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Pharm 46 Asthma

LECOM Pharm Ch 46 integrated Asthma

Drug derived from atropine ipratropium
MOA of ipratropium in asthma M3 cholinergic receptor antagonist, bronchorelaxation and decreased mucus
SE of ipratropium dry mouth, GI upset
Long acting Anticholinergic used for COPD Tiotropium
MOA of epinephrine α-, β1-, β2- adrenergic agonist
MOA of isoproterenol β1-, β2- adrenergic agonist
Activation of beta-adrenergic receptors has what effect on cAMP? Ca++? K permeability? increases cAMP; decreases intracellular Ca; increases K permeability
Stereoisomer of albuterol that has higher affinity for β2- adrenergic receptors? Levalbuterol (R-)
SE caused by epinephrine but not isoproterenol? Why? HTN; alpha adrenergic agonist
5 “newer” agents that bind β2- adrenergic receptors 200-400x more than β1-? levalbuterol, albuterol, terbutaline, bitolterol, pirbuterol
MOA of Salmeterol/Formoterol? Difference? long acting β2- adrenergic agonist; Formoterol is fast acting, salmeterol is not
MOA of theophylline nonselective phosphodiesterase inhibitor; prevents cAMP degredation and T-cell immunomodulator
Drug used in Tx of asthma that can cause ventricular arrhythmias and seizures Theophylline
Pt w/ Hx of asthma. Dx with GERD and started on new drug. Pt presents to the ED with NVD, insomnia and then seizure. What are the 2 drugs he is being treated with? Theophylline and Cimetidine
Glucocorticoids decrease what 2 factors that reduce the inflammatory response in asthma? Il-4 and IL-5
2 inhaled steroids that do not exhibit 1st pass metabolism beclomethasone and triamcinolone
Oral infection by this bug can be a side effect of inhaled steroids. How can you mitigate? Candida ; spacer and wash out mouth
MOA of cromolyn “mast cell stabilizer” as well as preventing mediator release from other WBCs
This drug is used with success in younger patients as well as those with exercise induced asthma. cromolyn
Downfall of cromolyn administration QID treatments- inhaled
MOA of zileuton 5-Lipoxegenase inhibitor
These levels are decreased with Zileuton treatment. LTA, LTC, LTD, LTE
MOA of montelukast and zafirlukast CysLT1 receptor blockers aka LTC4, LTD4, LTE4 blocker
What is different about Tx with Leukotriene pathway blockers than all the other drugs? oral administration
What is seen in Pts with decreased pulmonary function with administration of leukotriene pathway inhibitors? slight increase in pulmonary function
MC toxicity with Zileuton treatment hepatotoxicity
An asthmatic Pt presents with granulomatous vasculitis iinvolving the small arteries of the heart, lungs, kidney and skin. What drug is causing this? Leukotriene receptor blockers aka montelukast and zafirlukast
MOA of omalizumab FcεRI antibody; blocks IgE from binding on mast cell and decreases circulating levels of IgE
Omalizumab also has this effect of IgE receptors downregulation of receptor production
Tx with Omalizumab differs from all other asthma treatments because of what? It is parenteralally administered; SubQ every 2-4 weeks
Treatment with theophylline and zifirlukast results in what? decreased levels of zafirlukast
Created by: csheck