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38 Cards in this Set
- Front
- Back
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What is asthma
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-narrowing of bronchi thought to be caused by an underlying chronic inflammatory disorder
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In asthma, what do allergans interact with
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-IgE on mast cells or basophils
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What type of T cells are involved in asthma
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-TH2
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What two things are produced by asthma
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eosinophilia and chronic airway inflammation
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How is asthma diagnosed
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-methacholine challenge to induce a bronchospasm
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levomethamphetamine is used to treat what
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-chronic morning cough caused by allergies (if it's asthma this treatment won't work)
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What size of particles can get into lungs
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.5-10 uM
-smaller are exhaled -larger are are swallowed |
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What are B2 adrenergic agonists used for:
-short acting -long acting |
-immediate inhaler relief via bronchodilation
-prophylaxis |
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What are the main receptors on bronchiolar smooth muscle
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-B2 adrenergic receptors
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albuterol, levalbuterol, metaprotrenol, terbutaline, pirbuterol are used for:
-what are they |
-acute bronchospasm
-short-acting B2 adrenergic agonists |
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salmeterol and formoterol:
what are they uses why they work |
-long-acting B2 adrenergic agonists (much more selective for B2)
-chronic bronchospasm prophylaxis -salmeterol has a lipophilic chain that anchors it |
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why can't formoterol be given once an asthma attack has started
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-required adequate tidal volume
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Glucocorticoids:
uses given how can be used in an attack |
-treat underlying inflammation assc w/asthma
-inhalant or systemic (more side effects) -canNOT be used, are not bronchodilators |
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beclomethasone dipropionate, triamciniloneacetonide, flunisolide, budesonide, fluticasone propionate are all
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-glucocorticoids used to treat asthma
-effects start at 1 week and may continue for months after stopping therapy |
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What is LTD4?
-potency **ON EXAM** |
-leukotriene
-1000x as potent as histamine as a bronchoconstrictor |
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zafirlukast, montelukast are all
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-leukotriene receptor antagonists
-compete to antagonize cys-LT1 receptor |
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Zileuton
-what it does -side effect |
-inhibits lipoxegenase to block leukotriene production
-5% have elevated liver enzymes, so seldom used in US |
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Which are better, leukotriene inhibitors or glucocorticoids
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-glucocorticoids
-both used in conjunction with inhalers |
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Omalizumab
-what is it -treats -does it bronchodilate |
-recombinant humanized monoclonal ab against IgE
-used in allergic responses -no, given by injection every 2 weeks, only effective when >90% of IgE is reduced |
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cromolyn sodium and nedocromil sodium
-what it does -used -problem -how it's diff from glucocorticoids |
-blocks bronchospasm, release of histamine
-to treat asthma - given 4 mg qid -compliance b/c it tastes bad -no candidiasis, but overall effect isn't as good |
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Theophylline
-how it works -used for what -side effect |
-inhibits adenylate cyclase (decreases cAMP degradation) and antagonises adenosine receptors to block bronchospasm
-nocturnal asthma -can be fatal, status epilepticus |
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Bronchospasm occurs with activation of what receptor
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muscarinic M3
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ipratropium and tiotropium:
-what are they -used to treat |
-anticholinergic agents used to activate PS system to prevent bronchospasm
-emphysema and COPD |
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What categories of drugs are given for Stage A risk
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-ACEi or ARBs
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What categories of drugs are given for Stage B risk
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ACEi, ARBs, B-blockers
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What categories of drugs are given for Stage C risk
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-diuretics, ACEi, B-blockers
-some pts may also need aldosterone antagonists, digitalis, hydralazine/nitrates |
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What three categories of drugs reduce afterload
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-ACEi
-ARBs -isosorbide dinitrate/hydralazine |
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What categories of drugs produce diuresis
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-loop diuretics
-spironolactone |
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Which categories of drugs cause positive ionotropy
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-adrenergic anonists
-cAMP PDE inhibitors -digitalis glycosides |
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captopril, enalapril, ramipril, lisinopril, quinapril, are prescribed to patients with waht
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-pts w/heart failure with reduced LVEF
-all ACEi |
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losartan, valsartan, candesartan are used for patients with what
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-heart failure with reduced LVEF
-same as ACEi but WITHOUT cough and angioedema -all ARBs |
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bumetanide, furosemide, torsemide act where
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-LoH (loop diuretics)
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thiazides and metolazone act where
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-distal portion of the tubules
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Who should take a diuretic
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-patient with evidence of fluid retention
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Bisoprolol
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selectively blocks B1 receptors
-reduces risk of death |
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sustained release metoprolol
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selectively blocks B1 receptors
-reduces risk of death |
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carvedilol
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blocks alpha 1, b1 and b2 receptors
-reduces risk of death |
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digoxin MOA
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-sensitizes cardiac baroreceptors (increases PS activity)
-inhibits Na/K/ATPase in kidney (reduces renin release) |
