Asthma Medications and Biologic Therapies Quiz

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Questions and Answers

Which medication is indicated for immediate relief of asthma symptoms?

Mast cell stabilizers

Long-acting anticholinergics

Short-acting beta-adrenergic agonists (correct)

Leukotriene antagonists

What is the primary goal of asthma pharmacotherapy?

To eliminate the need for long-term control medications

To achieve and maintain control of asthma symptoms (correct)

To prevent all asthma attacks

To provide immediate relief only

Which medication is classified as a long-acting anti-inflammatory agent for asthma?

Mast cell stabilizers

Corticosteroids (correct)

Short-acting beta-adrenergic agonists

Roflumilast

What is the basic mechanism of action of antitussive agents?

To suppress or relieve coughing Signup and view all the answers

What is the recommended initial dose of Ipratropium Br for asthma exacerbation?

0.5mg every 30 minutes X 3 Signup and view all the answers

What should be monitored in patients with severe respiratory distress unresponsive to medications?

FEV1 or PEF, O2 saturation, and pulse Signup and view all the answers

When should patients be admitted to the ICU for asthma exacerbation?

If there is impending respiratory failure Signup and view all the answers

When should controller medications be reassessed for asthma patients?

If patients have asthma symptoms or need a rescue inhaler more than twice a week Signup and view all the answers

Which class of medications is preferred for long-term control in combination with low-dose inhaled corticosteroids (ICS)?

Long-acting beta-2 agonists (LABAs) Signup and view all the answers

What adverse effects are associated with beta-2 agonists?

Heart rate changes, tremors, nervousness Signup and view all the answers

Which medication is indicated for significant asthma exacerbations?

Systemic corticosteroids Signup and view all the answers

Which biologic agent is used for moderate to severe asthma with poor ICS control?

Omalizumab (Xolair) Signup and view all the answers

What is the observed risk associated with salmeterol according to the SMART study?

Increased risks of respiratory-related death or life-threatening experiences Signup and view all the answers

Which medication class is the most effective anti-inflammatory agent for asthma?

Inhaled corticosteroids (ICS) Signup and view all the answers

In which situations are other beta agonists like terbutaline and isoproterenol used?

Only in emergencies Signup and view all the answers

What are the potential adverse effects of inhaled corticosteroids (ICS)?

Oral candidiasis, dysphonia, reflex cough Signup and view all the answers

What is the example of a low-dose ICS-formoterol prescription provided for?

Long-term control of asthma Signup and view all the answers

What is the preferred combination for long-term control in asthma management?

LABAs and low-dose ICS Signup and view all the answers

When are systemic corticosteroids indicated in asthma treatment?

For significant asthma exacerbations Signup and view all the answers

How are biologic agents like omalizumab (Xolair) administered?

Subcutaneously Signup and view all the answers

Which cells become activated and sensitized by IgE in asthma?

Mast cells and lymphocytes Signup and view all the answers

What can provoke acute inflammation in asthma?

Viral infection, allergens, and irritants Signup and view all the answers

What are the goals of asthma treatment?

Achieving few symptoms, no sleep disturbance, no exercise limitation, maintaining normal lung function, preventing flare-ups and asthma deaths, and minimizing medication side-effects Signup and view all the answers

Which treatment delivery device is breath-actuated and delivers micronized drug particles via inspiration?

Dry powder inhalers (DPIs) Signup and view all the answers

What is the primary role of parasympathetic (vagal) stimulation in airway tone?

Provides normal resting airway tone Signup and view all the answers

Which factor contributes to chronic airway hyperreactivity in asthma?

Chronic inflammation involving various cells Signup and view all the answers

What is the primary function of nebulizers in asthma treatment?

Produce an aerosol from liquid connected to compressed O2 Signup and view all the answers

What distinguishes soft mist inhalers (SMIIs) from metered dose inhalers (MDIs)?

SMIIs are larger than MDIs, without propellant, and produce a high fine particle fraction Signup and view all the answers

What is the effect of chronic inflammation in asthma on airways?

Leads to the remodeling of airways with fibrotic tissue and increased smooth muscle Signup and view all the answers

What is the role of catecholamines like epinephrine in asthma treatment?

Cause bronchodilation Signup and view all the answers

What is the genetic susceptibility to produce IgE directed toward common environmental allergens known as?

Atopy Signup and view all the answers

What is the function of IgE in asthma?

Causes mast cells and lymphocytes to become activated and sensitized when challenged by allergens Signup and view all the answers

Which medication is indicated for poorly controlled moderate to severe asthma in patients with positive skin or in vitro testing for allergens?

Omalizumab (Xolair) Signup and view all the answers

What is the indicated blood eosinophil count for the use of Mepolizumab in severe asthma patients?

150/microL or greater Signup and view all the answers

How is Reslizumab administered for severe eosinophilic asthma?

Intravenously Signup and view all the answers

What is the primary target of Benralizumab in the treatment of severe eosinophilic asthma?

IL-5 Signup and view all the answers

What is the mechanism of action of Dupilumab in the treatment of eosinophilic asthma?

Blocks the effects of IL-4 Signup and view all the answers

What is the target of Tezepelumab in the treatment of severe asthma maintenance?

TSLP Signup and view all the answers

How does the Global Initiative for Asthma classify and manage asthma severity?

Based on impairment and risk of exacerbations Signup and view all the answers

What are the biomarkers for T2/eosinophilic asthma?

Child onset allergic asthma Signup and view all the answers

What are the risk factors for death due to asthma?

Prior ICU admissions Signup and view all the answers

How are mild to moderate asthma exacerbations managed at home?

SABA or GC (budesonide)-formoterol Signup and view all the answers

What is the management approach for intermediate and poor responses to SABA?

Oral corticosteroids Signup and view all the answers

Study Notes

Asthma Medications Overview

Classes of medications for asthma include beta-2 agonists, glucocorticosteroids, leukotriene blockers, mast cell stabilizers, methylxanthines, and biologic agents
Beta-2 agonists are divided into short-acting (SABAs) and long-acting (LABAs), with examples like albuterol and formoterol
LABAs are preferred for long-term control in combination with low-dose inhaled corticosteroids (ICS), and they are not used without anti-inflammatory medications
The SMART study observed increased risks of respiratory-related death or life-threatening experiences with salmeterol, leading to FDA warnings
Other beta agonists like terbutaline and isoproterenol are only used in emergencies
Adverse effects of beta-2 agonists include heart rate changes, tremors, nervousness, hypokalemia, and potential tolerance with chronic use
Inhaled corticosteroids (ICS) are the most effective anti-inflammatory agents for asthma, improving responsiveness to beta2 agonists and lung function
ICS are preferred for daily maintenance therapy, with low, medium, and high-dose regimens depending on asthma severity
Adverse effects of ICS include oral candidiasis, dysphonia, reflex cough, and various systemic effects
A specific example of low-dose ICS-formoterol prescription is provided, with stepwise instructions for use
Systemic corticosteroids are indicated for significant asthma exacerbations and have potential adverse effects such as headache, palpitations, tachycardia, agitation, emesis, and seizures
Biologic agents like omalizumab (Xolair) are used for moderate to severe asthma with poor ICS control, administered via subcutaneous injection based on IgE levels and weight

Biologic Therapies for Severe Asthma

Omalizumab (Xolair) is indicated for poorly controlled moderate to severe asthma in patients with positive skin or in vitro testing for allergens, and adverse effects include pain at injection, headache, and rare anaphylaxis.
Mepolizumab is a monoclonal antibody to IL-5, indicated to reduce exacerbations in severe asthma patients with blood eosinophil counts of 150/microL or greater, administered subcutaneously.
Reslizumab, a monoclonal anti-IL-5 antibody, is indicated for severe eosinophilic asthma in patients age 18 or older, administered via IV infusion every 4 weeks.
Benralizumab, an interleukin-5 receptor antagonist, is indicated for severe eosinophilic asthma and administered subcutaneously.
Dupilumab blocks the effects of IL-4, indicated for moderate-to-severe eosinophilic asthma, administered subcutaneously every other week.
Tezepelumab is a monoclonal antibody that binds to epithelial cytokine TSLP, indicated for severe asthma maintenance in patients ≥12 years of age, administered subcutaneously every 4 weeks.
The Global Initiative for Asthma classifies and manages asthma severity based on impairment and risk of exacerbations, determining changes in therapy.
Newly diagnosed patients with mild intermittent asthma are treated with infrequent symptom relief, while those with severe asthma are referred to asthma specialists.
Biomarkers for T2/eosinophilic asthma include child onset allergic and adult onset hypereosinophilic asthma.
Risk factors for death due to asthma include a history of severe attacks, prior ICU admissions, and recent ED visits, among others.
Mild to moderate asthma exacerbations can be managed at home with SABA or GC (budesonide)-formoterol, with reassessment to determine the next steps.
Intermediate and poor responses to SABA require ED management with possible admission, including inhaled beta agonist and anticholinergic via nebulizer.

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Description

Test your knowledge of asthma medications and biologic therapies with this quiz. Learn about the classes of medications, their specific examples, indications, administration methods, and potential adverse effects. Explore the use of biologic agents for severe asthma and understand the management of asthma severity and exacerbations.