Resp: 7. Maloney : Asthma/copd

Front 1

what cell's response is exaggerated in asthma?

Back 1

TH2

Front 2

Chronic inflammation and Airway hyperresponsiveness seen in asthma are caused by what cells?

Back 2

eosiniophils

Front 3

bronchospasm in asthma is due to what cell? releasing (3)?

Back 3

mast cell: histamine, leukotrienes, cytokines

Front 4

What are the most effective drugs for the chronic treatment of asthma?

Back 4

anti-inflammatory drugs

Front 5

in general there are 2 types of asthma drugs, what are they?

Back 5

anti-inflammatory

bronchodilators

Front 6

What is probably the best, most versatile, often used type of anti-inflammatory drug?

Back 6

corticosteroids

Front 7

what are 4 of the anti-inflammatory drugs (general) that can be used in asthma

Back 7

Corticosteroids
Mast cell stabilizers
Leukotriene modifiers
Omalizumab

Front 8

What is the best way to minimize the side effects from steroids when treating asthma?

Back 8

administer via inhalation to prevent widespread effect

Front 9

what is the cornerstone of asthma therapy??

Back 9

ANTI-INFLAMMATORY EFFECT

Front 10

what is the mechanism of action for inhaled corticosteroids?

Back 10

ant-inflammatory effect

The cornerstone of asthma therapy

more specifically: Potentiate b adrenergic agents by enhancing cAMP production and up regulating receptor level

Front 11

do you give corticosteroids for acute asthma attacks? why?

Back 11

NO

it isn't fast enough and doesn't have a direct effect on muscle tension

Front 12

what is the long term control of asthma?

Back 12

Inhaled Corticosteroids

Front 13

oral candidiasis (thrush) is a side effect of what? why?

Back 13

corticosteroids

they are immunosuppressive... so it gives fungus the chance to grow

Front 14

what can you do to prevent reflex cough/bronchospasm in corticosteroid use

Back 14

give a B2 agonist before giving steroid

Front 15

Prednisone
Prednisolone
Methylprednisolone

are what kind of drugs?

Back 15

Oral Systemic Corticosteroids

Front 16

When would you use oral systemic corticosteroids for asthma???

what are 3 examples of these again?

Back 16

acute severe exacerbation

Prednisone
Prednisolone
Methylprednisolone

Front 17

when do you use oral systemic corticosteroids for long-term control?

Back 17

in the most severe, difficult-to-control asthma cases

where inhaled don't work

Front 18

Cromolyn is what kind of drug

Back 18

mast cell stabilizer

Front 19

Nedocromil is what kind of drug

Back 19

mast cell stabilizer

Front 20

how does Cromolyn work?

Back 20

prevents mast cell degranulation aka release of histamine, leukotrienes, cytokines

Front 21

would Cromolyn reverse severe bronchoconstriction?

Back 21

NO!

Front 22

are mast cell stabilizers the preferred agents for long term treatment of asthma?

Back 22

NO

corticosteriods are

Front 23

what would you use for exercise induced asthma?

Back 23

Cromolyn (this is actually only one option; B blockers work here too)

Front 24

what are the side-effects of Cromolyn

Back 24

almost none!

Front 25

leukotrienes do what to smooth muscle?

Back 25

bronchoconstrict

Front 26

How can you prevent/modify the action of leukotrienes?

Back 26

inhibit their production or block their receptor

Front 27

Zileuton does what? how does it do this?

Back 27

inhibits production of leukotrienes

5-lipoxygenase inhibitor

Front 28

Montelukast does what? how?

Back 28

blocks leukotriene receptors

CytLT1 antagonists

Front 29

Zafirlukast does what? how

Back 29

blocks leukotriene receptors

CytLT1 antagonists

Front 30

are leukotriene modifiers used in acute asthma treatment?

Back 30

NO

Alternative, not preferred, treatment option for mild persistent asthma

Front 31

why are leukotriene modifiers good for Aspirin-sensitive asthmatics

Back 31

if you are blocking COX you start making more leukotrienes, so if you block their production/receptors, you can help these pts

Front 32

what type of drug do you want to use for Aspirin-sensitive asthmatics

Back 32

Leukotriene Modifiers

montelukast (possibly preferred)

Front 33

Omalizumab is what kind of drug?

Back 33

Recombinant humanized monoclonal antibody to IgE

Front 34

how does Omalizumab work?

Back 34

stops IgE bound with antigen from binding to Mast cells...thus stopping the release of Histamine, Leukotrienes, and Cytokines

Front 35

what is a major concern with the use of Omalizumab

Back 35

you can have the possibility for anaphylaxis

Front 36

what are the 3 bronchodilators? (general)

Back 36

b2 agonists
M blockers
Methylxanthines

Front 37

what are the 3 long acting B2 agonists?

Back 37

Salmeterol (can last a long time but takes a while to work)

Formoterol

Arformoterol

Front 38

Do you want to use albuterol or salmetorol in an acute asthma attack? why

Back 38

albuterol

salmetorol will last longer, but is slower to start working

Front 39

Ipratropium bromide is what kind of drug

Back 39

Anticholinergic

Front 40

Tiotropium bromide is what kind of drug

Back 40

Anticholinergic

Front 41

Tiotropium bromide is normally used for what?

Back 41

COPD

Front 42

what are the 2 receptors found on the lung?

Back 42

M3 (activation causes constriction)

B2 (activation causes dilation)

Front 43

What is the signaling pathway by which b2 receptor activation causes bronchodilation?

Back 43

Gs and increase cAMP

Front 44

What enzyme breaks down cAMP?

Back 44

phosphodiesterase

Front 45

Theophylline is what kind of drug

Back 45

Methylxanthine
which is a phosphodiesterase inhibitor

prevents cAMP degradation
--this in turn allows for B2 receptor activation to cause bronchodilation for a longer period of time

Front 46

Aminophylline is what kind of drug

Back 46

Methylxanthine
which is a phosphodiesterase inhibitor

prevents cAMP degradation
--this in turn allows for B2 receptor activation to cause bronchodilation for a longer period of time

Front 47

what does Theophylline do (MOA)

Back 47

prevents cAMP degradation

works in both smooth muscle for relaxation and in mast cells to block adenosine receptors (anti-inflammatory)

Front 48

what asthma drug has a low therapeutic index?

Back 48

the methylxanthines (PDE inhibitors)

Front 49

what is the drug of choice for the acute asthma attack?

what should you give for a few days after?

Back 49

BETA AGONIST

systemic corticosteriod

Front 50

short acting beta agonists can also prevent exercise asthma...

Back 50

just know it

Front 51

what is your add on drug for quick relief?

Back 51

you start with B2 agonists (short acting)

then you add on anticholinergics (specifically Ipratropium bromide )

Front 52

what is your quick relief drug for moderate to severe exacerbations of asthma (after B agonists)

Back 52

Systemic corticosteroids

anti-inflammatory

Front 53

what is your first line drug for long term control of asthma

Back 53

Inhaled corticosteroids (anti-inflam)

Front 54

after inhaled corticosteroids, what are the long term control drugs for asthma?

Back 54

Leukotriene modifiers
Mast cell stabilizers
Omalizumab (refractory)
Inhaled long acting b2 agonists (LABAs)
Preferred add on to ICS
Methylxanthines

Front 55

what do you use for acute exacerbations of COPD? if you don't get a quick response?

Back 55

Short acting b2 agonist

If prompt response does not occur, then add anticholinergic

Front 56

what do you use for chronic therapy of severe COPD?

Back 56

Add inhaled glucocorticoid to bronchodilator treatment for more severe symptomatic COPD (chronic therapy)

Front 57

what kind of drug is Budesonide?

Back 57

Inhaled corticosteroid

Front 58

what kind of drug is Fluticasone?

Back 58

Inhaled corticosteroid

Front 59

Metaproterenol is what kind of drug?

Back 59

quick onset beta agonist

Front 60

Albuterol is what kind of drug?

Back 60

quick onset beta agonist

Front 61

Levalbuterol is what kind of drug?

Back 61

quick onset beta agonist

Front 62

Pirbuterol is what kind of drug?

Back 62

quick onset beta agonist

Front 63

Terbutaline is what kind of drug?

Back 63

quick onset beta agonist

Front 64

Salmeterol is what kind of drug?

Back 64

late onset beta agonist

Front 65

Formoterol is what kind of drug?

Back 65

late onset beta agonist

Front 66

Arformoterol is what kind of drug?

Back 66

late onset beta agonist