Anti-Inflammatory Agents (week 5)

Question 1

Name an inhaled Glucocorticoid

Answer 1

Beclomethasone (QVAR)

Question 2

What is the use of Beclomethasone?

Answer 2

Maintenance treatment of asthma as prophylactic therapy and long-term control of COPD

Question 3

What is the MOA of Beclomethasone?

Answer 3

Inhibits inflammatory cells and the release of inflammatory mediators (leukotrienes, histamines, prostaglandins)

Question 4

What are some common adverse effects of Beclomethasone?

Answer 4

Headache
Dysphonia
Pharyngitis
Oral candidiasis

Question 5

What is a serious adverse effect for Beclomethasone?

Answer 5

Adrenal suppression

*can cause slow growth in children

Question 6

What do you want to assess before administering Beclomethasone?

Answer 6

Current Infection
Desmopressin (MAR) (Can cause hyponatremia)
PMH of bone mineral density, Ocular disease, immunosuppression

Question 7

How do you want to administer Beclomethasone?

Answer 7

Administer bronchodilator first and allow 5 mins to elapse before administering the corticosteroid.

Question 8

How can you minimize adverse effects with Beclomethazone?

Answer 8

Rinse mouth and gargle

Question 9

Name an Oral Glucocorticoid

Answer 9

Prednisone

Question 10

What is the use of Prednisone for athma?

Answer 10

When symptoms cannot be controlled by inhalations.

S/S moderate to severe

Question 11

What is the MOA of Prednisone?

Answer 11

Suppression of migration of Polymorphonuclear Leukocytes and reversal of increased cap perm.

Question 12

What are some common adverse effects of prednisone?

Answer 12

Nausea
Vomiting
HTN
Fluid retention
Weight gain

Question 13

What are some severe adverse effects of prednisone?

Answer 13

Adrenal suppression
PUD
Hyperglycemia

Question 14

What do you want to assess before administering Prednisone?

Answer 14

BP
Blood glucose
MAR - Desmopressin
PMH of GI disease, ocular disease, renal impairment, hepatic disease

Question 15

How should you administer Prednisone?

Answer 15

Given in ‘bursts’; 40 to 60 mg/day for 3-10 days

Take with food or milk

Question 16

What do you want too evaluate after giving Prednisone?

Answer 16

Monitor for adrenal insufficiency

Minimize possible bone loss

Question 17

Name a leukotriene modifier

Answer 17

Zafirlukast (Accolate)

Question 18

What is the use of Zafirlukast (Accolate)?

Answer 18

Second-line therapy

Pro inflammatory

Question 19

What is the MOA of Zafirlukast (Accolate)?

Answer 19

Antagonizes the effects of leukotrienes which mediate airway edema, smooth muscle constriction, and altered cellular activity

Question 20

What are some common adverse effects of Zafirlukast (Accolate)?

Answer 20

Headache
Nausea
Vomiting

Question 21

What are some serious adverse effects of Zafitrlukast (Accolate)?

Answer 21

Neuropsychiatric events (black box warning)

Question 22

What are some interactions with Zafirlukast (accolate)?

Answer 22

Inhibits isoenzymes of CYP450 and suppresses metabolism of other drugs

Question 23

Name a mast cell stabilizer

Answer 23

Cromolyn

Question 24

What is the use of Cromolyn?

Answer 24

Chronic asthma

Question 25

What is the MOA of Cromolyn?

Answer 25

Stabilizes mast cells preventing release of histamine

Question 26

Name a PDE-4 Inhibitor

Answer 26

Roflumilast (Daliresp)

Question 27

What is the use of Roflumilast (Daliresp)?

Answer 27

To decrease the risk of exacerbations in severe COPD patients

Question 28

What is the MOA of Roflumilast (Daliresp)?

Answer 28

Selective inhibitors of PDE-4, reducing the cells in sputum

Question 29

What are some common adverse effects with Roflumilast (Daliresp)?

Answer 29

Diarrhea

Weight loss

Question 30

What are some serious adverse effects with Roflumilast (Daliresp)?

Answer 30

Suicidal thoughts

Angioedema