Asthma/COPD (Exam #2) Flashcards
What is the typical treatment process for asthma (3)?
- SABA
- Add ICS
- Add LABA (continue ICS ALWAYS and SABA PRN)
Why do you always have to use an ICS in conjunction with a LABA?
Prevent beta receptor down regulation (prevent/reverse tolerance)
Which group of meds are preferred for COPD, and why?
“-tropium” (Ipratropium, Tiotropium)
- Muscarinic antagonists → produce bronchodilation
What three groups of drugs are used to reduce inflammation in asthma?
- Corticosteroids (ICS)
- Leukotriene inhibitors
- Monoclonal Abs
What are the two SABA drugs?
- Albuterol
- Levalbuterol
What are the three LABA drugs? What is often combined with these drugs (2)?
- Salmeterol
- Formoterol
- Vilanterol
+/- Fluticasone or Mometasone
What is the difference between Ipratropium and Tiotropium, and what class of drugs do they come from? What are they used for?
Muscarinic antagonists for COPD
- Ipratropium: often combined with Albuterol used as a rescue inhaler or acute attack
- Tiotropium: longer DOA, only once daily administration
Which LABA is administered orally, and what is an important PK of this drug?
Theophylline
- LOW therapeutic index (many AEs and drug interactions)
What is the MOA of Theophylline (2)?
- Blocks adenosine receptors (prevents bronchoconstriction)
- Phosphodiesterase inhibitor = increase cAMP (increase bronchodilation)
What four things INCREASE clearance of Theophylline? What DECREASES clearance of Theophylline?
- Increase: Phenytoin, Rifampin, smoking, oral contraceptives
- Decrease: Cimetidine
Which administration route of corticosteroids is preferred, and why (2)? When would the lesser preferred route be used?
INHALED: improve sxs, decrease BA requirements
- Oral have more systemic sxs - should only be used short-term and/or severe cases
What is the primary AE associated with ICS?
THRUSH (oropharyngeal Candidiasis)
What are the three ICS drugs?
- Fluticasone
- Beclomethasone
- Flunisolide
What asthmatic response is decreased with Leukotriene Inhibitors (2)? What do they decrease the need for?
Decrease asthmatic response to exercise, cold air
- Decrease need for ICS or oral steroids
What is the main Leukotriene Inhibitor drug?
Montelukast (Singulair)
What are the two main Monoclonal Ab drugs used for asthma, and what is the target of each?
- Omalizumab (Xolair): targets IgE
- Benralizumab: targets IL-5
What three AEs may be seen with Leukotriene Inhibitors?
- Increase in URIs
- Sore throat
- Sleepiness
What drug can be used to treat moderate/severe asthma not controlled with steroids?
Omalizumab (Xolair)
What drug is used to treat severe asthma with eosinophilic phenotype?
Benralizumab
What drug is used to treat asthma by inhibiting release of histamine from mast cells?
Cromolyn sodium
What drug is often used prophylactically for asthma in peds?
Cromolyn sodium
