Rsp1 Maloney Drugs To Treat Asthma And Copd

Front 1

What is the main effector function of TH2 cells?

Back 1

Activate B cells and stimulate the diffrentiation of eosinophils

Front 2

What immunoglobulin is responsible for the degranulation of mast cells?

Back 2

IgE

Front 3

The degranulation of mast cells causes the release of ____________,__________ and ___________ that causes ______________, chronic inflamation and airway ____________.

Back 3

Histamine

Leukotrienes

Cytokines

Bronchospasm

Hyperresponsiveness

Front 4

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

Back 4

Anti inflammatory agents

Front 5

Diffrentiate between the use of inhaled corticosteroidxs and systemic oral corticosteroids in the treatment of asthma or COPD.

Back 5

Inhalation is the best way to minimize the side effects from chronic steroid use (decreased absorbtion= less systemic effects)

Inhaled= long term therapy

Systemic= acute severe exacerbations or chronic severe asthma

Front 6

How do inhaled corticosteroid enhace the effectiveness of bronchodialators?

Back 6

they potentiate beta adernergic agents by enhancing cAMP production and up regulating receptor levels

No direct effect on muscle tension

Front 7

What is the 1st line drug for the long term control of persistant asthma?

Back 7

Inhaled corticosteroid

Front 8

What are some of the adverse effects of inhaled corticosteroids?

Back 8

Unplesant Taste

Oral candidiasis

Dysphonia

Reflex cough and brochospasm

Front 9

What are some of the adverse side effects to oral systemic corticosteroids?

Back 9

Think Cushing Syndrome:

Euphoria
Buffalo Hump
Hypertension
Thin arms and legs with muscle wasting
Cataracts
Moon facies
Increased abdominal fat
Avascular necrosis of the femoral head
Poor wound healing

Front 10

What therapeutic interventions can be used to block/inhibit the mediators of mast cells?

Back 10

Block Leukotrienes

Prevent the degranulation of mast cells

Block IgE from binding to mast cell


*****ANTIHISTAMINES NOT EFFECTIVE FOR ASTHMA!

Front 11

Which antiinflammatory agent causes Churg-Strauss syndrome and elevated liver enzymes as adverse effects?

Back 11

Leukotriene Modifiers

CSS- montelukast and zafirlukast

increased liver enzymes- Zileuton

Front 12

Which antiinflammatory agent has the potential to cause anaphylaxis?

Back 12

Omalizumab (Anti IgE agent)

Front 13

What are some of the side effects of mast cell stabilizers?

Back 13

Irritate throat (brochospasm and cough)

Unpleasant taste

minimal systemic absorbtion

Front 14

What is the MOA for mast cell stabilizers?

Back 14

Not clear

prevents the degranulation of mast cells and hence the release of mediators

Front 15

What is the precursor to Leukotrienes?

Back 15

Aracodonic Acid

Front 16

Name the leukotriene derivative that is best associated with Asthma and COPD

Back 16

COPD- LTB4

Asthma- LTD4

Front 17

How can you prevent or modify the action of leukotrienes?

Back 17

Inhibit 5 lipoxygenase (decrease production)

Block their receptors

Front 18

What is the mechanism of action for Montelukast?

Back 18

CytLT1 receptor antagonist; blocks the binding of LTD4 leukotrienes

Front 19

What is the mechanism of action for Omalizumab?

Back 19

Recombinany humanized monoclonal antibody to IgE that prevents allergen induced activation of mast cells and basophils

Front 20

Which antiinflamatory agent for the treatment of asthma is administed parentally (IV)?

Back 20

Omalizumab

Front 21

Why would montelukast reduce bronchoconstriction from asprin induced asthma?

Back 21

Asprin blocks COX which increases the lipogenoxydase pathway and elevated leukotriens.

LMs decrease the effects of this increase in the production of mediators

Front 22

What antiinflammatory agents are used to treat excercise induced asthma?

Back 22

Mast cell stabilizers

LABAs (used before excercise to prevent EIB)

SABAs (provide acute relief)

Front 23

what agents are second line drugs for the treament of mild persistant asthma?

Back 23

Leukotriene modifiers

Mast cell stabilizers

Front 24

What are thr 3 classes of agents that can act as brochodialators?

Back 24

B2 agonists

M blockers

Methylxanthines

Front 25

Name the class of drugs:

Albuterol
Levalbuterol
Tertbutaline

Back 25

Short acting beta agonists (SABA)

Front 26

Name the class of drug:

Salmeterol
Formoterol

Back 26

Long acting beta agonist (LABA)

Front 27

Name the class of drugs:

Ipatropium Bromide
Tiotropium bromide

Back 27

Anticholinergics (M blockers)

Front 28

How do you acheive the physiological antagonistic effects necessary for brochodialation in asthma?

Back 28

activate beta 2 receptors and block M3 receptors on the lungs

Front 29

What are some of the adverse effects of beta 2 agonists?

Back 29

Tremor

Hypokalemia

Palpitations/sinus Tachy

increased BP

Front 30

What is the signaling pathway by which beta 2 receptor activation causes bronchodialtion?

Back 30

Activates adenylate cyclase to increase cAMP which activates PKA that phosphorylates proteins

Front 31

What enzyme breaks down cAMP?

Back 31

Phosphodiesterase

Front 32

Name the class of drugs:

Theophylline
Aminophylline

Back 32

Methylxanthines

Front 33

What is the MOA of methylxanthines?

Back 33

inhibits phosphodiesterase

Inhibits adenosine receptors

(lead to relaxation in smooth muscle and antiinflammatory effect concerning T cells, Eosinophils and mast cells)


(Non selective PDE inhibitor but especially inhibits PDE4)

Front 34

What is the 1st line drug for the treatment of an exacerbation of asthma or COPD?

Back 34

SABAs

(ipatropium bromide may also be administed along with SABA in emergency)

Front 35

What are some of the side effects/ problems with Methylxanthines?

Back 35

Narrow therapeutic index/ erratic bioavailibility (monitor dru levels)

Irritates GI mucosa

Increased CNS stimulation (think problems with caffeine)

Front 36

What are the bronchodialators that are used in the long term control of asthma?

Back 36

Inhaled LABAs (used in conjection with inhaled corticosteroids)

Methylxanthines

Front 37

What is the treatment for acute exacerbations of COPD?

Back 37

SABAs

If prompt response does not occur add a M blocker

may also add systemic glucocorticoid if severe

Front 38

What treatment is used for the management of stable COPD?

Back 38

Choice of LABA, anticholinergic or methylxanthine (or combination depending on degree of symptom relief and side effects)

Add inhaled or systemic glucocorticoid for severe COPD