Allergic Rhinitis/Asthma Pharm Flashcards
MOA of 1st generation anti-histamines.
Down regulate H-1 receptors
May reduce eosinophil survival
Main side effect of 1st generation anti-histamines
Sedation
-cross BBB due to lipophilicity
MOA of 2nd generation anti-histamines.
Down regulate H-1 receptors
-less CNS effects due to less lipophilicity
MOA of 3rd generation anti-histamines
Metabolites of 2nd generation
- down regulate H-1 receptors
- decreased mast cell granule release
- down regulate adhesion molecule expression
- inhibit IL-4 and IL-13 release
What are metered-dose inhalers (MDIs)?
Inhaler used to nebulize medication in aerosol form, mainly used for beta agonists
Main problem with using beta agonists for asthma treatment.
Tolerance: b-agonists are best used in short-term rescue situations for symptom relief. There are actually negative effects with long-term use.
Which drugs are better for long-term asthma management?
Inhaled glucocorticoids (steroids) -don't provide immediate relive like B-agonists but are better for lung tissue
Benefit of long-acting beta agonists.
Reduced tolerance
MOA of corticosteroids
Inhibit inflammatory mediator production (cytokines, leukotrienes)
Reverse Downregulation of Beta 2 receptors caused by beta agonists
Inhibit attraction of inflammatory cells to site of inflammation
Only inhaled corticosteroid approved in pregnancy.
Budesonide
2 problematic effects of inhaled steroids due to local deposition.
- Dysphonia: medication accumulates on vocal cords
2. Thrush: creates environment for Candida proliferation
3 systemic complications of inhaled steroids.
- Growth Deceleration
- Osteoporosis
- Adrenal Suppression (negative feedback)
What are the 2 MOAs of the Leukotriene Modifying drugs?
- 5-lipoxygenase inhibitors (prevent leukotriene formation)
2. Leukotriene receptor antagonists
