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Pharmacology > Asthma drugs > Flashcards

Asthma drugs Flashcards

1
Q

General principles of Asthma management

A

The overall objectives of antiasthma therapy are to:
To return lung function to as near normal as possible
To prevent acute exacerbations of the disease
To achieve a normal quality of life
Permits normal activities (exercise)

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2
Q

Primary classes of drug therapy

A

Bronchodilators

Anti-inflammatory agents

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3
Q

Referred as RELIEVERS

- they provide rapid symptomatic relief

A

Bronchodilators

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4
Q

Referred as CONTROLLERS

-provide long-term stabilization of symptoms

A

Anti-inflammatory agents

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5
Q

Used both in maintenance therapy and as needed to reverse acute attacks

A

Bronchodilators

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6
Q

Must be used in conjunction with bronchodilators except for mild asthma

A

Anti-inflammatory agents

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7
Q

All treatment regimens should include PATIENT EDUCATION that is focused on the following:

A
  • The appropriate use of medications to control symptoms
  • Recognition of the signs of a deteriorating disease status
  • Prevention strategies
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8
Q

A/E of Epinephrine

A

Feeling of nervousness and anxiety
Hand and upper extremity tremors
Palpitation
Extreme hypertension, CVA, pulmonary edema, angina and arryhythmias

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9
Q

A/E of Isoproterenol

A

Tachycardia, dizziness and nervousness

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10
Q

A/E of B2 adrenoreceptors

A

Muscle tremor

Tachycardia and palpitations

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11
Q

Pharmacological effects of Theophylline

A

Smooth muscle relaxation
CNS excitation
Cardiac stimulation

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12
Q

Theophylline inhibits

A

cyclic nucleotide phosphodiesterases

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13
Q

Actions of Theophylline in Asthma

A 
Antagonism of adenosine
Inhibition of mediator release
Increased sympathetic activity
Alteration in immune cell function
Reduction in respiratory muscle fatigue
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14
Q

Effect of theophylline is px with Heart failure, liver disease and severe respiratory obstruction

A

Slow down its metabolism

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15
Q

A/e of theophylline

A

Nausea and vomiting (most frequent for those receiving for the first time) (20mcg/ml)
Probability of seizures (>40 mcg/mL)
Arrhythmia, hypotension, and cardiac arrest (bolus IV injection)

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16
Q

Effect of theophylline in children

A

In children: restlessness, agitation, diuresis, fever.

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17
Q

T/F: Theophylline Half life is prolonged in patients with CHF

A

TRue

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18
Q

T/F: You can give theophylline with Cimetidine and Zileuton

A

False: Extreme caution in patients who are medicated with Cimetidine & Zileuton

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19
Q

Adrenomimetic agents are use both as ____ & ____ to maintain patency over the long term

A

These agents are used both as needed to reverse acute episodes of bronchospasm and prophylactically to maintain airway patency over the long term.

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20
Q

Pharmacologic effects of adrenomimetic agents

A

Pharmacologic effects: bronchodilation, tachycardia, anxiety and tremor.

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21
Q

What are examples of the bronchodilator drugs

A 
Epinephrine
Isoproterenol
Selective Beta 2-adrenoceptor agonist
Theophylline
Anticholinergics
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22
Q

Action of epinephrine

A

activates both alpha and beta receptors

23
Q

Epinephrine is administered

A

Subcutaneously

Administered subcutaneously to manage severe acute episodes of bronchospasm and status asthmaticus

24
Q

Epinephrine timing of effect

A

5-15 minutes

Measurable improvement in pulmonary function is maintained for up to four hours

25
Q

Epinephrine cardiovascular effcts

A

increased heart rate, increased cardiac output, increased stroke volume, elevation of systolic pressure, decrease in diastolic pressure and decrease in systemic vascular resistance.

26
Q

Isoproterenol action

A

Beta adrenoceptor agonist

Not selective for b1 and B2

27
Q

Isoproterenol administration

A

inhalation

Administered exclusively by inhalation from metered dose inhaler or from nebulizers

28
Q

Isoproterenol is mainly used for

A

bronchospasm

29
Q

Isoproterenol timing effect

A

Effect is instantaneous but short-lived

30
Q

Examples of Selective Beta 2-adrenoceptor agonist

A

Terbutaline
Albuterol
Salmeterol

31
Q

Selective B2-adrenoceptor agonist administration

A

Terbutaline and Albuterol are administered either orally or by inhalation

Salmeterol is given by inhalation only

32
Q

Selective B2-adrenoceptor agonist timing

A

Terbutaline and Albuterol Used for acute attacks due to rapid onset

Salmeterol suitable for prophylactic use more than in acute attacks (due to slow onset of action)

33
Q

When to use Terbutaline and Albuterol

A

acute attacks

prematur labor

34
Q

When to use Salmeterol

A

Prophylaxis

35
Q

Action of anticholinergics

A

stimulate cholinergic nerve fibers > (+) muscarinic cholinoreceptors > (+) bronchoconstriction, mucus secretion, broncho vasodilation

36
Q

Quaternary amine derivative of atropine that is used via inhalation in the treatment of COPD and Asthma

A

Ipratropium Bromide

37
Q

Advantages of Ipratropium bromide

A
  • Has a slower onset of action thus suitable for prophylactic use
  • More effective in COPD than Asthma
  • Effective in patients who have psychogenic asthma and in patients taking beta blockers
  • It does not inhibit mucociliary clearance so it does not promote accumulation of secretions in lower airways
38
Q

A/E of anticholinergics

A

dry mouth, headache, nervousness, dizziness, nausea and cough

39
Q

Examples of anti-inflammatory agents

A

Corticosteroids

40
Q

Main mechanism of corticosteroids as asthma drug

A

inhibit inflammatory processes

41
Q

Disadvantage of corticosteroids

A

The clinical effects take several hours to several days to develop making it not advisable for quick relief of acute bronchospasm

Most of the agents are used for maintenance treatment of asthma as prophylactic therapy

42
Q

A/E of Steroids

A 
Systemic Steroids:
Adrenal suppresion
Cushingoid changes 
Growth retardation
Cataracts
Osteoporosis
CNS effects/behavioral changes
Increased susceptibility to infections

Inhaled Corticosteroids
Generally well tolerated
Either poorly absorbed or rapidly metabolized and inactivated
Most frequent side effects: oral candidiasis, dysphonia, sore throat and irritation
Adverse effects outweigh the benefits from inhaled steroids

43
Q

Alternative therapies for asthma

A

Leukotriene Modulator

44
Q

Example of leukotriene modulators

A

Zafirlukast, Montelukast,and Zileuton

45
Q

Most common side effects of Zafirlukast, Montelukast,and Zileuton

A

Dyspepsia

46
Q

Main use fo Zafirlukast, Montelukast,and Zileuton

A

For prophylaxis and chronic treatment of asthma

should not be used for acute episodes

47
Q

Administration of Zafirlukast, Montelukast,and Zileuton

A

oral

48
Q

Contraidications of taking Zileuton

A

Zileuton inhibits the metabolism of Theophylline
Zileuton has drug reaction with warfarin, terfenadine and propranolol
Zileuton is contraindicated in patients with acute liver disease

49
Q

Zafirlukast increases plasma concentration of ___ and decreases plasma concentrations of ___

A

Warfarin ; Theophylline and Erythromycin

50
Q

Prophylaxis for mild or moderate asthma (4-6 weeks)

A

Cromolyn sodium and Nedocromil sodium

51
Q

Admission of Cromolyn sodium and Nedocromil sodium

A

Inhalation

52
Q

Advantage of Cromolyn sodium and Nedocromil sodium

A

Safe in children

53
Q

Action of Cromolyn sodium and Nedocromil sodium

A

stabilizes mast cells > prevent mediator release > inhibit effects on irritant receptors and inflammatory cells

54
Q

Non-pharmacologic Treatment of Asthma

A 
Cessation of smoking
Avoidance of environmental exposure
Engage in physical activity (swimming)
Avoidance of occupation exposures
Avoidance of medications that can trigger Asthma attacks
Healthy diet

Pharmacology (11 decks)

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