Pharmaology - Asthma Flashcards Preview

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Flashcards in Pharmaology - Asthma Deck (34)
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1
Q

Class: Albuterol

A

short-acting beta-2 agonist (4-6 hours)
bronchodilator
inhaled

2
Q

Class: Terbutaline

A

short-acting beta-2 agonist (4-6 hours)
bronchodilator
inhaled, can also be subQ

3
Q

Class: Metoproterenol

A

short-acting beta-2 agonist (4-6 hours)

bronchodilator

4
Q

Class: Pirbutol

A

short-acting beta-2 agonist (4-6 hours)

bronchodilator

5
Q

What is a major effect of beta 2 agonists?

A

Reduction in cholinergic transmission

***increase in intracellular cAMP –> bronchodilation

6
Q
Use:
Albuterol
Metoproterenol
Pirbutol
Terbutaline
A

Acute exacerbations;

Exercise-induced or mild asthma

7
Q

Class: Salmeterol

A

bronchodilator

long-acting beta-2 agonist (partial agonist)

8
Q

Class: Formoterol

A

bronchodilator

long-acting beta-2 agonist (full agonist)

9
Q

Class: Indicaterol/Vilanterol

A

bronchodilator

long-acting beta-2 agonist

10
Q

What long-acting beta-2 agonists are only indicated for use in COPD?

A

Indicaterol

Vilanterol

11
Q

Long-acting beta-2 agonists are always used in combination with what in the treatment of asthma?

A

Corticosteroids

12
Q

T/F: Beta-2 agonists are less effective in treating COPD

A

True

13
Q

Side effects: Beta-2 agonists

A

Tremor (beta-2 receptors in muscles);
Tachycardia;
Prolongation of QTc - dose dependent –> can lead to fatal v-tach;
Hypokalemia;
V/Q mismatch –> hypoxia;
tolerance with chronic use (short-acting);
overuse associated with respiratory mornidity (long-acting)

14
Q

Class: Ipratroprium

A

Antimuscarinic - bronchodilator

15
Q

Class: Tiotroprium

A

Antimuscarinic - bronchodilator

**longest half life at M3 receptor

16
Q

Class: Atropine

A

Antimuscarinic - bronchodilator

**most systemic side effects

17
Q

Class: Acidlinium

A

Antimuscarinic - bronchodilator
newer formulation of tiotroprium, shorter *circulation half-life
less side effects (systemic, CNS)

18
Q

What antimuscarinic is long-acting for use in COPD?

A

Tiotroprium

19
Q

What antimuscarinic is short-acting for use in COPD?

A

Ipratroprium

20
Q

What is a secondary effect of tiotroprium as an antimuscarinic in the treatment of COPD?

A

Anti-inflammatory effects - reduces neutrophil migration;
reduces airway remodeling;
decreased mucus production

21
Q

Side effects: Antimuscarinic agents (COPD)

A

urinary retention;
acute angle glaucoma;
dry mouth

22
Q

T/F: Better M3 selectivity confers better side effect profile in antimuscarinic agents (ie triotroprium) used for COPD.

A

True

23
Q

Why are methylxanthines used in the treatment of COPD if they are only weak bronchodilators?

A

They reverse diaphragmatic fatigue and have anti-inflammatory effects, restores sensitivity to corticosteroids

Examples: Theophylline, Theobromine, Caffeine, Roflumilast

**narrow therapeutic window - not really used anymore, as well as MULTIPLE drug interactions bc of cytochrome P450

24
Q

Roflumilast is unique among the methylxanthines (treatment of COPD) in that:

A

It produces the most anti-inflammatory effect;

Selective PDE4 inhibitor

25
Q

Corticosteroids increase the responsiveness of the lungs to beta-2 agonists.

A

True

26
Q

Class: Budesonide

A

Inhaled corticosteroid

27
Q

Class: Fluticasone

A

Inhaled corticosteroid

28
Q

Class: Beclamethasone

A

Inhaled corticosteroid

29
Q

Oral thrush is a side effect of what drugs?

A

Inhaled corticosteroids
ie Budesonide
Fluticasone
Beclamethasone

30
Q

What is the first-line therapy for persistent asthma?

A

Inhaled corticosteroids
ie Budesonide
Fluticasone
Beclamethasone

use before adding in long-acting beta-2 agonists

31
Q

How is Ciclesonide different from other inhaled corticosteroids such as fluticasone?

A

Ciclesonide is a prodrug that is only activated in the airway by an esterase, which results in less systemic absorption and side effects

32
Q

Class: Ciclesonide

A

Inhaled corticosteroid

Prodrug**

33
Q

Class: Omalizumab

A

IgE inhibitor

mAB

34
Q

Use: Omalizumab

A

Asthma patients who are refractory to other medications ie corticosteroids