Asthma & COPD Medications

Question 1

What are the medication options for Asthma & COPD?

Answer 1

1. Beta2 agonists (long and short-acting)
2. Inhaled anticholinergics (long and short-acting)
3. Inhaled glucocorticoids
4. Methylxanthines

Question 2

Beta 2 agonist and Methylxanthines overview

Answer 2

help open up the airways

Question 3

anticholinergics overview

Answer 3

block muscarinic receptors. This prevents bronchoconstriction, causing airways to open.

Question 4

inhaled glucocorticoids overview

Answer 4

prevent inflammation in the airways

Question 5

Beta 2 Agonists that you should know (hint: -terol)

Answer 5

1. Albuterol
2. Levalbuterol
3. Formoterol
4. Salmeterol

Question 6

Albuterol & Levalbuterol common uses

Answer 6

-are short-acting beta2 agonists (SABAs)
-They start working in about five minutes and last a few hours. This makes them ideal as “rescue” medications for when clients are having active respiratory problems.

Question 7

Formoterol and Salmeterol Common Uses

Answer 7

-are long-acting beta2 agonists (LABAs)
-They have a slower onset of action but last for 12 hours. These are frequently used for COPD but can be used for asthma.

Question 8

LABAs should only be used if ____

Answer 8

combined with another medication (e.g., a corticosteroid or long-acting anticholinergic)

Question 9

Beta 2 Agonists Mechanism of Action

Answer 9

These medications trigger beta2 adrenergic receptors in the lungs, causing the smooth muscle around the bronchioles to relax, causing them to open (bronchodilation).

Question 10

LABA Monotherapy Warning (Beta 2 Agonists)

Answer 10

There’s a significantly increased risk of death and hospitalization if clients are only prescribed long-acting beta2 agonists by themselves

Question 11

Inhaled Anticholinergic Medications you should know (hint: -tropium)

Answer 11

1. Ipratopium
2. Tiotropium

Question 12

Ipratropium Common Uses

Answer 12

short-acting anticholinergic. Like the SABAs it has a short onset of action and can be given as needed for COPD.

Question 13

Tiotropium Common Uses

Answer 13

long-acting anticholinergic. It’s used as a “controller” for COPD. Inhaled anticholinergics aren’t commonly used for asthma.

Question 14

Inhaled Anticholinergic Mechanism of Action

Answer 14

When you are at rest, acetylcholine triggers muscarinic receptors in your airway. This causes bronchoconstriction. These medications block muscarinic receptors, causing bronchodilation.

Question 15

Inhaled Anticholinergic side effects

Answer 15

dry mouth
hoarseness

Question 16

What are the Inhaled Glucocorticoid (controllers) Medications that you should know (hint: “-sone”)

Answer 16

1. Budesonide
2. Fluticasone
3. Mometasone

Question 17

Inhaled Glucocorticoid Common Uses

Answer 17

These inhaled formulations are used for asthma and COPD. They are especially effective for asthma. However, they take a week or more to work.

Question 18

Inhaled Glucocorticoids Mechanism of Actions

Answer 18

Glucocorticoids prevent the immune system from creating chemical triggers of inflammation. This reduces the inflammation of airway mucosa.

Question 19

Inhaled Glucocorticoids side effects

Answer 19

-oral candidiasis/thrush (fungal infection in mouth)
*patients should rinse mouth after using this med

Question 20

Montelukast Common Uses

Answer 20

-mainly prescribed for asthma.
-Sometimes it is also prescribed for seasonal allergic rhinitis.
- meant for maintenance therapy. It is not a rescue or as-needed medication.

Question 21

Montelukast Mechanism of Action

Answer 21

blocks leukotriene receptors

Question 22

Montelukast High Yield Concepts

Answer 22

-usually well tolerated
-reports of mood changes or suicidal ideation (neuropsychiatric effects)
-usually taken at bedtime

Question 23

Theopyline belongs to a group of drugs called

Answer 23

methylxanthines

Question 24

Theophyline Common Uses

Answer 24

-commonly prescribed for asthma and COPD.
-Current guidelines recommend using beta2 agonists and anticholinergics instead due to narrow therapeutic index

Question 25

Theophylin Mechanism of Action

Answer 25

causes the smooth muscles of the bronchi to relax, causing bronchodilation

Question 26

What drugs cause theophylline levels to decrease?

Answer 26

tobacco, marijuana, phenytoin

Question 27

What drugs cause theophylline levels to increase?

Answer 27

fluoroquinolone antibiotics

Question 28

Theophylline blood levels should be between

Answer 28

10 and 20 mcg/mL

Question 29

Symptoms of Theophylline toxicity include

Answer 29

-mild toxicity: nausea, vomiting, diarrhea, and restlessness
-high toxicity: fatal heart dysrhythmias and seizures.

Question 30

Clients should avoid what food interaction since they are from the same drug class?

Answer 30

caffeine