Asthma/copd/allergy Drugs

Front 1

how does asprin cause asthma

Back 1

because it blocks cyclooxgenase pathway leading to arachidonic acid diverted to leukotrienes which leads to build up and severe bronchoconstriction

Front 2

two types of anti-asthma drugs

Back 2

drugs that prevent bronchconstriction

drugs that cause bronchodilation

Front 3

two types of bronchodilators

Back 3

B2 agonists

Theophylline

Front 4

4 types of anti-asthma drugs that passively prevent bronchoconstriction

Back 4

1. Ipratropium

2. Theophylline

3. Lukast

4. Zileuton

Front 5

which anti-leukotriene blocks enzyme phospholipase A2

Back 5

glucocorticoids

Front 6

which anti-leukotriene blocks enzyme lipoxygenase

Back 6

zileuton

Front 7

if leukotrienes are produced anyway what is used and why

Back 7

zafirlukast or montelukast because it blocks interaction of leukotrienes with leukotriene receptors

Front 8

4 types of bronchodilation therapy drugs

Back 8

1. B-2 agonists

2. Muscarinic antagonists

3. Adenosine and cAMP phosphodiesterase

4. Leukotriene antagonists

Front 9

how do beta 2 agonist work

Back 9

they are G-s receptors that increase cAMP and cause bronchodilation

Front 10

two types of beta-agonists

Back 10

short acting and long acting

Front 11

3 types of short acting B2 agonists

Back 11

1. albuterol

2. Terbutaline

3. Levalbuterol

Front 12

2 types of long acting B2 agonists

Back 12

1. Salmeterol

2. Formoterol

Front 13

how do beta 2 agonists act as bronchdilators

Back 13

they phosphorylate MLCK which is an inactive form. if inactivated there is none available for activating MLC so there is no contraction.

Front 14

FDA warning for long lasting beta 2 agonists

Back 14

they increase the death rate from asthma attacks, especially in blacks

Front 15

even if a patient is on a long lasting beta 2 agonist what should be given if they show signs on an acute attack

Back 15

rapid acting beta 2 agonist such as albuterol inhaler should be used

Front 16

side effects of beta 2 agonist

Back 16

tremors and cardiovascular toxicity

Front 17

chronic use of beta 2 agonist leads to what

Back 17

downregulation (tolerance)

Front 18

what is given with status asthmaticus

Back 18

4 puffs of albuterol every 20 minutes for one hour

Front 19

if attack lasts longer than one hour

Back 19

patient needs to go to the hospital. on the way, a corticosteroid may be administered

Front 20

two types of anti-cholinergic drugs

Back 20

atropine

ipratropium bromide

Front 21

mechanism of action for anti-cholinergic drugs

Back 21

they block M3 receptors on smooth muscle

Front 22

when are these drugs useful

Back 22

only when vagal tone is a contributing factor

Front 23

three types of methylxanthines

Back 23

caffeine

theophylline

aminophylline (given as IV infusion)

Front 24

major mechanism of action for methylxanthines

Back 24

competitive antagonist at adenosine receptors

Front 25

other two mechanisms

Back 25

inhibits phosphodiesterase leading to an increase in cAMP

prevents calcium mediated contractions

Front 26

which methylxanthines is used to treat status asmathicus

Back 26

aminophylline

Front 27

adverse effects of theophylline are dependent on what

Back 27

dose

Front 28

high doses of theophylline can lead to what

Back 28

convulsions and tachycardia

Front 29

theophylline has what size therapeutic range

Back 29

small

Front 30

4 types of anti-inflammatory agents

Back 30

1. glucocorticoids

2. mast cell stabilizers

3. leukotriene synthesis inhibitors/antagonists

4. anti IgE antibody

Front 31

4 types of corticosteroids used in asthma

Back 31

1. Beclomethasone

2. Budesonine

3. Fluticasone

4. Triamcinolone

Front 32

main side effect of inhaled corticosteroid use

Back 32

oral candidiasis

Front 33

why?

Back 33

deposition of corticosteroids in oral mucosa. over a long period leads to local immunosuppression

Front 34

two other side effects from long term use of inhaled corticosteroid

Back 34

1. Osteoporosis

2. Cataracts

Front 35

two types of mast cell stabilizers

Back 35

cromolyn sodium

nedocromil

Front 36

do mast cell stabilizers bronchodilate

Back 36

no, they prevent the release of inflammatory mediators such as histamine

Front 37

most popular leukotriene inhibitor

Back 37

montelukast

Front 38

side effects of leukotriene inhibitors

Back 38

Inhibits chemotaxis leading to severe bacterial infection

Liver toxicity in the use of Zileuton

Front 39

type of humanized monoclonal anti-IgE antibody used in the treatment of severe allergic asthma

Back 39

omalizumab

Front 40

how does it work

Back 40

it neutralizes IgE by binding to serum IgE which prevents interaction with IgE receptors

Front 41

when is it used and why

Back 41

it is only used in resistant conditions because it is very expensive

Front 42

when is epinephrine used

Back 42

in status asthmaticus

Front 43

when severe, what can status asthmaticus cause

Back 43

respiratory acidosis

Front 44

how do expectorants work

Back 44

they increase tracheobronchial secretions or breaks the disulfide bond in vicid mucus

Front 45

two popular expectorants

Back 45

ammonium salts

acetyl cysteine

Front 46

main difference between asthma and COPD

Back 46

no reversible constriction in COPD

Front 47

what drug improves COPD

Back 47

long lasting tiotropium

Front 48

seasonal rhinitis is also known as what

Back 48

hayfever

Front 49

which type occurs throughout the year

Back 49

perennial allergic rhinitis

Front 50

antihistamnes act on what type of receptors

Back 50

H1

Front 51

what is the mechanism of action

Back 51

they are H1 receptor antagonists

Front 52

antihistamines have what type of properties

Back 52

anticholinergic (1st generation agents)

Front 53

one of the major problems with antihistamines

Back 53

sedation

Front 54

4 types of nonselective first generation oral antihistamines

Back 54

1. Brompheniramine

2. Chlorpheniramine

3. Clemastine

4. Diphenhydramine

Front 55

peripherally selective 2nd generation oral antihistamines

Back 55

1. Cetirizine

2. Levocetririzine

3. Fexofendadine

4. Loratadine

5. Desloratadine

Front 56

CNS depression is least likely to occur with which second generation oral antihistamine

Back 56

Fexofenadine

Front 57

what intranasal antihistamine is used for relieving allergic rhinorrhea

Back 57

Azelastine

Front 58

oral decongestants

Back 58

phenylephrine

pseudoephedrine

Front 59

two most important intranasal decongestants

Back 59

phenylephrine

oxymetazoline

Front 60

biggest problem with intranasal decongestants

Back 60

rhinitis medicamentosa

Front 61

what happens

Back 61

with prolonged used, over 3-5 days, congestion will come back due to downregulation

Front 62

drug of choice for allergic rhinitis

Back 62

intranasal corticosteroids

Front 63

3 types of intranasal corticosteroids

Back 63

1. Flunisolide

2. Fluticasone

3. Mometasone

Front 64

mechanism of action for intranasal cromolyn

Back 64

mast cell stabilizer- prevents inflammatory mediator release

Front 65

mechanism of action for intranasal anticholinergic

Back 65

it blocks the action of acetylcholine

Front 66

mechanism of action for montelukast

Back 66

leukotriene receptor antagonist

Front 67

does montelukast treat an attack

Back 67

no