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Dental Pharmacology II Exam 1 > Asthma > Flashcards

Asthma Flashcards

1
Q

β-2 agonist

A

Albuterol
Salmeterol
Formoterol

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2
Q

Inhaled Corticosteroids

A

Fluticasone

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3
Q

Oral Corticosteroids

A

Prednisone

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4
Q

Mast Cell Stabilizers

A

Cromolyn

Nedocromil

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5
Q

Methylxanthines

A

Theophyline

Aminophylline

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6
Q

Leukotriene antagonists

A

Montelukast

Zarfilukast

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7
Q

Anticholinergic

A
  • Atrovent = Ipratroprium
  • Combivent =
    Ipratropium + Albuterol
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8
Q

IgE Antibody

A

Omalizumab (Xolair)

Benralizumab (Faserna)

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9
Q

Drug Classes for bronchodilation

A
  • Methylxanthines
  • Anticholinergics
  • β-2 agonists
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10
Q

What drug should be avoided in Methyxanthine class?

A

Erythromycin

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11
Q

What are Anticholinergics used for?

A
  • Inhibit parasympathetic effects on respiratory system
  • Increased mucos
  • Smooth muscle contraction
  • Alt. for pts w/ adverse rxn to β-adrenergics or in combo with β-adrenergics
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12
Q

side effects of methylxanthines

A

tachy, arrhythmia, seizures, and insomnia

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13
Q

What are the Anti-Inflammatory drug classes for asthma treatment?

A

Corticosteroids
Chromolyn, Nedocromil
Leukotriene modifiers

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14
Q

Corticosteroids

A

Beclomethasone: vanceril, beclovent

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15
Q

Cromolyn & Nedocromil

A

Intal

Tilade

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16
Q

Leukotriene Modifiers

A

Accolate
Singulair
Zyflo

17
Q

Monoclonal Antibody (mAb)

A

Identical antibodies produced by ONE TYPE of immune cell, all CLONES of a single parent cell

18
Q

Polyclonal Antibody

A

Antibodies derived from different cell lines

19
Q

Isotypes

A

Immunoglobuline grouped by variation in heaby chain constant domains:

IgG
IgA
IgM
IgE
IgD
20
Q

Reduces Serum Levels of IgE

Down-Regulates expression of IgE receptors on mast cells and basophils

A

Omalizumab (Xolair)

21
Q

Benralizumab (Faserna)

A

Reduces IgE levels

22
Q

Dental side-effect of prolonged use of β-2 agonists

A

Decreased saliva –> Increase in lactobacilli and S. mutans –> caries

23
Q

Oral health considerations in people with asthma

A

Decreased salivary flow and caries

Increased oral mucosal changes (nebulized corticosteroids –> oropharyngeal candidiasis, tongue enlargement, dysphonia, throat irritation and xerostomia)

Increased gingivitis (inhaled steroids –> immunological depression; mouth breathing, increased calculus production)

Orofacial abnormalities (increased anterior face height, higher palatal vaults, greater overjet, and posterior crossbites from mouth breathing)

24
Q

If a patient is wheezing and coughing should they be treated?

A

no. ask them to return when symptoms disappear

25
Q

If you have a pt with hx of asthma and they are anxious in the dental chair which of the following can you administer?

a. Hydroxyzine
b. Benzodiazepene
c. IV sedation
d. Narcotics
e. Barbituates
f. NO

A

Anxiety is a known asthma trigger.

NO = medical consult since NO can potentially cause airway irritation. for mild-mod asthmatics only.

Hydroxyzine and Benzodiazepines = safe

Narcotics and barbiturates = AVOID

IV sedation = use extreme caution. Limited airway control

26
Q

What are the appropriate therapies for pain management in asthmatic pt.?

a. local anesthetic + vasoconstrictor
b. local anesthetic only
c. Acetaminophen
d. NSAIDs, aspririn

A

vasonstrictors = AVOID d/t sodium metabisulfite (highly allergenic)

Acetaminophen = YES

NSAIDs = AVOID! 20% of asthmatic pts experience bronchoconstriction after ingestin NSAIDs

27
Q

Fluoride supplements should be prescribed for all asthmatic pts.

True or False

A

True.

Especially for those using β-agonists

28
Q

To maintain good OHI, Instruct asthmatic pts to _______ after using inhaler

A

rinse mouth

29
Q

You may need to be aware of the possibility of prescribing antifungal agents for asthmatic pts using inhaler.

True or False

A

True.

oropharyngeal candidiasis is an oral health concern

30
Q

major cause of death in asthmatics

A

Mucous plugs

31
Q

MOA of inhaled β-agonists

A

stimulate adenylyl cyclase and cAMP production

32
Q

What do Methylxanthanes do?

A

Reduce bronchoconstriction of early and late phase

Do not affect hyperresponsiveness in bronchioles

33
Q

Early Phase asthma

A

Allergen/irritant activates mast cells

Inflammatory mediators are released

Intense inflammation (bronchial wall constrictions, vasodilation/permeability, epithelial damage)

Bronchospasm (mucous secretion, edema)

34
Q

Late Phase astchma

A

5-6hrs

Inflammation

Lymphocytes, Monocytes,
Eosinophils and Neutrophils infiltrate

mediators (IL4, IL-5, TNF) accentuate cytokines from Eosinophils and neutrophils

^ ^ Self-perpetuating cycle

*Future attacks may be worse

Dental Pharmacology II Exam 1 (3 decks)

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