Pharmacology Chapter 20

Front 1

What are the 3 classes of bronchodilators?

Back 1

Beta agonsists, muscarinic antagonists, and methylxanthines

Front 2

What are the 4 classes of anti-inflammatory responses?

Back 2

Release inhibitors, steroids, antibodies, and slow anti inflammatory drugs.

Front 3

What are the 2 classes of leukotriene antagonists?

Back 3

Lipoxygenase inhibitors and receptor inhibitors

Front 4

What do beta adrenoceptor agonsists stimulate? What 2 downstream effects does this cause?

Back 4

- Stimulate adenylyl cyclase (AC) synthesis.
- AC catalyzes conversion of ATP to cAMP
- cAMP causes bronchodilation

Front 5

What enzyme does methylxanthines inhibit?
What are the effects of this enzyme?
What are the downstream effects?

Back 5

- Methylxanthines inhibits phosphodiesterase (PDE)
- PDE degrades cAMP
- Allows cAMP to build up and cause bronchodilation.

Front 6

Muscarinic antagonists block what?
What effect does this have?

Back 6

- Muscarinic antagonists competitively block muscarinic receptors in the airways.
- Prevents bronchoconstriction by vagal discharge.

Front 7

What common negative side effects do beta adrenoreceptor agonists possess?

Back 7

- Skeletal muscle tremors where Beta-2 receptors are present.
- Tachycardia
- Arrythmia from excessive use
- Diminishing return when acute sympathomimetrics are used.

Front 8

What are beta adrenoreceptor agonists also referred to as?

Back 8

Sympathomimetrics

Front 9

What are common adverse effects of methylxanthines?

Back 9

GI distress, tremor, insomnia

Front 10

What do corticosteroids reduce?
What do they inhibit?

Back 10

- Reduce synthesis of arachidonic acid by phospholipase A-2
- Inhibit expression of COX-2 (the inducible form of cyclooxygenase)

Front 11

What are the effects of corticosteroids?

Back 11

Glucocorticoids bind to intracellular receptors and activate glucocorticoid response elements (GREs) in the nucleus which causes the synthesis of substances that prevent complete expression of inflammation and allergy.

Front 12

What are the 2 types of leukotriene antagonists?

Back 12

1. Leukotriene receptor blockers
2. Lipoxygenase inhibitor

Front 13

How to do monoclonal antibodies treat asthma?

Back 13

- Targets antibodies (IgE) that bind to mast cells

Front 14

What are the 3 short acting beta agonists?

Back 14

1. Albuterol
2. Metaproterenol
3. Terbutaline

Front 15

What is the mechanism of short acting Beta agonists?

Back 15

Beta-2 selective agonist and bronchodilation

Front 16

What are the toxicities of short acting beta agonists?

Back 16

Tremor and tachycardia

Front 17

What are the 2 long acting Beta agonists?

Back 17

Salmeterol and formoterol

Front 18

What are the 3 mechanisms of long acting beta agonists?

Back 18

Beta-2 selective agonist
Bronchodilation
Potentiation of corticosteroid action

Front 19

What are the 3 toxicities of long acting beta agonists?

Back 19

Tremor, tachycardia, and cardiovascular events

Front 20

What are the 2 non-selective sympathomimetrics?

Back 20

Epinephrine and isoproterenol

Front 21

What is the mechanism of nonselective sympathomimetrics?
Epinephrine is what kind of agonist?

Back 21

Nonselective beta activation, epinephrine is an alpha agonist

Front 22

What 2 subclasses are obsolete for treating asthma?

Back 22

Non selective and indirect-acting sympathomimetrics

Front 23

What are the 3 kinds of methylxanthines?

Back 23

1. Theophylline
2. Caffeine
3. Theobromine

Front 24

What are the 2 mechanisms of methylxanthines?

Back 24

1. PDE inhibition
2. Adenosine receptor antagonist

Front 25

What are 2 types of antimuscarinic agents?

Back 25

1. Ipratropium
2. Tiotropium

Front 26

What is the mechanism of antimuscarinic agents?

Back 26

Competitive muscarinic antagonists

Front 27

What are short acting beta agonists used for?

Back 27

Acute asthma attack relief

Front 28

What are long acting beta agonists used for?

Back 28

Asthma prophylaxis (preventative measure)

Front 29

What are methylxanthines used for?

Back 29

Nocturnal asthma prophylaxis

Front 30

What are antimuscarinic agents used for?

Back 30

Bronchodilator in asthma and COPD

Front 31

What are the 2 toxicities of antimuscarinic agents?

Back 31

1. Dry mouth
2. Cough

Front 32

What are the 2 mast cell stabilizers?

Back 32

Cromolyn and nedocromil

Front 33

By what mechanism do mast cell stabilizers work?

Back 33

Reduce release of inflammatory and bronchoconstrictor mediators from sensitized mast cells

Front 34

What are mast cell stabilizers used for?

Back 34

Prophylaxis of asthma
- Cromolyn can be used for allergies too

Front 35

What are the 3 leukotriene antagonists?

Back 35

Montelukast, zafirlukast, and zileuton

Front 36

What are the adverse effects of zileuton?

Back 36

Elevation of liver enzymes

Front 37

What is the common ending of corticosteroids?

Back 37

"sone"

Front 38

By what mechanism do all corticosteroids work?

Back 38

1. Inhibition of phospholipase A2
2. Reduced expression of cyclooxygenase

Front 39

What are the adverse side effects of inhaled corticosteroids?

Back 39

Pharyngeal candidiasis (fungal infection)

Front 40

What is a an antibody used to treat asthma?

Back 40

Omalizumab

Front 41

By what mechanism do anti-IgE monoclonal antibodies work?

Back 41

- Bind IgE antibodies on mast cells to prevent sensitization
- Reduces reaction to inhaled antigen

Front 42

When are antibodies used?

Back 42

Prophylaxis of severe asthma, not responsive to all other drugs

Front 43

What are the negative aspects of antibody treatment?

Back 43

Expensive, toxicities not well understood yet

Front 44

What are inhaled corticosteroids used for?

Back 44

Prophylaxis of asthma (drug of choice)

Front 45

What are systemic (oral) corticosteroids used for?

Back 45

Severe refractory chronic asthma