Asthma Drugs Flashcards
Hydrocortisone (Solu-Cortef), Prednisone, Qday low dose or 10 day taper attack Methylprednisolone (IV) Triamcinolone (Azmacort) Fluticasone (Flovent), Beclomethasone (Qvar), Budesonide (Pulmicort), Momeetasone (Pulmicort), & Cicleesonide (Alvesco) Flunisolide (Aerobid)...
Are all what class of drug?
Corticosteroids
Tiotropium (Spiriva) is a __[1]___-acting drug.
Ipratropium (Atrovent) is a ___[2]___-acting drug.
[2a] used how many times in acute attack?
[3] And What class of drug are they??
[1] Long-acting
[2] Short acting
[2a] 1 time only with SABA
[3] Anticholinergic
Omalizumab (Xolair) is what class of drug? Route?
Anti-IgE
SQ
Zafirlukast (Accolate),
Montelukast (Singulair), &
Zileuton (Zyflo CR)…
Are all what class of drug??
Leukotriene Modifiers
Albuterol (Proventil), &
Levalbuterol (Xopenex)…
Are __[1]__-acting and are what class of drug[2]?
[1] Short-acting (SABA)
[2] B2-Adrenergic Agonists
Salmeterol (Serevent),
Formoterol (Foradil Aerolizer), &
Arformoterol (Brovana)…
Are __[1]__-acting and are what class of drug[2]?
[1] Long-acting (LABA)
[2] B2-Adrenergic Agonists
Aminophylline/Theophylline is what class of drug? Route?
Methylxanthines
PO
Fat soluble so toxicity is a concern
Combivent, Buoneb, Advair,
Symbicort, Dulera…
Are all what class of Drug?
Combination Agents
How do Corticosteroids work and how are they effectively used for asthma?
Examples: Hydrocortisone (Solu-Cortef), Prednisone, Fluticasone (Flovent), Beclomethasone (Qvar), Budesonide (Pulmicort), Momeetasone (Pulmicort), & Cicleesonide (Alvesco)
- Is an Anti-inflammatory medication that reduces bronchial hyper-responsiveness, blocks the late phase reaction and inhibits migration of inflammatory cells.
- Is more effective in long term control than any other drug.
How do Leukotriene Modifiers work and how are they effectively used for asthma?
Examples:
Zafirlukast (Accolate),
Montelukast (Singulair), &
Zileuton (Zyflo CR)
- Is an anti-inflammatory that interferes with the synthesis or blocks the action of leukotrienes which are inflammatory mediators As well as potent bronchoconstrictor’s.
- Can be successfully used as add-on therapy to reduce (but not substitute) the doses of inhaled corticosteroids.
How do Anti-IgE drugs work and how are they effectively used for asthma?
Examples:
Omalizumab (Xolair)
- Is an anti-inflammatory that decreases circulating free IgE levels
- For use with patients that have moderate to severe persistent, allergic asthma, that cannot be controlled with an inhaled corticosteroid
How do B2 Adrenergic Agonist drugs work and how are they effectively used for asthma?
Examples: SABA's: Albuterol (Proventil), & Levalbuterol (Xopenx) LABA's Salmeterol (Serevent), Formoterol (Foradil Aerolizer), & Arformoterol (Brovana)
- Is a Bronchodilator used to relieve acute Bronchospasm
- SABAs can prevent exercise induced asthma when used B4 the trigger.
- SABA’s are used as rescue medications for acute Exacerbations.
- LABA’s are for Long term control & are used along with ICS’s and are not intended for monotherapy.
How do Methylxanthines work and how are they effectively used for asthma?
Examples:
Aminophylline/Theophylline
- Is a bronchodilator with mild anti-inflammatory effects, but the exact mechanism of action is unknown.
- Used only as an alternative therapy Since there is a relatively high incidence of interaction with other drugs.
How do Anticholinergic drugs work and how are they effectively used for asthma?
Examples:
Short-Acting: Ipratropium (Atrovent)
Long-Acting: Tiotropium (Spiriva)
- Is a bronchodilator that blocks the bronchoconstricting influence of the parasympathetic nervous system.
- These drugs are used for quick relief in those patients unable to tolerate SABA’s.
Cromolyn Sodium (Intal) Nedrocromil Sodium (Tilade)
What class of drug? Action?/Use when?
Mast Cell Stabilizer
anti-inflammatory inhibits exercise induced bronchospasm
Use B4 exercise (duh!)
Amantadine (Symmetrel) Oseltamivir (Tamiflu) Zanamivir (Relenza) Class? Tx what?
Class: antiviral
Tx: Flu
Oseltamivir (Tamiflu) [1]
Zanamivir (Relenza) [2]
Route? timing?
Route [1] PO give within 48 hrs of exposure
[2] inhaler give within 48 hrs of exposure
Palivizumab (Synagis)
Class?
Tx what? In whom?
Dosage/frequency
monoclonal ab
Preventative Tx RSV in High risk <24mo.
Give Q30days in RSV season.
ribaviron (Virazole) [2]
Class?
Tx what? In whom?
antiviral
Tx RSV in seriously ill children.
State 1 additional category of drugs used to Tx RSV
Bronchodilators
benzodiazepines (alprazolam) (clonazepam) (lorazepam) (Ativan) Valium Librium
Used to Tx? For how long?
How?
Who should not use these (why?)
Anxiety Short term Tx
increase action of GABA (slow neural transmission)
not for use by pt. with Hx substance abuse. Can be addictive.
propanolol - Beta blockers
Used to Tx?
How?
Anxiety (s/s “stage fright”)
blocks B adrenergic receptors
clonidine
Used to Tx?
How?
Anxiety
stimulates alpha adrenergic (calming effect)
Prozac (need to add other drugs)
Wellbutrin
Zoloft
Paxil
Category?
Used to Tx
KNOW when used
SSRI / antidepressant
Anxiety
1st line drug for Tx all anxiety disorders
Buspirone (Buspar)
Used to Tx?
Why use this instead of benzodiazepines?
GAD -
Less sedating than benzodiazepines
Cymbalta
Effexor
Category?
SNRI - Serotonin and Norepinephrine re-uptake inhibitors
Symptoms of SSRI withdrawal syndrome?
How can it be prevented?
headache, NV, flu-like
Taper (titrate down) dose of SSRIs - DO NOT STOP abruptly
phenelzine sulfate (NARDIL) Tranylcypromine (Parnate) Class? side effects? restrictions?
MAOI inhibitors (these were the 1st antidepressants - not very safe, but still work for very resistant disorders) Hypertensive crisis dietary restrictions NO TYRAMINE (avocados, cheese, smoked meats, fava beans (Chianti is OK ;)
