Anti-Inflammatory Agents (week 5) Flashcards
Name an inhaled Glucocorticoid
Beclomethasone (QVAR)
What is the use of Beclomethasone?
Maintenance treatment of asthma as prophylactic therapy and long-term control of COPD
What is the MOA of Beclomethasone?
Inhibits inflammatory cells and the release of inflammatory mediators (leukotrienes, histamines, prostaglandins)
What are some common adverse effects of Beclomethasone?
Headache
Dysphonia
Pharyngitis
Oral candidiasis
What is a serious adverse effect for Beclomethasone?
Adrenal suppression
*can cause slow growth in children
What do you want to assess before administering Beclomethasone?
Current Infection
Desmopressin (MAR) (Can cause hyponatremia)
PMH of bone mineral density, Ocular disease, immunosuppression
How do you want to administer Beclomethasone?
Administer bronchodilator first and allow 5 mins to elapse before administering the corticosteroid.
How can you minimize adverse effects with Beclomethazone?
Rinse mouth and gargle
Name an Oral Glucocorticoid
Prednisone
What is the use of Prednisone for athma?
When symptoms cannot be controlled by inhalations.
S/S moderate to severe
What is the MOA of Prednisone?
Suppression of migration of Polymorphonuclear Leukocytes and reversal of increased cap perm.
What are some common adverse effects of prednisone?
Nausea Vomiting HTN Fluid retention Weight gain
What are some severe adverse effects of prednisone?
Adrenal suppression
PUD
Hyperglycemia
What do you want to assess before administering Prednisone?
BP
Blood glucose
MAR - Desmopressin
PMH of GI disease, ocular disease, renal impairment, hepatic disease
How should you administer Prednisone?
Given in ‘bursts’; 40 to 60 mg/day for 3-10 days
Take with food or milk
What do you want too evaluate after giving Prednisone?
Monitor for adrenal insufficiency
Minimize possible bone loss
Name a leukotriene modifier
Zafirlukast (Accolate)
What is the use of Zafirlukast (Accolate)?
Second-line therapy
Pro inflammatory
What is the MOA of Zafirlukast (Accolate)?
Antagonizes the effects of leukotrienes which mediate airway edema, smooth muscle constriction, and altered cellular activity
What are some common adverse effects of Zafirlukast (Accolate)?
Headache
Nausea
Vomiting
What are some serious adverse effects of Zafitrlukast (Accolate)?
Neuropsychiatric events (black box warning)
What are some interactions with Zafirlukast (accolate)?
Inhibits isoenzymes of CYP450 and suppresses metabolism of other drugs
Name a mast cell stabilizer
Cromolyn
What is the use of Cromolyn?
Chronic asthma
What is the MOA of Cromolyn?
Stabilizes mast cells preventing release of histamine
Name a PDE-4 Inhibitor
Roflumilast (Daliresp)
What is the use of Roflumilast (Daliresp)?
To decrease the risk of exacerbations in severe COPD patients
What is the MOA of Roflumilast (Daliresp)?
Selective inhibitors of PDE-4, reducing the cells in sputum
What are some common adverse effects with Roflumilast (Daliresp)?
Diarrhea
Weight loss
What are some serious adverse effects with Roflumilast (Daliresp)?
Suicidal thoughts
Angioedema
