3: Asthma Medications Flashcards
3 classes of rescue meds.
SABA
Anticholinergics
Systemic corticosteroids
Peak effect of SABA.
15-30 minutes (wears off in 4-6 hours).
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Albuterol sulfate
SABA
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Proventil
SABA
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Ventolin
SABA
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Levalbuterol
Nonracemic SABA
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Xopenex
Nonracemic SABA
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Ipratropium
Anticholinergic
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Atrovent
Anticholinergic
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Prednisone
Systemic Steroid
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Prednisolone
Systemic Steroid
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Methylprednisolone
Systemic Steroid
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Dexamethasone
Systemic Steroid
6 classes of long-term control meds.
ICS Cromolyn Sodium and Nedocromil Immunomodulators Leukotriene Modifiers LABA Methylxanthines
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Salmeterol
LABA
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Serevent
LABA
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Fluticasone
ICS
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Flovent Diskus
ICS
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Budesonide
ICS
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Pulmicort Flexhaler
ICS
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Respules
ICS
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Montelukast
Leukotriene Modifier
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Singulair
Leukotriene Modifier
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Theophylline
Methylxanthine
What class is omalizumab?
Monoclonal Antibody
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Symbicort
Combined ICS/LABA (Budesonide/Formoterol)
Is this a SABA, anticholinergic, systemic corticosteroid, ICS, immunomodulator, leukotriene modifier, LABA, or methylxanthine?
Advair
Combined ICS/LABA (Salmeterol/Fluticasone)
Prolonged use of albuterol is associated with what?
Tachyphylaxis d/t beta2-receptor downregulation and receptor hyposensitivity.
Nonracemic form of albuterol offers a significant reduction in which adverse effects?
Muscle tremors
Tachycardia
Hyperglycemia
Hypokalemia
T/F Levalbuterol is effective in smaller doses than albuterol.
True. And dose may be doubled in acute severe episodes.
SABAs are used for what 2 situations?
Treat bronchospasm in acute episodes.
Prevent bronchospasm in exercise-induced asthma.
Acts as bronchodilator by inhibiting muscarinic receptors and reduces vagal tone of airways.
Anticholinergics
Adjuvant therapy with SABA for treatment of acute exacerbations.
Anticholinergics
Works to inhibit secretions from serous and seromucous glands lining nasal mucosa.
Anticholinergic (applied locally)
Used for a short course (3-10 days) to gain control of poorly controlled episodes.
Systemic Corticosteroids
When are systemic corticosteroids used long-term?
Used for long-term prevention of symptoms in severe persistent asthma as well as for suppression, control, and reversal of inflammation.
What does a systemic corticosteroid do for SABAs?
It reverses the subsensitivity and downregulation of beta2 receptors from frequent and repetitive use of SABAs.
Which systemic corticosteroid is not associated with vomiting?
Dexamethasone
Preventive treatment of nocturnal asthma or exercise-induced asthmatic symptoms.
LABAs
T/F LABAs are stand-alone meds for both asthma and COPD.
False. They are never to be used alone in asthma. They are only used if other meds do not control asthma and must be used in combination with other meds.
Long-term control of symptoms. Suppression, control, and reversal of inflammation.
ICSs
Most potent anti-inflammatory agents but are least likely to cause adverse effects b/c poorly absorbed systemically.
ICSs
Adverse effects of ICSs.
Oral candidiasis
Dysphonia
Reflex cough
Bronchospasm
How are adverse effects of ICS minimized?
With spacer and MDI.
Block late asthmatic response to allergens.
Reduce airway hyperresponsiveness.
Inhibit cytokine production, adhesion protein activation, and inflammatory cell migration and activation.
Reverse beta2-receptor downregulation and subsensitivity.
ICS
How do leukotrienes cause problems?
+ bronchospasm, increased vascular permeability, mucosal edema, and inflammatory cells.
Long-term control and prevention of symptoms, especially nocturnal symptoms.
Methylxanthines
Causes bronchodilation and minimal anti-inflammatory properties. Less effective than ICSs. Potential toxicity, so monitor serum concentrations. Used infrequently.
Methylxanthines
Moderate-to-severe persistent asthma patients who react to perennial allergens. Symptoms are not controlled by inhaled corticosteroids.
Monoclonal Antibodies
Bind selectively to human IgE on the surface of mast cells and basophils.
Monoclonal Antibodies
This has a risk of severe allergic reaction and is only used in 12+ age group.
Omalizumab (Monoclonal Antibody)
Decrease asthma exacerbations when inhaled short-acting beta2-agonists and corticosteroids have failed.
Combined ICS/LABA