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7. Respiratory Agents (tussive, asthma, UR) > Antiasthmatics > Flashcards

Antiasthmatics Flashcards

1
Q

Albuterol Sulfate for inhalation brand names

A

Proventil, Ventolin, Proair

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2
Q

Albuterol Sulfate Indications/Dosages

A

Maintenance to prevent exacerbation of bronchospasms: 2 inh QID
Exercise-induced bronchospasm: 2 inh 15 min prior to exercise

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3
Q

Albuterol Sulfate Mechanism

A

stinulates adenyl cyclase, which catalyzes formation of cAMP from ATP, causing relaxation of bronchial, uterine, and vascular smooth muscle through stimulation of B2-adrenergic receptors

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4
Q

Albuterol Sulfate Metabolism and excretion

A

Metabolized in the liver
Excreted in urine and feces
Minimal systemic absorption

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5
Q

Albuterol Sulfate drug interactions

A

other sympathomimetics, tricyclic antidepressants, MAO-I’s: increase toxicity of medication
Non-potassium sparing diuretics: May worsen hypokalemia and/or ECG changes
Digoxin: may decrease serum digoxin levels

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6
Q

Albuterol Sulfate CI/Precautions

A

CI: patients with hypersensitivity
caution in patients with CV disorders, HTN, hyperthyroidism, DM, and nursing mothers/pregnancy
Proventil can cause paradoxical bronchospasms (life-threatening)

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7
Q

Albuterol Sulfate Pregnancy category

A

C

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8
Q

Albuterol Sulfate ADR’s

A

Nausea, vomiting, nervousness, headache, insomnia, tremor, dizziness, HTN, tachycardia, palpitations

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9
Q

Albuterol Sulfate Patient education

A

Do not take more frequently than recommended
Seek medical attention if taking more frequently or becomes ineffective
Avoid contact with eyes
Shake canister before inhalation
Inhalation technique
Clean mouthpiece weekly, let air dry

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10
Q

Beclomethasone brand name

A

QVAR

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11
Q

Beclomethasone indication/dosage

A

maintenance treatment of asthma, prophylactic therapy in patients >5y, reduce or eliminate need for systemic corticosteroids.
children 5-11: 40-80mcg BID
adults: 40-160mcg BID, max dose is 320mcg BID

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12
Q

Beclomethasone mechanism

A

bind to receptor proteins in cytoplasm of cells, form steroid-receptor comples, which enters the nucleus of the cell and reacts with DNA, then stimulates transcription of mRNA, which carry out anti-allergy and anti-inflammatory actions
decreases airway inflammation and improves asthma symptoms

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13
Q

Beclomethasone drug interactions

A

additive effects with systemic corticosteroids

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14
Q

Beclomethasone CI/precautions

A

CI: primary treatment of status asthmaticus
caution: transfer from systemic CS (death due to adrenal insufficiency)
do not use a bronchodilator, do not use for rapid relief of bronchospams
secondary fungal infections in mouth can occur

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15
Q

Beclomethasone pregnancy category

A

undefined, use with caution in pregnancy

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16
Q

Beclomethasone ADR’s

A

headache, URTI, and pharyngitis

thrush possible

17
Q

Beclomethasone patient education

A 
avoid contact with eyes
not for immediate/rescue relief, should be used on a regular basis
can take up to 4 weeks to see benefit
use bronchodilator minutes before QVAR
prime initially and after 10 days of nonuse
store upside down, resting onc anister
follow instructions for inhalation
clean inhaler at least weekly
18
Q

Budesonide brand name

A

Pulmicort

19
Q

Budesonide indication/dosage

A

maintenance treatment of asthma and prophylactic therapy
Adults and Kids 6y+: initiate at 180mcg (children) or 360mg (adults) BID.
Max dose is double this for each group

20
Q

Budesonide mechanism

A

binds to receptor proteins found in cytoplasm of sensitive cells (steroid-receptor complex), reacts with DNA and stimulates transcription of mRNA, creating enzymes that carry out antiallergy and anti-inflammatory activity

21
Q

Budesonide drug interactions

A

ketoconazole may increase plasma levels

22
Q

Budesonide CI/precautions

A

CI: primary treatment of status asthmaticus
caution: transferring from systemic CS to inhaled CS (adrenal insufficiency)
not a rapid-acting inhaler
secondary oral candidal infections can occur, wash mouth thoroughly after use

23
Q

Budesonide ADRs

A

Turbohaler: headache, asthenia, pain, dyspepsia, nausea, oral candidiasis, arthralgia, cough, respiratory infection, rhinitis and sinusitis
Respules: respiratory infection, rhinitis, cough, otitis media, vomiting, diarrhea, abdominal pain and rash

24
Q

Budesonide patient education

A

avoid contact with eyes
not a rescue inhaler
may take as long as 4 weeks to see benefits
use bronchodilators prior to ICS
do not mix respules with other solutions in nebulizer
rinse mouth without swallowing after each use
red mark appears when there are 20 or fewer doses left

25
Q

Budesonide + Formoterol brand name

A

Symbicort

26
Q

Budesonide + Formoterol indication/dosage

A

treatment of asthma in patients 12y+: 2 inhalations BID (either 80/4.5 or 160/4.5 inhalers)
COPD: 2 inhalations BID of 160/4.5 inhaler only

27
Q

Budesonide + Formoterol mechanism

A

Budesonide: potent anti-inflammatory corticosteroid showing inhibitory activities against multiple cell types (mast, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (histamine, eicosanoids, leukotrienes, and cytokines)
Formoterol: stinulates adenyl cyclase to relax smooth muscle and inhibit release of mast cell mediators (histamine, leukotrienes, etc)

28
Q

Budesonide + Formoterol drug interactions

A

additive effects with systemic CS
other sympathomimetics, TCAs, and MAO-I’s increase toxicity of Budesonide + Formoterol
B-blockers decrease effectiveness of formoterol
3A4 inhibitors may increase plasma levels (ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefaxodone, nelfinavir, saquinavir, ketoconazole, telithromycin)

29
Q

Budesonide + Formoterol CI/precautions

A

CI: primary treatment of status asthmaticus
LABA’s increase risk of ASTHMA-RELATED DEATH.
caution: patients transferring from OCS to ICS
not a rapid-acting inhaler
secondary oral candidiasis
caution in patients with CV disorders, hypertension, hyperthyroidism, DM.

30
Q

Budesonide + Formoterol pregnancy category

A

C

31
Q

Budesonide pregnancy category

A

B

32
Q

Budesonide + Formoterol ADRs

A

mild-moderate in severity

URTI, nasopharyngitis, headache, vomiting, sinusitis, bronchitis, oral candidiasis, nasal congestion

33
Q

Budesonide + Formoterol patient education

A 
avoid contact with eyes
rinse mouth after use
report decreased effectiveness of rescue inhalers
not a rescue inhaler!
may take up to 4 weeks to see benefit

7. Respiratory Agents (tussive, asthma, UR) (3 decks)

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