Asthma And Copd Pharm I

Front 1

What are the two categories of asthma drugs?

Back 1

1. Anti-inflammatory drugs

2. Bronchodilators

Front 2

On what receptors do bronchodilators act?

Back 2

1. B2 receptors--- sympathetic

2. M3 receptors--- parasympathetic

Front 3

How does a B2 receptor agonist lead to asthma symptom relief?

Back 3

Increases adenylyl cyclase---> increase in cAMP---> increased sequestration of Ca--> increased airway smooth muscle relaxation due to inhibition of release of bronchoconstrictors from mast cells

Front 4

What are the SABAs (short-acting B2-receptor agonists)?

Back 4

-Albuterol

-Levalbuterol

-Pirbuterol

Front 5

How are SABAs administered?

Back 5

1. Inhalation

Front 6

What is the clinical use of SABAs?

Back 6

1. Rapid relief of acute symptoms

2. Prevent exercise-induced bronchoconstriction

Front 7

What does 2x weekly use of SABAs indicate?

Back 7

Need for long-term control drug

Front 8

What are the LABAs (long-acting B2 receptor agonists)?

Back 8

1. Salmeterol

2. Formoterol

Front 9

What is the duration of action of SABAs?

Back 9

2-6 hours

Front 10

What is the duraiton of action of LABAs?

Back 10

12 hours

Front 11

What is the clinical use of LABAs?

Back 11

-Long-term control and prevention of symptoms in moderate or severe persisten asthma

-Prevention of exercise-induced bronchoconstriction

Front 12

What drug does the use of LABAs affect?

Back 12

Corticosteroids--- decrease dose and enhance effects

Front 13

How should LABAs be used?

Back 13

Not as a monotherapy

Front 14

What are the adverse effects of LABAs and SABAs?

Back 14

1. Skeletal muscle tremor

Front 15

What is another name for non-selective PDE inhibitors?

Back 15

1. Methylxanthines

Front 16

What is the MOA of non-selective PDE inhibitors?

Back 16

1. Inhibit PDE resulting in increased cAMP levels and relaxation of smooth muscle

2. Competitively block adenosine receptors

Front 17

What is the MOA of antimuscarinic agents?

Back 17

1. Bronchodilation by competitively blocking M3 receptors

Front 18

What is the short-acting antimuscarinic (SAMA)?

Back 18

1. Ipratropium bromide

Front 19

What is the LAMA?

Back 19

1. Tiotropium bromide

Front 20

What is the clinical use of SAMAs?

Back 20

1. Patients intolerant of inhaled SABAs

Front 21

When should a SAMA+SABA be used?

Back 21

1. MOderate or severe asthma exacerbations

Front 22

What is the clinical use of LAMA?

Back 22

Chronic tx of asthma

Front 23

What are the categories of anti-inflammatory agents?

Back 23

1. Anti-IgE

2. Mast cell stabilizers

3. Corticosteroids

4. Leukotriene pathway inhibitors

Front 24

What is the MOA of anti-inflammatory agents?

Back 24

1. Induce eosinophila poptosis

2. Inhibit recruitment of eosinophils, basophils, and other leukocytes

Front 25

How are anti-inflammatory agents administered in the tx of asthma?

Back 25

1. Inahler

2. Oral

Front 26

What is the clinical use of ICS?

Back 26

1. As monotherapy, for pts who need more than occasional use of inahlaed SABAs

Front 27

What is the most effective long-term tx available for mild, moderate, or severe persistent asthma?

Back 27

1. ICS+LABA

Front 28

What is the clincial use of oral corticosteroids+SABAs in the tx of asthma?

Back 28

1. Short-term relief of moderate and severe exacerbations

Front 29

What is the use of short courses of oral corticosteroids?

Back 29

1. Control the disease before initiating the long-term tx

2. Corticosteroids are routinely used but not curative

Front 30

What are the adverse effects of ICSs?

Back 30

1. Dysphonia

2. Oral candidiasis

Front 31

What are some inhaled ICSs?

Back 31

1. Beclomethasone dipropionate

2. Triamcinolone acetonide

3. Flunisolide

4. Budesonide

5. Fluticasone propionate

6. Ciclesonide

Front 32

What are some oral ICSs?

Back 32

1. Prednisone

2. Prednisolone

Front 33

What are the mast cell stabilizers?

Back 33

1. Cromolyn

2. Nedocromil

Front 34

What is the MOA of mast cell stabilizers?

Back 34

1. Inhibit the degranulatino of mast cells and reduce the release of mediators

2. Inhibit the response of eosinophils to antigens

Front 35

What is the clinical use of mast cell stabilizers?

Back 35

1. Preventive treatment before exercise or unavoidable exposure to known allergens

2. Alternative, but not preferred, agent for mild persistent asthma

Front 36

What is the use of cromolyn sodium?

Back 36

1. Tx of asthma in children of all ages

Front 37

What is the use of nedocromil?

Back 37

1. Tx of asthma in children >5 y/o

Front 38

What is the 5-lipoxygenase inhibitor?

Back 38

1. Zileuton

Front 39

What are the leukotriene inhibitors?

Back 39

1. Zafirlukast

2. Montelukast

Front 40

What is the clinical use of leukotriene inhibitors?

Back 40

1. Alternative tx for mild persistent asthma

2. Aspirin-induced asthma

Front 41

When should leukotriene inhibitors be combined with ICSs?

Back 41

1. For tx of moderate persistent asthma

Front 42

What should you monitor in a pt on zileuton?

Back 42

Liver function

Front 43

What drug should you watch with a patient taking zafirlukast?

Back 43

1. Inhibits CYP2C9, will increase half-life of warfarin