Pharmacology - Prostaglandins, Eicosanoids and Drugs for Asthma

Phospholipase A2

Enzyme responsible for converting membrane lipids to arachidonic acid

COX-2

COX 1 or 2: found primarily in inflammatory cells and has a major role in tissue injury

COX-1

COX 1 or 2: important for a variety of normal physiologic processes

LTB4

Eicosanoid responsible for leukocyte chemotaxis

LTC4 and LTD4

Eicosanoids responsible for bronchoconstriction, slow-reacting substance of anaphylaxis (SRSA)

PGE1

Eicosanoid responsible for vascular smooth muscle relaxation, maintains PDA, protective effects on gastric mucosa and uterine contraction

PGE2

Eicosanoid responsible for vascular smooth muscle relaxation, maintains PDA, increases uterine tone

PGI2 (Prostacyclin)

Eicosanoid responsible for vascular smooth muscle relaxation (peripheral, pulmonary, coronary) and inhibition of platelet aggregation

PGF2a

Eicosanoid responsible for increasing uterine tone, decreasing IOP

TXA2

Eicosanoid responsible for platelet aggregation

Prostaglandin E1 analog

Drug class of Misoprostol and Gemeprost

Prostaglandin E1 analog

Drug class of Alprostadil

Misoprostol

Use of this drug has been linked to a teratogenic effect of Moebius sequence

Alprostadil

Prostaglandin analog used in the maintenance of PDA and in erectile dysfunction (given as injection into the cavernosa)

Prostaglandin E2 analog

Drug class of Dinoprostone and Sulprostone

Prostaglandin E2 analogs

Lower concentrations of this drug class contract while higher concentrations relax uterine and cervical smooth muscles; used to soften the cervix at term before induction with oxytocin

Prostaglandin F2a analogs

Drug class of Carboprost, Bimatoprost, Travoprost, Unoprostone

Prostaglandin I2 analogs

Drug class of Ecoprostenol, Beraprost, Iloprost, Treprostinil

Prostaglandin I2 analogs

Drug class used in pulmonary HTN and reduces platelet aggregation in dialysis machines

Prostaglandin F2a analogs

Drug class of Latanoprost, Bimatoprost, Travoprost, Unoprostone

Latanoprost

Drug used in glaucoma with AEs of lengthening of eyelashes, alters colors of iris

Phosphodiesterase 5 inhibitor

Drug class of Sildenafil, Tadalafil, Vardenafil

Beta2-selective agonists (short-acting)

Drug class of Albuterol/Salbutamol, Terbutaline, Procaterol, Fenoterol

Beta2-selective agonists (short-acting)

Drug of choice for acute asthma attacks

Beta2-selective agonists (long-acting)

Drug class of Salmeterol, Formoterol, Bambuterol, Indacaterol

Asthma prophylaxis (not for acute relief)

Use of Beta2-selective agonists (long-acting)

Beta2-selective agonists (long-acting)

Drug class that increases mortality in asthma when used alone

Muscarinic receptor antagonists

Drug class of Ipratropium, Tiotropium, Glycopyrronium

Muscarinic receptor antagonists

Drug class of Umeclidinium

Methylxanthine

Drug class of Theophylline, Aminophylline, Pentoxifylline and Doxofylline

Inhibits phosphodiesterase 3
Inhibits adenosine receptor

MOA of Theophylline

Methylxanthines

Drug class used for asthma (prophylaxis against nocturnal attacks)

Pentoxifylline

Methylxanthine used in intermittent claudication

Beta blockers

Antidote to Methylxanthine overdose

Mast cell stabilizer

Drug class of Cromolyn, Nedocromil, Lodoxamide

Methylxanthines

Drug class with a higher clearance in adolescents and smokers

Prevents calcium influx --> no mast cell degranulation

MOA of Mast cell stabilizers

Corticosteroids

Drug class of choice for asthma prophylaxis

Oropharyngeal candidiasis

Major AE of inhaled corticosteroids

Leukotriene synthesis (Lipooxygenase) inhibitor

Drug class of Zileuton

Zileuton

Drug used in asthma prophylaxis with AEs of flulike syndrome, headache, drowsiness, dyspepsia, hepatitis and elevation of liver enzymes

Leukotriene receptor antagonist

Drug class of Montelukast, Zafirlukast and Pranlukast

Omalizumab

Anti-IgE antibody used in the prophylaxis of severe, refractory asthma not responsive to all other drugs

Mucolytic

Drug class of Carbocisteine, Ambroxol, Bromhexine

Expectorant

Drug class of Guaifenasin

Centrally acting antitussive, opioid antitussive

Drug class of Dextromethorphan

False

True or false: Dextromethorphan has an addictive potential

Centrally acting antitussive, NON-opioid antitussive

Drug class of Butamirate Citrate

Peripherally acting antitussive

Drug class of Levodropropizine

Morphine

Opioid antitussive that may be effective in suppressing cough but indicated only in intractable cough from bronchial carcinoma