Pharm 20 Asthma

Front 1

what are the most important mediators of bronchoconstriction released from mast cells in immunologic responses?

Back 1

Leukotrienes B4, C4, and D4

Front 2

what are the best classes of drugs to use in acute asthmatic bronchospasm?

Back 2

bronchodilators: B2 agonists, muscarinic antagonists, and theophylline

Front 3

DOC for reversal of asthmatic bronchoconstriction?

what other drugs can be used?

Back 3

b2-selective agonists:
albuterol, terbutaline, metaproterenol, salmeterol, formoterol

epinephrine and isoproterenol can also be used

Front 4

MOA of albuterol/salmeterol/etc?

Back 4

stimulate adenylyl cyclase which increases cAMP in smooth muscle which results in bronchodilation

Front 5

what condition warrants the use of bronchodilators but is associated with increased incidence of toxicity?

Back 5

COPD

Front 6

toxic effects of beta-agonists?

Back 6

skeletal muscle tremor, inc HR/contractility (at high dose), arrhythmias (when used excessively or in COPD pts at normal dose)

Front 7

bronchodilators that inhibit phosphodiesterase?

Back 7

methylxanthines (theophylline)

Front 8

toxic effects of methylxanthines?

Back 8

GI distress, tremor, insomnia, (in overdose): severe n/v, hypotension, arrhythmias, convulsions

Front 9

what drug would you use to reverse the cardiovascular toxicity from an overdose of theophylline?

Back 9

beta-blocker

Front 10

MOA of ipratropium?

Back 10

muscarinic receptor blocker in airways (blocks vagal discharge)

Front 11

in what patients do antimuscarinic bronchodilators work best?

Back 11

children and COPD pts

Front 12

toxic effects of ipratropium?

Back 12

minor atropine-like effects (mydriasis, sedation, hyperthermia, constipation)

Front 13

long acting muscarinic antagonist?

Back 13

tiotropium

Front 14

drugs that have no bronchodilatory action, but prevent bronchoconstriction locally, e.g. in food allergy, conjunctiva and nasopharynx allergic rxns?

Back 14

cromolyn, nedocromil

Front 15

toxic effects of cromolyn/nedocromil?

Back 15

cough and irritation of airway when given aerosol

Front 16

first-line therapy for moderate to severe asthma?

Back 16

inhaled corticosteroids
(beclomethasone, budesonide, dexamethasone, flunisolide, fluticasone, mometasone)

Front 17

drugs used IV for status asthmaticus?

Back 17

prednisolone, hydrocortisone

Front 18

MOA of corticosteroids in asthma?

Back 18

dec leukotrienes via dec synthesis of arachidonic acid by phospholipase A2
Dec expression of COX-2.
Inc responsiveness of B adrenoceptors in airway

Front 19

what would you give a child with moderate asthma that was not responsive to aerosol beta agonists?

Back 19

inhaled glucocorticoids

Front 20

most common complication of inhaled corticosteroids?

Back 20

candidiasis

Front 21

drugs that are effective in preventing exercise-, antigen-, and aspirin-induced bronchospasm, but not recommended for acute asthma?

Back 21

leukotriene receptor blockers
(zafirlukast, montelukast)
5-lipoxygenase inhibitor
(zileuton)

Front 22

drug that decreases conversion of arachidonic acid to leukotrienes by inhibiting 5-lipoxygenase?

Back 22

Zileuton

Front 23

toxicity of Zileuton?

Back 23

elevated liver enzymes

Front 24

monoclonal antibody that binds IgE on sensitized mast cells and prevents their degranulation?

Back 24

Omalizumab

Front 25

Indications for Omalizumab?

Back 25

prophylactic mgmt of asthma
(must be given parenterally)