Asthma and Allergy Flashcards
Beta2 adrenergic agonists
(short acting and long acting)
Classification
MOA
ROA
Classification: bronchodilator MOA: 1. stimulate AC (adenylyl cyclase) causing increase in cAMP resulting in bronchodilation 2. inhibit release of mediators from mast cells ROA: 1. Inhalation 2. oral 3. SC (terbutaline)
Beta2 adrenergic agonists (short acting and long acting) Use Unique Use Side Effects
Use: symptom relief of bronchospasm in acute asthma attacks
Unique Use: used in combination with corticosteroids in an inhaler
Side Effects:
1. skeletal muscle tremors
2. tachy
3. anxiety, restlessness, apprehension
Theophylline
Classification:
MOA:
ROA:
Classification: Bronchodilator
MOA:
1. Inhibits cAMP phosphodiesterase causing an increase of cAMP
2. competitive antagonist at adenosine receptors
ROA:
1. oral
2. slow IV over 40 mins
Theophylline
Use
Unique Use
Side Effects
Use: maintenance therapy for chronic asthma
Unique Use: sustained release oral therapy
Side Effects:
1. Narrow therapeutic window
2. convulsions
3. tachy
4. circulatory collapse
- used under child 2
- rarely used because of side effects, drug interactions, limited effectiveness and risk of life threatening complications of overdose
Ipratropium
Classification:
MOA:
ROA:
Classification: Bronchodilator
MOA:
1. Competitively blocks the muscarinic receptors in the airway
ROA:
1. Inhalation
Ipratropium
Use
Unique Use
Side Effects
Use:
Alone or in combination with B2 adrenergic agonists in acute asthma
Unique Use:
Used when a coexisting chronic bronchitis or cough is a symptom in an asthmatic patient
Side Effects:
Minimal, if dosage is too high may cause atropine like effects
Corticosteroids
Classification:
MOA:
ROA:
Classification: Anti-inflammatory agent
MOA:
- Inhibits phospholipase A2 activity
- reduction in the synthesis of arachidonic acid
- inhibition of the release of leukotrienes and prostaglandins
ROA:
- Inhalation
- Oral
- IV
Corticosteroids
Use
Unique Use
Side Effects
Use: Maintenance therapy for chronic asthma
Unique Use:
Treats the underlying inflammation of asthma, reducing frequency and severity of attacks
Side Effects:
1. short term-increased energy, insomnia, hunger, agitation, mood alterations
- long term-osteoporosis, cataracts, myopathy, hypothalamic-pituitary adrenal axis suppression, supression
Cromolyn
Classification:
MOA:
ROA:
Classification: anti-inflammatory agent
MOA: decrease in the release of mediators such as histamine and leukotrienes
ROA:
1. inhalation
Cromolyn
Use
Unique Use
Side Effects
Use:
prophylactic treatment for preventing bronchospasm
Unique Use:
- used prior to use of exercise
- used prior to cold air
Side Effects:
occasional coughing
Zafirlukast, Montelukast
Classification:
MOA:
ROA:
Classification: leukotriene inhibitor MOA:1. antagonist at the LTD4 leukotriene receptor 2. The LTE4 receptor is also blocked ROA: 1. oral
Zafirlukast, Montelukast
Use
Unique Use
Side Effects
Use: prophylactic therapy for preventing bronchospasm
Unique Use: 1. aspirin induced asthma 2. prior to the cold Side Effects: 1. headache 2. nausea
Zileuton
Classification:
MOA:
ROA:
Classification:leukotriene inhibitor
MOA: inhibits 5- lipoxygenase to decrease the production of leukotrienes
ROA:
oral
Zileuton
Use:
Unique Use:
Side Effects:
Use: prophylactic therapy for preventing bronchospasm
Unique Use:
- Exercise induced asthma
- Aspirin induced asthma
- Antigen-induced asthma
Side Effects:
1. contraindicated in patients with hepatic disease
Doxepin
use for chronic urticaria not responding to other H1 antagonists (antihistamine)
What are the most effective nasal sprays?
glucocorticoids
montelukast are useful in patients with waht?
concomitant allergic rhinitis and asthma or coexisting nasal polyposis
