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Questions and Answers
Which of the following is true about LABAs?
Which of the following is true about LABAs?
SABAs are long-acting bronchodilators that provide relief for 12 hours.
SABAs are long-acting bronchodilators that provide relief for 12 hours.
False
What is the primary mechanism of action of beta agonists?
What is the primary mechanism of action of beta agonists?
They bind to Beta 2 smooth muscle cells, stimulating relaxation and bronchodilation via the cyclic AMP pathway.
The drug ________ is a long-acting muscarinic antagonist that lasts for 24 hours.
The drug ________ is a long-acting muscarinic antagonist that lasts for 24 hours.
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Match the following bronchodilators with their classifications:
Match the following bronchodilators with their classifications:
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Which of the following is a side effect of inhaled corticosteroids?
Which of the following is a side effect of inhaled corticosteroids?
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Oral decongestants can safely be given to children for more than 3 days.
Oral decongestants can safely be given to children for more than 3 days.
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What is the mechanism of action (MOA) of leukotriene antagonists?
What is the mechanism of action (MOA) of leukotriene antagonists?
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Patients with severe liver disease should ______ leukotriene modifiers.
Patients with severe liver disease should ______ leukotriene modifiers.
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Match the following medications with their associated precautions:
Match the following medications with their associated precautions:
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Study Notes
Bronchodilators
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SABA (Short-Acting Beta2-Agonists): Act quickly, lasting 4-6 hours; used for acute bronchospasm.
- Examples: Albuterol (ProAir, Ventolin, Proventil), Levalbuterol (Xopenex), Pirbuterol (Maxair), Tirbutaline (Brethine)
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LABA (Long-Acting Beta2-Agonists): Last 12 hours, but must be used with inhaled corticosteroids; never use alone as they are linked to increased asthma deaths when used alone.
- Examples: Salmeterol, Formoterol, Afromoterol.
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Mechanism of Action (Beta2-agonists): Bind to beta2 receptors in airway smooth muscle, stimulating relaxation and bronchodilation. They also have beta1 effects, causing potential side effects.
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Mechanism of Action (Muscarinic Antagonists): Block muscarinic cholinergic receptors, reducing cyclic GMP and smooth muscle contraction.
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SAMA (Short-Acting Muscarinic Antagonists): Act quickly, lasting 4-6 hours; less common use for acute bronchospasm unless combined with Albuterol.
- Examples: Ipratropium bromide (Atrovent), Ipratropium bromide/albuterol (Combivent)
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LAMA (Long-Acting Muscarinic Antagonists): Provide longer-lasting bronchodilation (24 hours).
- Examples: Tiotropium bromide (Spiriva), Aclidinium bromide, Umeclidinium bromide (Incrûse Ellipta), Revefenacin (Yupelri) (The first LAMA available as a nebulized long-acting form)
Side Effects & Precautions (Bronchodilators)
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Beta2-agonists: Monitor patients with arrhythmias, cardiovascular disease, and hyperthyroidism.
- Side effects: Tachycardia, tremors
- Pregnancy: Use only when benefits outweigh risks particularly during labor (may interfere with uterine contraction).
- LABAs and ULABAS: Use only in combination with inhaled corticosteroids.
- Muscarinic Antagonists: Side effects include dry mouth, cough, headache. Avoid in patients with benign prostatic hyperplasia (BPH) or angle-closure glaucoma.
Inhaled Corticosteroids
- Mechanism of Action: Inhibit IgE and mast cell-mediated inflammation in bronchial mucosa, reducing late-phase allergic reactions.
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Side effects: Xerostomia (dry mouth), hoarseness, mouth irritation, dysgeusia (taste disturbance), oral candidiasis (thrush).
- Precautions: Risk of hypothalamic-pituitary-adrenal (HPA) axis suppression and growth inhibition in children, especially with higher doses.
- Instructions: Rinse mouth and spit after use to prevent thrush and other side effects.
Leukotriene Modifiers
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Leukotriene Antagonists: Block leukotriene receptors.
- Example: Montelukast (Singulair)
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Mechanism of Action: Inhibit cysteinyl leukotriene receptors, preventing the action of LTD4.
- Side effects: Headache, sore throat, neuropsychiatric events
- Precautions: Avoid in severe liver disease; can be used with mild-moderate liver disease.
- Considerations: Chewable forms contain phenylalanine, so use with caution in PKU (Phenylketonuria) patients.
Decongestants
- Mechanism of Action: Alpha-adrenergic agonists causing vasoconstriction of respiratory tract mucous membranes.
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Side Effects/Precautions: CNS effects (anxiety, restlessness, etc.); increased blood pressure and heart rate; risk of rebound congestion if used for longer than 3 days.
- Contraindications: Avoid in patients with hypertension, coronary artery disease, or on monoamine oxidase inhibitors (MAOIs), and avoid in children.
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Description
Test your knowledge on bronchodilators, including SABA and LABA types, their mechanisms of action, and examples of medications. This quiz covers essential aspects of respiratory pharmacology to enhance your understanding of asthma management. Perfect for students and healthcare professionals.
