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Respiratory Exam 1 > Pharmacology of OLDs > Flashcards

Pharmacology of OLDs Flashcards

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1
Q

which immune cells are in asthma

A
  • mast cells
  • eosinophils
  • Th2 lymphocytes
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2
Q

which immune cells are in COPD

A
  • neutrophils
  • macrophages
  • CTLs
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3
Q

what is the parasympathetic receptor in the lung

what happens when we activate it

A
  • M3

- bronchoconstriction

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4
Q

what is the sympathetic receptor in the lung

what happens when we activate it

A
  • B2

- bronchodilation

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5
Q

drugs that are beta 2 agonists

A
  • albuterol
  • epineprhine
  • salmeterol
  • formoterol
  • indacaterol

ISAFE

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6
Q

drugs that are M3 antagonists

A
  • Ipatropium (nonselective)
  • Tiotropium
  • Glycopyrrolate (nonselective)
  • Aclidinium
  • Umeclidium

ITAGU

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7
Q

drug that is M3 agonist

A
  • methacholine
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8
Q

SABA (short acting beta agonist) drugs

A
  • albuterol

- epinephrine

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9
Q

LABA (long acting beta agonist drugs)

A
  • salmeterol (A/COPD BID)
  • formoterol (A/COPD BID)
  • indacaterol (COPD QD)
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10
Q

short acting M3 antagonists

A
  • ipatropium
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11
Q

long acting M3 antagonists

A
  • tiotropium
  • aclidinium
  • umeclidinium
  • glycoprrolate

TAGU

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12
Q

rescue therapy used for

duration of effect

A
  • treatment of acute symptoms

< 12 hours

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13
Q

maintenance therapy used for

duration of effect

A
  • prevention of acute asthma symptoms

- > 12 hours or <12 with multiple dosing

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14
Q

can you use ipatropium for maintenance therapy?

how?

A
  • yes

- you take multiple doses per day (4 to be exact)

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15
Q

epinephrine selectivity

A
  • alpha 1, 2

- beta 1, 2

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16
Q

epinephrine indications

A
  • anaphlyaxis (allergy)
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17
Q

epinephrine dosing (how we put it in the patient)

A
  • subQ
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18
Q

albuterol indications

albuterol dosing (how we put it in the patient)

A
  • asthma (acute)

- inhalation, prn

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19
Q

what happens if you chronically use short acting beta agonists

A
  • beta 2 receptors will desensitize to it
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20
Q

chronic use of short term beta agonists how they become desensitized within minutes

A
  • phosphorylation by PKA and GPCR
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21
Q

chronic use of short term beta agonists and how they become down regulated within hours

Study These Flashcards
A
  • receptor degradation
22
Q

important toxicities of beta two agonists are because of

some toxicities

are these effects major concerns?

Study These Flashcards
A
  • cross agonism of beta 1 in the heart
  • they are only partial agonists
  • tachycardia
  • chest pain
  • a-fib
  • angina
  • vasoconstriction
  • hypertension
  • not generally major concerns
23
Q

what is the full beta 2 agonist

24
Q

what happens with the majority of drugs that you inhale

Study These Flashcards
A
  • swallow vast majority
25
important toxicities of M3 antagonists are primarily based on which system examples of some toxicities
- parasympathetic - inhibit rest and digest responses - dry mouth - urinary retention - constipation
26
corticosteroid drugs
- beclomethasone - triamcinolone - flunisolide - fluticasone - budesonide - mometasone - solumedrol - predinosone BFFB TMSP
27
which corticosteroid drug do you give via IV
- solumedrol
28
which corticosteroid drug do you give via oral
- prednisone
29
in which way do you give most corticosteroid drugs?
- inhaled
30
inhaled corticosteroid toxicities:
- immunosuppression - thrush - pneumonia
31
most inhaled steroids in pregnancy are which category except which drug (what category)
- C | - prednisone (D)
32
why do we use corticosteroids with long acting beta 2 agonists
- they increase bronchiole smooth muscle responsiveness to beta 2 agonists because they - increase the synthesis of the beta 2 receptor
33
MOA of Zileuton
- inhibit synthesis of leukotrienes by inhibiting 5-lipoxygenase
34
MOA of Montelukast and Zafirlukast
- competitive antagonists for leukotriene binding to receptors in bronchiole smooth muscle
35
what inhibits leukotriene synthesis by also inhibiting phospholipase A2 activity how?
- corticosteroids | - increase expression of lipocortin
36
leukotriene inhibitors treat what kind of asthma
- allergic asthma
37
side effects of montelukast
- vasculitis (Churg-Strauss syndrome also known as eosinophilic granulomatosis with polyangiitis - suicide tendencies?
38
can we use montelukast during pregnancy
- yes
39
mepolizumab target used in which kind of asthma
- IL-5 | - severe eosinophilic asthma
40
omalizumab target used in which kind of asthma
- IgE - inhibits mast cell activation | - IgE-mediated allergic asthma
41
omalizumab and mepolizumab are given how
- SubQ
42
can you use omalizumab and mepolizumab in pregnancy
- yes
43
theophylline bronchodilator effects
- inhibits phosphodiesterase in bronchiole smooth muscle | - competitive antagonist of adenosine (which induces smooth muscle contraction in bronchioles)
44
theophylline toxicities
- seizures | - arrhythmias
45
why is theophylline use declining
- difficulties in safe dosing | - low therapeutic index
46
Moa of cromolyn
- stabilizes mast cells - prevents degranulation of mast cells - prevents release of inflammatory mediators
47
roflumilast MOA
- inhibits phosphodiesterase-4 (very selective) in bronchiole smooth muscle - less toxicities
48
only with COPD drugs do you see what
- anti-cholinergic
49
why don't we use LABAs alone
- they may increase risk of death from asthma
50
what do we use roflumilast for (what condition)
- COPD

Respiratory Exam 1 (27 decks)

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