pulm 2 - drugs
Terms
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- name the three bronchodilators used for OPD
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1. b agonists
2. anticholinergics
3. theophylline (phosphodiesterase inhibitors) - name the 4 anti-inflamms used in OPD?
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1. corticosteroids
2. leukotriene agents
3. cromolyns
4. anti-IgE therapy - what is the prototype for short acting bronchodilator (b agonist)? long acting?
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short acting: salbutamol (ventolin)
long acting: sameterol - MOA of anticholinergics
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bind to M receptors (especially interested in M3)
promote relaation of smooth muscle - bronchodilation -
prototypes for anticholintergics
a) short acting
b) long acting -
1) ipratropium (Atrovent)
2) tiotropium - what is the first line drug in COPD (ACUTE AND CHRONIC!)
- the short acting anticholinergic called ipratropium
- MOA of theophylline
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inhibits phosphodiesterases (which usually break down cAMP) - prolonged cell signalling
increased NTs and autocoids --> SM relaxation and bronchodilation
**memory trick - theo...filines - main bad thing about theophylline
- NARROW THERAPEUTIC INDEX (the and filene's are too good to be true)
- what is the 2nd line drug for COPD?
- theophylline
- 3 effects of corticosteroids
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1. inhibit cytokine and eicosanoid synthesis
2. reduce accumulation of eosinophils and basophils
3. decrease vascular permeability - what are the 2 orally administered corticosteroids?
- prednisone, prednisolone
- methylprednisolone is an example of...
- an IV administered corticosteroid
- hydrocortisone is an example of...
- an IV administered corticosteroid
- beclomethasone is an example of...
- an inhaled corticosteroid
- fluticasone is an example of...
- an inhaled coridcosteroid
- budesonide is an example of
- an inhaled corticosteroid
- leukotrienes are part of a broad group of chemicals called...; what do these do?
- eicosanoids; stiumulate luekocyte aggregation, borhncial mucous secretion, SM contraction
- what are 2 ways we can target leukotrienes in OPD?
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1. leukotriene receptor antagonists
2.leukotriene synth inhibitors - indication for leukotriene agents?
- cases of 'mild' asthma - a nice alternative to corticosteroids
- zafirlukast is an example of a...
- leukotriene antagonist
- zileuton is an example of...
- a leukotriene synthesis inhibitor
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which is NOT a MOA of cromolyn:
-mast cell inhibition
-supression of chemotactic peptides
-inhibition of parasympathetics and cough reflexes
-decreased IgE synthesis
-decreased activation and aggregation of leukocytes - decreased IgE synthesis
- do you see the effects of cromolyn immediately?
- no - it takes 2-3 mos of regular use
- omalizumab is an example of...
- anti-IgE therapy
- indications for anti-IgE therapy
- mod-severe asthma; allergies
- is anti-IgE therapy used for acute/chronic asthma
- chronic
- MOA of IgE therapy
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= monoclonal AB against IgE
-binds to IgE, preventing IgE from binding to the mast cell and basophil