Term
| What drug class has both anti-inflammatory and bronchodilating effects? |
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Definition
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Term
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Definition
- Increase cAMP through activation of adenylyl cyclase
- Activation of K+ channels - hyperpolarization of SM |
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Term
| What is the major mechanisms for airway dilation? |
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Definition
| Sympathetic release of epi from adrenal gland - dilation by binding to B2 |
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Term
| What is the mechanism for bronchoconstriction? |
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Definition
| Excitatory nerves and the vagus nerve -- Ach |
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Term
| What are the effects of increasing cAMP? |
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Definition
- Decrease in the activity of inflammatory cells - Mast cells, eosinophils, lymphocytes - decr release of histamine, LT, cytokines.
- Incr in mucociliary activity |
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Term
| How do anticholinergics work? |
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Definition
- Inhibit binding of Ach to M1 and M3 --> inhibit SM contraction
- inhibit M1 and M3 secretions, M2 auto-receptors
- Similar in structure to ATROPINE |
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Term
| What drugs are anticholinergics? |
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Definition
- Ipratroprium/Atrovent - t1/2 = 3hrs
- Tiotropium/Spiriva - T1/2 = 10 hours. M3>M2.
**better in COPD>asthma |
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Term
| How do methylxanthines work? |
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Definition
- Inhibit PDE activity, there for cAMP and cGMP breakdown
- Similar in structure to CAFFEINE
- Also competitive antagonist at adenosine receptors - prevents adenosine-induced bronchoconstriction
**Aminophylline - complex w/ ethylene diamine that increases solubility |
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Term
| How do corticosteroids work for asthma tx? |
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Definition
- Bind to cytoplasmic steroid receptors to block transcription. Decr cytokines, leukotrienes, PGs
- Block degranulation and histamine release |
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Term
| How do mast cell stabilizers work? |
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Definition
Stabilize mast cell membranes to decrease degranulation, release of histamine, LTs, and ILs
- Cromolyn/Nasalcrom |
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Term
| How do leukotriene modifiers work? |
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Definition
- Synthesis inhibitors - inhibits 5-lipoxygenase - conversion from AA - Zileuton/Zyflo
- Receptor antagonists - binds to LT receptors to decrease bronchoconstriction - Zafirlukast/Accolate and Montelukast/Singulair |
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Term
| How is anti IgE therapy used? |
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Definition
- For moderate to severe asthma that is not well controlled
- a recombinant MAB binds to the Fc of IgE - cannot bind to receptors on mast cells, basophils, B & T lymphocytes. DECREASE in circulating IgE.
- Dose based on weight q2-4 weeks |
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Term
| What is the difference between COPD tx and asthma? |
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Definition
- Greater use of anticholinergics - muscarinic receptor mechanism more dominant
- Lower effectiveness of Beta receptor agonists - obstruction not due to SM contraction
- Less chronic use of steroids |
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Term
| What combo products are used for asthma and COPD? |
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Definition
- Fluticasone and salmeterol/Advair - Asthma and COPD
- Budesonide and formoterol/Symbicort - asthma and COPD
- Ipratropium and albuterol/Combivent - COPD only |
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Term
| What disease states are associated with Type I hypersensitivity? |
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Definition
- Bronchial Asthma
- Allergic Rhinitis
- Food Allergy
- Anaphylaxis |
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Term
| How are antihistamines used to treat allergic rhinitis? |
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Definition
- Histamine is released by mast cells, binds to H1 receptors --> vasodilation and increased vascular permeability
- H1 antagonists inhibit this binding |
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Term
| What are first generation antihistamines? |
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Definition
Clemastine/Tavist
Diphenhydramine/Benadryl
Doxylamine/Nyquil
Brompheniramine/Dimetane
Chlorpheniramine/Chlortrimeton |
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Term
| What are 2nd generation antihistamines? |
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Definition
Azelastine/Astelin or Astepro
Cetirizine/Zyrtec
Desloratidine/Clarinex
Fexofenadine/Allegra
Levocetirizine/Xyzal
Loratidine/Claritin or Alavert
Olopatidine/Patanase |
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Term
| What intranasal corticosteroids are used for allergic rhinitis? |
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Definition
-Beclomethasone/Beconase
-Budesonide/Rhinocort
- Flunisolide/Nasalide
- Fluticasone/Flonase
- Triamcinolone/Nasacort
- Mometasone/Nasonex
- Ciclesonide/Omnaris |
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