Allergies & Asthma; L5 (12-09-15) Flashcards

1
Q

Beta2 adrenergic agonists (short, long acting)

Classification: __
ROA: Inhalation; oral; subcutaneous (terbutaline)

  • *MOA**:
    1) Stimulate __ (__ __) -> increases __ -> __
    2) Inhibits release of mediators from ____
  • *Therapeutic use: symptom relief in __ in __ asthma attacks**
  • Unique therapeutic use: is used in combo with corticosteroids in an inhaler
  • *Side-effects**:
    1) __ __ __
    2) __
    3) __, __, __
A

Beta2 adrenergic agonists (short, long acting)

Classification: bronchodilator
ROA: Inhalation; oral; subcutaneous (terbutaline)

  • *MOA**:
    1) Stimulate AC (adenylyl cyclase) -> increases cAMP -> bronchodilation
    2) Inhibits release of mediators from mast cells
  • *Therapeutic use: symptom relief in bronchospasm in acute asthma attacks**
  • Unique therapeutic use: is used in combo with corticosteroids in an inhaler
  • *Side-effects**:
    1) Skeletal muscle tremors
    2) Tachycardia
    3) Anxiety, restlessness, apprehension
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2
Q

Theophylline

Classification: __
ROA: oral; slow IV over 40 minutes

  • *MOA**:
    1) Inhibits __ __, causing increase of __
    2) Competitive antagonist at __ receptors
  • *Therapeutic use: __ therapy for __ asthma**
  • Unique therapeutic use: sustained release oral therapy
  • *Side-effects**:
    1) __ __ __
    2) __
    3) __
    4) __ __
A

Theophylline

Classification: bronchodilator
ROA: oral; slow IV over 40 minutes

  • *MOA**:
    1) Inhibits cAMP phosphodiesterases, causing increase of cAMP
    2) Competitive antagonist at adenosine receptors
  • *Therapeutic use: maintenance therapy for chronic asthma**
  • Unique therapeutic use: sustained release oral therapy
  • *Side-effects**:
    1) Narrow therapeutic window
    2) Convulsions
    3) Tachycardia
    4) Circulatory collapse
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3
Q

Ipratropium

Classification: __
ROA: inhalation

MOA: competitively blocks the __ receptors in the airways

  • *Therapeutic use: alone or in combo with __ __ __ in __ asthma**
  • Unique therapeutic use: used when a coexisting chronic bronchitis or cough is a symptom in an asthmatic patient

Side-effects: __; if dosage is too high it may cause __-__ effects

A

Ipratropium

Classification: bronchodilator
ROA: inhalation

MOA: competitively blocks the muscarinic receptors in the airways

  • *Therapeutic use: alone or in combo with B2 adrenergic agonists in acute asthma**
  • Unique therapeutic use: used when a coexisting chronic bronchitis or cough is a symptom in an asthmatic patient

Side-effects: minimal; if dosage is too high it may cause atropine-like effects

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4
Q

Corticosteroids

Classification: ____
ROA: inhalation; oral; IV

MOA: reduce the synthesis of __ __ by __, which inhibits the release of __ and __

  • *Therapeutic use: __ therapy for __ asthma**
  • Unique therapeutic use: treats the underlying inflammation of asthma, reducing frequency and severity of attacks
  • *Side-effects**:
    1) Short term: increased __, __, __, __, and __ alterations
    2) Long term: __, __, __, __ __ __ suppression, __
A

Corticosteroids

Classification: anti-inflammatory agent
ROA: inhalation; oral; IV

MOA: reduce the synthesis of arachidonic acid by phospholipase A2, which inhibits the release of leukotrienes and prostaglandins

  • *Therapeutic use: maintenance therapy for chronic asthma**
  • Unique therapeutic use: treats the underlying inflammation of asthma, reducing frequency and severity of attacks
  • *Side-effects**:
    1) Short term: increased energy, insomnia, hunger, agitation, and mood alterations
    2) Long term: osteoporosis, cataracts, myopathy, hypothalamic/pituitary adrenal axis suppression, depression
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5
Q

Cromolyn

Classification: ____
ROA: inhalation

MOA: decrease in the release of mediators such as __ and __

  • *Therapeutic use: __ therapy for preventing __**
  • Unique therapeutic use: a) used prior to exercise; b) prior to cold air exposure

Side-effects: occasional __

A

Cromolyn

Classification: anti-inflammatory agent
ROA: inhalation

MOA: decrease in the release of mediators such as histamine and leukotrienes

  • *Therapeutic use: prophylactic therapy for preventing bronchospasm**
  • Unique therapeutic use: a) used prior to exercise; b) prior to cold air exposure

Side-effects: occasional coughing

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6
Q

Zafirlukast, Montelukast

Classification: ____
ROA: oral

  • *MOA**:
    1) Antagonist at the __ __ receptor
    2) The __ receptor is also blocked
  • *Therapeutic use: __ therapy for preventing __**
  • Unique therapeutic use: a) aspirin-induced asthma; b) prior to cold air exposure
  • *Side-effects**:
    1) __
    2) __
A

Zafirlukast, Montelukast

Classification: leukotriene inhibitor
ROA: oral

  • *MOA**:
    1) Antagonist at the LTD4 leukotriene receptor
    2) The LTE4 receptor is also blocked
  • *Therapeutic use: prophylactic therapy for preventing bronchospasm**
  • Unique therapeutic use: a) aspirin-induced asthma; b) prior to cold air exposure
  • *Side-effects**:
    1) Headache
    2) Nausea
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7
Q

Zileuton

Classification: ____
ROA: oral

MOA: inhibits __ to decrease production of __

  • *Therapeutic use: __ therapy for preventing __**
  • Unique therapeutic use: a) exercise/aspirin-induced asthma; b) antigen-induced asthma

Side-effects: contraindicated in patients with __ disease

A

Zileuton

Classification: leukotriene inhibitor
ROA: oral

MOA: inhibits 5-lipooxygenase to decrease production of leukotrienes

  • *Therapeutic use: prophylactic therapy for preventing bronchospasm**
  • Unique therapeutic use: a) exercise/aspirin-induced asthma; b) antigen-induced asthma

Side-effects: contraindicated in patients with hepatic disease

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8
Q

Diphenhydramine

Classification: __ __ receptor antagonist (__ gen)
ROA: oral; IV

MOA: blocks __ __ receptors

  • *Indications**:
    1) __ __
    2) __
    3) Adjunctive therapy in __ reactions

Major side-effects: MARKED __ or __ due to muscarinic receptor blockade

A

Diphenhydramine (Benadryl)

Classification: histamine H1 receptor antagonist (1st gen)
ROA: oral; IV

MOA: blocks histamine H1 receptors

  • *Indications**:
    1) Allergic rhinitis
    2) Urticaria
    3) Adjunctive therapy in anaphylactic reactions

Major side-effects: MARKED sedation or agitation due to muscarinic receptor blockade

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9
Q

Chlorpheniramine

Classification: __ __ receptor antagonist (__ gen)
ROA: oral

MOA: blocks __ __ receptors

  • *Indications**:
    1) __ __
    2) Common ingredient in __ medications

Major side-effects: slight __ or __ due to muscarinic receptor blockade

A

Chlorpheniramine

Classification: histamine H1 receptor antagonist (1st gen)
ROA: oral

MOA: blocks histamine H1 receptors

  • *Indications**:
    1) Allergic rhinitis
    2) Common ingredient in OTC medications

Major side-effects: slight sedation or agitation due to muscarinic receptor blockade

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10
Q

Fexofenadine

Classification: __ __ receptor antagonist (__ gen)
ROA: oral

MOA: blocks __ __ receptors

  • *Indications**:
    1) __ __
    2) __ chronic __

Major side-effects: n/a

A

Fexofenadine (Allegra)

Classification: histamine H1 receptor antagonist (2nd gen)
ROA: oral

MOA: blocks histamine H1 receptors

  • *Indications**:
    1) Allergic rhinitis
    2) Idiopathic chronic urticaria

Major side-effects: n/a

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11
Q

Loratidine

Classification: __ __ receptor antagonist (__ gen)
ROA: oral

MOA: blocks __ __ receptors

  • *Indications**:
    1) __ __
    2) __ reactions to __
    3) Adjunctive therapy in __ reactions

Major side-effects: __, __, __

A

Loratidine (Claritin)

Classification: histamine H1 receptor antagonist (2nd gen)
ROA: oral

MOA: blocks histamine H1 receptors

  • *Indications**:
    1) Allergic rhinitis
    2) Allergic reactions to blood
    3) Adjunctive therapy in anaphylactic reactions

Major side-effects: nausea, fatigue, headache

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12
Q

Certirizine

Classification: __ __ receptor antagonist (__ gen)
ROA: oral

MOA: blocks __ __ receptors AND blocks __ release

  • *Indications**:
    1) __ __
    2) __ chronic __

Major side-effects: __, __, and __ __

A

Certirizine (Zyrtec)

Classification: histamine H1 receptor antagonist (2nd gen)
ROA: oral

MOA: blocks histamine H1 receptors AND blocks histamine release

  • *Indications**:
    1) Allergic rhinitis
    2) Idiopathic chronic urticaria

Major side-effects: sedation, fatigue, and dry mouth

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13
Q

Doxepin

Classification: __ __ receptor antagonist (__ gen)
ROA: oral

MOA: blocks __ __ receptors

Indications: Chronic __ not responding to other __ __ (**UNIQUE COMPARED TO OTHER FIVE __-__ DRUGS)

Major side-effects: __, __ in non-depressed patients

A

Doxepin

Classification: histamine H1 receptor antagonist (2nd gen)
ROA: oral

MOA: blocks histamine H1 receptors

Indications: Chronic urticaria not responding to other H1 antagonists (**UNIQUE COMPARED TO OTHER FIVE ANTI-H1 DRUGS)

Major side-effects: disorientation, confusion in non-depressed patients

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14
Q

Allergy Summary:

  • __ nasal sprays are the most effective single-agent maintenance therapy for allergic rhinitis
  • __ gen agents are familiar to pts and are OTC, but they have several __ __-__
  • __ gen agents - preferred when __ therapy is desired
  • If __ nasal sprays alone are not sufficient, then add an __ nasal spray
  • Pts who are refractory to __ nasal sprays and have asthma or nasal polyposis, __ may be helpful
A

Allergy Summary:

  • Glucocorticoid nasal sprays are the most effective single-agent maintenance therapy for allergic rhinitis
  • 1st gen agents are familiar to pts and are OTC, but they have several adverse side-effects
  • 2nd gen agents - preferred when antihistamine therapy is desired
  • If glucocorticoid nasal sprays alone are not sufficient, then add an antihistamine nasal spray
  • Pts who are refractory to glucocorticoid nasal sprays and have asthma or nasal polyposis, montelukast may be helpful
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