Anti-inflammatory (respiratory) Flashcards
Therapeutic uses of inhaled glucocorticoids?
Maintenance treatment of asthma as prophylactic therapy and long-term control of COPD.
What is the prototype for inhaled glucocorticoids?
Beclomethasone (QVAR)
What are the adverse effects of Beclomethasone (QVAR)?
oropharyngeal fungal infections, dysphonia, bronchospasm, osteoporosis (high doses), and adrenal suppression
Precautions to take with QVAR?
active untreated infections; diabetes or glaucoma; underlying immunosuppression; systemic corticoid therapy
MOA of glucocorticoids?
prevent inflammation, suppress airway mucus production, promote responsiveness of beta 2 receptors in the bronchial tree
When is an oral glucocorticoid use vs the inhaled route?
When sx cannot be controlled by an inhaled form
Prototype for oral steroid?
Prednisone
Adverse effects of Prednisone?
adrenal suppression; myopathy; hyperglycemia; PUD; growth suppression in children; osteoporosis; infection; fluid and electrolyte disturbances; increased appetite and weight gain; Cushing’s, cataracts/glaucoma, psychotic disorders
Contraindications for beclomethasone?
Hypersensitivity; acute attack of asthma/status asthmaticus
How can adverse effects of dysphonia and oral candidiasis with use of steroids be minimized?
rinse mouth and gargle
Difference between short-term and long-term oral therapy of steroids?
Short-term: manifestations following an acute asthma episode.
Long-term: chronic severe asthma
What route is used for status asthmaticus?
short-term IV
Why should we monitor blood glucose levels with the use of prednisone?
prednisone will cause insulin resistance → insulin is less effective at moving glucose into the cells → increased blood glucose
Precautions for steroid use?
pregnancy, young children, DM, HTN, heart failure, PUD, osteoporosis, kidney dysfunction, and current resistant infection.
Contraindications for prednisone?
systemic fungal infections and live vaccines
Prednisone drug interactions?
- concurrent use of drugs that increase the risk of hypokalemia (diuretics).
- concurrent use of NSAIDs which can increase the risk of GI ulceration.
- Concurrent use of glucocorticoids and hypoglycemic agents (insulin). Effects of insulin will be lowered.
T/F. Oral glucocorticoids are used short-term for 3-10 days following an acute asthma exacerbation.
True
What are leukotriene modifiers?
Suppress the effects of leukotrienes
What do leukotrienes mediate?
airway edema, smooth msl constriction, and increase mucous production
MOA of leukotriene modifiers?
reduce inflammation, bronchoconstriction, airway edema, and mucous production
Example of a leukotriene modifiers?
Zafirlukast (Accolate)
Adverse effects of Accolate?
HA, N/V, diarrhea, arthralgia, myalgia, and neuropsychiatric events
What is the route of administration of Accolate?
oral → rapid absorption
What are two drugs that interact with Accolate?
warfarin and Theophylline
