukotriene-R antagonist

Question 5

Omalizumab, Mepolizumab + Dupilumab drug class?

Answer 5

Biologic

Question 6

what drug biologically inert until activated by lung esterase?

Answer 6

Ciclesonide (corticosteroid)

Question 7

What drug Metabolised by CYP3A4 ~ 10% bioavailability (1st pass)?

Answer 7

Budesonide (corticosteroid)

Question 8

B2 agonists:
which ones…
1. short acting
2. long acting slow onset
3. long acting rapid onset

Answer 8

1. Salbutamol
2. Salmeterol
3. Formoterol

Question 9

Short acting vs long acting anticholinergic?

Answer 9

Ipratropium = short acting
Tiotropium = long acting

Question 10

2nd line add on therapy?

Answer 10

Monteleukast (leukotriene R antagonist)

Question 11

Which biologic is IgE neutralizing antibody?

Answer 11

Omalizumab

Question 12

Which biologic is IL-5 inhibitor (affects eosinophils)?

Answer 12

Mepolizumab

Question 13

Which biologic is IL4R neutralizing antibody (affects IL4+IL13)?

Answer 13

Dupilumab

Question 14

which biologic is for atopic dermatitis?

Answer 14

Dupilumb

Question 15

Sore mouth, sore throat, dysphonia, oral thrush

↓ growth rate (children), osteoporosis (adults, glaucoma

Answer 15

Ciclesonide + budeonide (corticosteriod)

Question 16

Tachycardia, palpitations, nervousness, tumour, hypokalemia, restlessness, dizziness, headache, nausea

Use of 2+ canisters/ yr associated w/ exacerbations + mortality

Monotherapy not recommended:  severe exacerbations + death

Tolerance may develop to long acting

Answer 16

B2 agonists (salbutamol, salmeterol, formoterol)

Question 17

Dry mouth, metallic taste

Mydriasis + glaucoma (if released into eye)

Answer 17

Anticholingergics (Ipratropium, tiotropium)

Question 18

Headache, abdominal pain, flu-like sx
Hepatotoxicity (rare)
Boxed warning issue: neuropsychiatric effects (depression, agitation/ aggression, hallucinations, suicidal ideation)

Answer 18

Montelukast (Leukotriene-R antagonist)

Question 19

Injection site reactions (45%), viral infections (24%), URTI (19%), headache (15%), sinusitis (16%), pharyngitis (10%)

Answer 19

Omalizumab

Question 20

Headache, nasal congestion, pharyngitis, injection site reactions (pain, erythema, swelling, itching)

Malignancy (rare)

Hypersensitivity rxns (rare): swelling (face, mouth, tongue), fainting, dizziness, hives, breathing issues, rash

Answer 20

Mepolizumab

Question 21

Injection site reactions (14-18%), oropharyngeal pain (2%), eosinophilia (2%), arthralgia, hypersensitivity

Answer 21

Dupilumab