Pulmonary Pharm
Terms
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- What are the 2 drug classes to treat Asthma? Name the drugs in each class. (3)(2)
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1. Bronchodilators (Beta-2 Adrenoceptor Agonists, Methylxanthines, Muscarinic receptor antagonists)
2. Anti-inflammatory agents (Cromolyn Sodium, Neodocromil) - Beta-2 Adrenoceptor Agonists have what kind of suffix?
- -erol
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Describe the onset of Beta-2 agonists?
Duration? -
Rapid onset of action, 15-30 minutes.
Provide 4-6 hours relief. - What is a common Beta-2 agonist Bronchiodilater?
- Albuterol
- What is the difference between Beta-1 and Beta-2 receptors?
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Beta-1: Affect the heart, act by increasing the rate and force of contraction of the heart.
Beta-2: work on bronchial smooth muscle, cause bronchodilation. - What is Albuterol used for?
- Asthma and Prevention of exercise-induced bronchospasm.
- What are the 3 MOA of Albuterol?
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-Dilates the bronchi by a direct action on the Beta-2 adrenoceptors on the smooth muscle.
-Inhibits vagal tone
-Increases muscle clearance by the cilia. - What are the CVS SE of Albuterol?
- -CVS: (mainly due to beta-1 receptor stimulation), tachycardia, hypertension, angina and arrhythmias.
- What are the CNS SE of Albuterol?
- CNS: nervousness, anxiety, headache, dizziness, and insomina. Stimulant effect.
- What determines the likelihood of CV SE of any drug?
- Depends on if they have Beta-1 or Beta-2 selectivity. If they have beta-2 selectivity, they will only cause bronchiodilation and not effect the heart.
- What is an example of a Methylxanthine? How are they different from Beta-2?
- Theophylline. Used much less than Beta's. Naturally occuring. Theobromine - chocolate.
- Bronchiodilation in Methylxanthines is due to what?
- May be due to increasing cAMP.
- What are the CNS and CVS effects of Methylxanthines?
- CNS Stimulation, CVS cardiac stimulant, vasodilation of most vascular beds, (constriction of cerebral blood vessels). Accelerates mucus clearnace by the cilia.
- Name a type of Muscarnic receptor Antagonists bronchiodilator.
- ATROVENT
- How do muscarnic receptor antagonists work?
- Inhibit ACH mediated bronchospasm. Inhibits the increased mucus secretion in asthma, increase mucociliary clearnace of bronchial secretions.
- How is muscarnic receptor use different from other bronchiodilators?
- Used for bronchospasm associated with chronic bronchitis, emphysema and rhinorrhea (runny nose). SE: dry mouth and cough
- Generally, asthma is treated with...
- Bronchodilators and anti-inflammatory gulcocorticoids.
- Name three glucocorticosteroids that are used as anti-inflammatory drugs.
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1. Beclomethasone
2. Triamcinolone
3. Fluticasone - Are NSAIDs useful for asthma as a bronchiodilator?
- NO, in fact you can get Aspirin induced asthma.
- How do glucocorticosteroids work?
- They decrease inflammation from the inside out, starting at the cellular level. They reduce existing bronchial inflammation and/or prevent subsequent inflammation. Decrease # and activity of WBCs involved in airway inflammation.
- If someone is wheezing, what type of asthma med should you give them? Be specific.
- B2, not anti-inflammatory. Anti-inflammatory are used for PREVENTION, not in emergency situations.
- Name 2 uses of Beclomethasone.
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1. Used w/ pts who have severe asthma dn require inhalation of B2 agonist mroe than once daily.
2. Nasal spray, allergic rhinitis. - How do anti-inflammatory drugs like Beclomethasone work?
- Reduces the hyper-responsiveness or bronchiocontriction of airway
- Do Beclomethasone/Glucocorticosteroids cause bronchioconstriction or bronchiodilation?
- Neither. They PREVENT bronchioconstriction, but DO NOT cause bronchiodilation.
- Cromolyn sodium and nedocormal are....
- Anti-inflammatory drugs, specificially mast cell inhibitors.
- Cromolyn Sodium and Neodocormal are used for...
- Intended use as a prophylactic ONLY. PREVENTION ONLY!!! Derease bronchial hyperresponsiveness.
- How does Mast Cell Inhibitors like Cromolyn Sodium and Neodocormal work? MOA?
- Inhibit the release of inflammatory mediators from mast cells after exposure to an antigen. It is neither a brochodilator nor does it have any direct effect on smooth muscle.
- What are two distinguishing features about Mast Cell Inhibitors?
- They have a horrible taste and low SE.
- Are Mast Cell Inhibitors used to treat asthma?
- NO!! They are PREVENTION only.
- What is Cromolyn Sodium used for? What does it treat?
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They are used for:
-Prevention of Asthma
-Prevention of allergen or exercise-induced bronchoconstriction.
-Allergic rhinitis
Treats cough/wheezing/throat irritation, nasal congestion. Do not take if you have an asthma attack. - Drugs used to treat asthma include... (2)
- Bronchodilators and anti-inflammatory agents
- Druges to treat Rhinitis include...(4)
- Bronchodilators, anti-inflammatory agents, antihistamines and cromolyn sodium.
- Drugs to treat COPD include...(3)
- COPD bronchodilators, anti-inflammatory agents and anticholinergics.
- Drugs to treat cough include...(2)
- Dextromethorphan and opioids.