Flashcards in Pharmacology Deck (19)
What are the general treatment strategies for asthma?
Omalizumab is an anti-IgE, Steroids inhibit cytokine release and inflammation, antileukotrienes inhibit inflammation, b-agonists theophylline and muscarinic antagonists are used to block bronchoconstriction
How does theophylline work for asthma (2 ways)
1) inhibits phosphodiesterase hydrolysis of cAMP --> increased cAMP --> bronchodilation
2) blocks actions of adenosine, a vasoconstrictor
What are the toxic effects of theophylline?
Narrow therapeutic index. Cardiotoxicity (arrythmias), neurotoxicity (seizures), abdominal pain. Metabolized by p450
What are some b2 agonists used for asthma treatment?
Albuterol (used in acute exacerbation)
Salmeterol, formoterol: prophylaxis. Toxicity = tremor, arrythmia
Muscarinic antagonist, prevents bronchoconstriction. Can be used for COPD.
What steroids are used for asthma tx?
Corticosteroids. Inactivate NF-kB, reducing TNF-a and other cytokines/inflammatory agents. Also reduce mucus production.
Most common side effect for inhaled steroids
Oropharyngial candida infection
Montelukast, zafirlukast: block leukotriene receptors
Sileuton: 5-lipoxygenase inhibitor, blocks conversion of arachadonic acid to leukotrienes.
Prevent inflammation and bronchoconstriction
Monoclonal anti-IgE. Used for allergic asthma resistant to steroids and b2 agonists.
Provocation test for asthma
Methacoline (muscarinic agonist) test
Endothelin-1 (vasoconstrictor) antagonist --> tx for pulmonary hypertension
Mast cell stabilizers
First generation antihistamines: examples, uses, toxicity
Diphenhydramine, dmenhydrinate, chlorpheniramine
Allergy, motion sickness, sleep.
Crosses BBB --> sedation, antimuscarinic, anti-a-adrenergic
Second generation antihistamines: examples, uses, toxicity
Loratadine, fexofenadine, desloratadine, certirizine (-adine)
Far less sedating than first generation. Mild anticholinergic effects
Thins respiratory secretions --> decreases mucus viscosity.
Mucolytic agent, often used in CF.
Also antidote for acetominophen OD
Decreases sensitivity of cough receptors, antagonizes NMDA glutamate receptors. Mild opioid effect.