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Pharmacology > Respiratory Pharmacology > Flashcards

Respiratory Pharmacology Flashcards

1
Q

what is asthma

A

reversible airway obstruction as a result of bronchial hyper-reactivity, airway inflammation, mucous plugging, and smooth muscle hypertrophy

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2
Q

how does bradykinin cause an increase in cough

A
  • increase prostaglandins (PGE2-PG12)
  • increase leukotrienes
  • increase histamine
  • activate type J receptors at peripheral vagal afferent endings/ non myelinated or C fibers
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3
Q

drug used to diagnose asthma

A

methacholine

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4
Q

inadequate surfactant lead to RDS so how then can that be prevented in women about to give birth

A

give them dexamethasone (glucocorticoids)

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5
Q

test used to check fetal lung maturity

A

lecithin to sphingomyelin > 2 in amniotic fluid indicates matured fetal lung

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6
Q

drugs used in asthma

A

bronchodilators: beta 2 agonists, antimuscarinics, methylxanthines

anti inflammatory agents: corticosteroids, leukotriene inhibitors, mast cell stabilizers, anti IgE antibody

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7
Q

beta 2 adrenergic agonists (classify by short acting for acute and long acting for non acute symptoms)

A

short acting: albuterol, pirbuterol, and terbutaline

long acting: salmeterol and formoterol

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8
Q

long acting beta 2 agonists can be taken in combination with what for control and prevention of symptoms in moderate to severe persistent asthma

A

inhalational corticosteroids

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9
Q

drugs used for exercise induced bronchoconstriction (EIC)

A

short acting beta 2 agonist
long acting beta 2 agonist
montelukast

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10
Q

adverse effects of beta 2 agonists

A
  • most common: tremor, tachycardia, arrhythmias, hyperglycemia
  • tolerance with excessive use
  • paradoxical bronchospasm
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11
Q

anticholinergics that are used as bronchodilators and conditions they are used

A

ipratropium - short acting for asthma, QID (4 times a day)

tiotropium - long acting for COPD

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12
Q

mechanism of anticholinergics in bronchial SM

A

parasympathetic stimulation –> bronchial constriction and mucous secretion so anticholinergics block the muscarinic receptors in SM –> bronchial dilation of airway

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13
Q

adverse effects of ipratropium

A

dry mouth

caution with glaucoma, BPH, and bladder neck obstruction

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14
Q

methylxanthines used to treat asthma

A

theophylline

aminophylline

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15
Q

mechanism of methylxanthines (name them again)

A

theophylline and aminophylline

inhibit phosphodiesterase hence increasing cAMP –> bronchodilation

also block adenosine receptors

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16
Q

drugs that increase theophylline plasma levels

A

cimetidine, erythromycin, and ciprofloxacin

17
Q

drugs that decrease theophylline plasma levels

A

phenytoin, phenobarbitone, and carbamazepine

18
Q

complications of theophylline overdose

A

tremor, insomnia, GI distress, nausea, hypokalemia, hyperglycemia

seizures and arrhythmias

19
Q

corticosteroids used in asthma

A

BF2 DP

beclomethasone
budesonide
fluticasone
flunisolide
dexamethasone
prednisolone
20
Q

drug given for uncontrolled allergic asthma

A

omalizumab

21
Q

what is corticosteroids relationship to beta receptors

A

it increases beta 2 responsiveness and help reduce the need for beta 2 agonists

prevent remodeling of the respiratory tract

22
Q

adverse effects of inhaled corticosteroids (ICS)

A
  • more limited than systemic steroids

- cough, oral thrush, and dysphonia (difficulty speaking)

23
Q

what are the systemic corticosteroids and their importance

A
  • dexamethasone and prednisolone: life saving in status asthmaticus
  • oral glucocorticoids: short course used for exacerbations with incomplete response to beta 2 agonists
24
Q

adverse effects of systemic corticosteroids and how do you minimize these effects

A 
abnormalities in glucose metabolism
increased appetite
weight gain
hypertension
adrenal suppression

limiting systemic therapy to few days

25
Q

risk of uncontrolled asthma in pregnant women

A

pre eclampsia
perinatal mortality
pre term labor
low birth weight

hence tx pregnant woman with asthma as aggressively as women who are not preggo

26
Q

effects of inhaled corticosteroids during first trimester

A

congenital abnormalities

endocrine and metabolic abnormalities

27
Q

leukotriene inhibitors

A

zileuton
zafirlukast
montelukast

28
Q

mechanism of leukotriene inhibitors

A

either block synthesis of leukotrienes or block the leukotriene receptors

  • zileuton inhibits 5-LOX which forms leukotriene from arachidonic acid
  • zafirlukast and montelukast are LTD4 receptor antagonist
29
Q

clinical uses of leukotriene inhibitors (name them again)

A

zileuton, zafirlukast, montelukast

  • prevent exercise, antigen, and aspirin induced asthma
  • prevent bronchoconstriction and airway inflammation long term but not useful in acute bronchospasm
30
Q

adverse effects of zileuton

A

elevated liver enzymes

31
Q

adverse effects of zafirlukast and montelukast

A

vasculitis and systemic eosinophilia resembling churg strauss

32
Q

what is omalizumab

A

anti IgE antibody (on mast cells) that prevents activation by triggers - prevents release of LTs and other mediators

33
Q

uses of omalizumab

A

prophylactic management in asthmatic pts

and in cases of inadequate control with ICS

34
Q

adverse effects of omalizumab

A

causes anaphylaxis - life threatening systemic allergic rxn

35
Q

release inhibitors used in asthma

A

cromolyn

nedocromil

36
Q

mechanism of release inhibitors in asthma (name them again)

A

cromolyn and nedocromil

prophylactic agent that stabilize the membrane of mast cells and prevent release of inflammatory mediator

37
Q

uses of cromolyn and nedocromil

A

not for acute attacks of asthma

pretreatment blocks allergen and exercise induce bronchoconstriction

prevents food allergy and hay fever

38
Q

adverse effects of cromolyn

A

infrequent laryngeal edema
cough
wheezing

39
Q

adverse effects of nedocromil

A

unpleasant taste

Pharmacology (79 decks)

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