Pulm: Drugs for Asthma and COPD

Question 1

What are the SABA drugs?

Answer 1

Albuterol
Terbutaline
Metaproterenol
Pirbuterol
Levalbuterol

All used in asthma PRN for symptom relief and can be used in COPD

Question 2

Adverse effects of albuterol

Answer 2

Headache, dizziness, insomnia, dry mouth, cough

Question 3

Warning when taking the SABA?

Answer 3

paradoxical bronchospasm, deterioration of asthma, CV effects

Question 4

What is the only B2 agonist available for SubQ injection?

Answer 4

Terbutaline

Question 5

Which of the SABA are safe in pts 4 years and older?

Answer 5

Levalbuterol

Question 6

MOA of the inhaled corticosteroids?

Answer 6

Anti-inflammatory as maintenance/prophylaxis of asthma

Question 7

What is important to remember when changing someone from systemic steroids to inhaled corticosteroids?

Answer 7

Wait a couple of months after stopping systemic to start inhaled
-deaths have occurred due to adrenal insufficiency

Question 8

What are the most effective drugs for controlling asthma?

Answer 8

ICS

-most potent inhibitors of inflammation

Question 9

When would budesonide or mometasone be contraindicated

Answer 9

in those with a milk allergy

Question 10

What are budesonide, flunisolide, or triamcinolone not used to treat?

Answer 10

status asthmaticus

-do not use for this or other acute asthmatic events that require intensive measures

Question 11

What are the inhaled corticosteroids?

Answer 11

Beclomethasone
Budesonide
Ciclesonide
Flunisolide
Fluticansone
Mometasone
Triamcinolone

if it ends in one or ide..

Question 12

Should you use ciclesonide in the presence of acute bronchospasm? what about around candida?

Answer 12

No

Question 13

What is great about flunisolide or triamcinolone, which are ICS?

Answer 13

It reduces/eliminates the need to switch to oral corticosteroids

Question 14

What is a warning when prescribing fluticasone?

Answer 14

Candida infection of the mouth

Question 15

MOA of prednisone

Answer 15

it is an Oral corticosteroid used with SABAs for severe asthma flare ups

Question 16

What is a warning when taking prednisone?

Answer 16

May suppress the Hypothalamic-pituitary-axis

Question 17

MOA of Fomoterol?

Answer 17

LABA used for moderate to severe asthma not controlled with ICS

or to prevent bronchoconstriction in those with COPD

Question 18

What should you always give with LABAs?

Answer 18

Inhaled corticosteroids

-deaths have occurred due to the long acting nature, and in acute flare ups the patients were not responsive to SABAs

Question 19

MOA of Salmetrol?

Answer 19

LABA used to prevent exercise induced bronchospasm

or to prevent bronchoconstriction in those with COPD

Question 20

What two LABA are used to treat breathing problems caused by COPD?

Answer 20

Indacaterol and vilanterol

Question 21

What LABA is used as a once a day bronchodilator treatment in COPD?

Answer 21

Olodaterol

Question 22

MOA of Atropine

Answer 22

Muscarinic antagonist to block the life threatening bronchoconstriction in Asthma and COPD

Question 23

What is the max dose of atropine given if a patient has CAD?

Answer 23

2-3mgs

Question 24

Which M3 antagonists are used as maintenance therapy to prevent bronchospasm in COPD?

Answer 24

Ipratroprium and aclidinium

Question 25

Which M3 antagonist is used as once a day maintenance therapy to prevent bronchospasm in COPD?

Answer 25

Tiotroprium

Question 26

MOA of methylxanthines (theophylline)?

Answer 26

Prevents PDE, so stops breakdown of cAMP=bronchodilation

Question 27

When is theophylline used?

Answer 27

Used in management of airway obstruction in asthma and COPD

Question 28

MOA of Montelukast?

Answer 28

LTD4 blocker, so blocks the CysLT1 receptor =less bronchoconstriction, mucus, and eosinophils

Question 29

MOA of Zileuton?

Answer 29

inhibits 5-lipoxygenase, so prevents the production of leukotrienes =less bronchoconstriction, mucus, and eosinophils

Question 30

Indications of montelukast?

Answer 30

Mainly in allergies and to prevent asthma attacks

Question 31

Should montelukast be used to reverse asthma attacks (status asmaticus?)

Answer 31

no

Question 32

MOA of Zafirlukast?

Answer 32

LTD4 and E4 blocker, so blocks the CysLT1 receptor =less bronchoconstriction, mucus, and eosinophils

Question 33

indication for zafirlukast?

Answer 33

Prophylaxis and treatment of asthma

Question 34

Warning when prescribing zafirlukast?

Answer 34

Hepatotoxicity | -monitor LFTs

Question 35

Indications of ziluton?

Answer 35

Prophylaxis and treatment of chronic asthma | -NOT FOR ASTHMA ATTACK

Question 36

Contraindications of ziluton?

Answer 36

Liver disease | -can worsen

Question 37

What monoclonal antibody is used to treat asthma?

Answer 37

Omalizumab | -binds the FReI portion of mast cells

Question 38

Indications of omalizumab?

Answer 38

Moderate to severe asthma patients with (+) skin test fo allergen not controlled by ICS also idiopathic urticaria pts who are symptomatic, dispite taking H1 antihistamines

Question 39

What caution should there be with omalizumab?

Answer 39

Anaphylaxis | -can be life threatening, so monitor

Question 40

If pt has Asthma-COPD Overlap, how would you treat?

Answer 40

ICS+LABA+LAMA