2- Asthma Flashcards
What is first line tx for asthma?
Beta 2 agonists
What is the MOA for beta 2 agonists in the tx of asthma?
Increase cAMP, relax airway smooth muscle, inhibit histamine release
How is a beta 2 agonist delivered in an emergency situation?
Injected
What drugs are SABAs? (5)
Albuterol
Levalbuterol
Pirbuterol
Terbutaline
Bitolterol
What is the use of SABAs?
(Albuterol, Levalbuterol, Pirbuterol, Terbutaline, Bitolterol)
Asthma attack in progress (act immediately)
Salmeterol drug class?
Long acting beta 2 agonist (LABA)
What is the use of Salmeterol?
Asthma prevention and prophylaxis (act after 20-30 min)
Salmeterol should always be used in conjunction with what?
Steroid (Advair)
(to avoid tolerance)
What are the SEs of beta agonists?
Tachycardia, nervousness, dizziness, tremor (oral)
Pt with asthma presents to your office in need of an inhaled medication to help with sxs. Hx reveals intolerance to beta 2 agonists. What should you prescribe them?
Ipratropium (Atrovent)
What is the MOA for Ipratropium?
Muscarinic antagonist
Pt presents with COPD and is in need of an inhaled medication to control sxs. What should you prescribe?
Ipratropium (Atrovent)
(if Combivent, give w/ albuterol)
The following are the MOAs for what drug?
PDE inhibitor (increases cAMP), blocks adenosine receptor, relaxes smooth muscle
Theophylline
What is the drug of choice for a pt whose asthma or COPD is NOT controlled by beta agonists or muscarinic antagonists?
Theophylline
Pt with asthma/ COPD presents to your office in need of tx. Upon taking hx, pt states they currently take cimetidine for acid reflux. What drug should you NOT prescribe them?
Theophylline
(caution w drug interactions in general)
What is the caution with Theophylline?
(asthma/ COPD 3rd line tx)
Low therapeutic index
What are the SEs of Theophylline?
CNS, cardiac, muscle, diuretic
Pt who has overdosed on Theophylline will display what sxs? (5)
Palpitations, HA, nausea, emesis, seizures
What anti-inflammatory drugs are used in the tx of asthma?
Corticosteroids, Leukotriene inhibitors, Cromolyn sodium
What drugs are used orally in severe asthma or asthma exacerbations and improve response to beta agonists?
Corticosteroids
(can also be inhaled)
What are the SEs of inhaled corticosteroids?
Oral candidiasis (thrush), hoarseness
What drugs are Leukotriene Inhibitors?
Zileuton (Zyflo CR)- 5-LO inhibitor
Zafirlukast (Accolate)- LT antagonist
Montelukast (Singulair)- LT antagonist
What drug is used for pt with aspirin-sensitive asthma?
Zileuton
What drugs have NO effect on asthma attack in progress (still need beta 2 agonist) but may allow for decreased steroid dose?
Leukotriene inhibitors
(Zileuton (Zyflo CR), Zafirlukast (Accolate), Montelukast (Singulair))
What are the SEs for leukotriene inhibitors?
URIs, sore throat, HA, abd pain, sleepiness
What asthma drug is a monoclonal antibody and prevents binding of IgE to cells a/w allergic response?
Omalizumab (Xolair)
What drug is used in the tx of moderate to severe allergic asthma?
Omalizumab (Xolair)
What are the SEs for Omalizumab (Xolair)?
(used in mod to severe allergic asthma)
Rash, injection site reactions, small decrease in platelets
What asthma drugs inhibit release of histamine from mast cells?
Cromolyn sodium, Nedcromil
(NOT bronchodilators)
What asthma drug is used for a pediatric patient or for prevention and is taken 4x daily (takes time to be effective)?
Cromolyn sodium, Nedcromil
What asthma drug can also be used for conjunctivitis? (eye drops)
Cromolyn
What is the asthma step therapy? (5 steps)
- SABA
- SABA + low dose ICS
- SABA + low dose ICS + LABA
- SABA + med dose ICS + LABA
- SABA + high dose ICS + LABA
- SABA + high dose ICS + LABA + oral steroid
