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RSM - Pulmonary Pharmacology Midterm
Asthma
Obstructive lung disease
Bronchial Hyperresponsiveness
History of Atopic Disease
Beta2 agonists
Corticosteroids
Curschmann's spirals
Hypertrophy of smooth muscle
Reversible
Charcot Leyden crystals
Methacholine challenge
Wheezing
Cough
Initially decreased PaCO2
Pulsus paradoxus
2 mins
Intermittent Asthma
Diagnosis
Symptoms (Bronchoconstriction) and Rescue Inhaler Use ≤ 2 / Week
No Interference With ADLs
Nighttime Awakening < 2 / Month
> 80 % of Predicted FEV1
1 min
Persistent Mild Asthma
Diagnosis
Symptoms (Brochoconstriction) and Rescue Inhaler Use > 2 Days / Week
Nighttime Awakening 3-4 / Month
Greater or equal to 80 % of Predicted FEV1
1 min
Persistent Moderate Asthma
Diagnosis
Symptoms (Bronchoconstriction) and Rescue Inhaler Use Daily
Nighttime Awakening > 1 / Week
60-80% Predicted FEV1
FEV1/FVC Decreased 5%
2 mins
Persistent Severe Asthma
Diagnosis
Symptoms (Bronchoconstriction) and Rescue Inhaler Use: Multiple/ Day
With Minimal Activity
Nighttime Awakening: Nightly
< 60% Predicted FEV1
> 5% Decrease FEV1/FVC
2 mins
Stages of Asthma Treatments
Mild Intermittent
Short-acting Inhaled Beta-Agonist
Mild Persistent
Low-Dose Inhaled Corticosteroid
Montelukast (Leukotriene Receptor Antagonist)
Moderate Persistent
Low to Medium-dose Inhaled Corticosteroid
Zileuton
Severe Persistent
High-Dose Inhaled Corticosteroid
Systemic Corticosteroids
Omalizumab (Allergies)
2 mins
Beta-2 Receptor
Characteristics
Gs protein class
Increased Heart Rate
Increased Contractility
Increased Lipolysis
Increased Insulin
Increased Aqueous Humor Production
Ciliary Muscle Relaxation
Vasodilation
Bronchodilation
Decrease Uterine Tone
2 mins
Beta-2 Agonists
Short-term Treatment
Terbutaline
Asthma
Tocolysis
Albuterol
Asthma
Long-term Treatment
Salmeterol
Asthma
Chronic Obstructive Pulmonary Disease (COPD)
3 mins
Albuterol (Proventil)
Mechanism
Short-Acting Beta-2 Agonist
Indications
Bronchospasm
Asthma
Side Effects
Angina
Tachycardia
Tremor
1 min
Terbutaline (Brethine)
Mechanism of Action
Beta-2 Agonists
Indications
Asthma
Tocolytic
Side Effects
Hypotension
Tremor
Tachycardia
Pulmonary Edema
Hyperglycemia
2 mins
Inhaled Corticosteroids
High Potency (Budesonide & Fluticasone)
Budesonide
Fluticasone
Beclamethasone
Mometasone
Flunisolide
Side Effects
Significant first pass metabolism (minimal systemic effects)
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