Asthma Drugs Flashcards by Tracy Andrus

Name the 4 Short-Acting Beta-2 Agonists (Bronchodilators)

Albuterol
Terbutaline
Metoproterenol
Pributal

How well did you know this?

Not at all

Perfectly

Name the 3 Long-Acting Beta-2 Agonists

Salmeterol
Formoterol
Indacaterol

How well did you know this?

Not at all

Perfectly

SABA & LABA

MOA

Relax bronchial smooth muscle;
Inhibit mediator release (mast cells, basophils);
Increase mucociliary clearance;
Suppression of microvascular permeability

How well did you know this?

Not at all

Perfectly

SABA
Uses
(Albuterol, Terbutaline, Metoproterenol, Pributal)

Prevent/Reduce exercise-induced bronchospasms;

Mild asthma & acute exacerbations

How well did you know this?

Not at all

Perfectly

LABA
Uses
(Salmeterol, Formeterol, Indacaterol)

Long-term asthma sx control (always in combination with ICS)

How well did you know this?

Not at all

Perfectly

SABA & LABA

Impt SE

MSK tremor;
Tachycardia;
Hyperglycemia;
Hypokalemia;
Hypomagnesemia

How well did you know this?

Not at all

Perfectly

SABA & LABA

Other SE

Tolerance with chronic use;
Prolonged QTc;
Lactic Acidosis;
Paradoxical Bronchospasm

How well did you know this?

Not at all

Perfectly

SABA
Misc
(Albuterol, Terbutaline, Metoproterenol, Pirbutal)

5 min to take action;
4-6hrs duration;
Nebulizer delivers more, but with greater SE
(Levalbuterol is R-isomer of albuterol)

How well did you know this?

Not at all

Perfectly

LABA
Misc
(Salmeterol, Formoterol, Indacaterol)

10-15 min to take action;
6-12 hrs duration;
Neb delivers more;
Oral = least effective, can be for night sxs

How well did you know this?

Not at all

Perfectly

Theophylline
Theobromine
Caffeine
Class

Bronchodilator (Methylxanthine)

How well did you know this?

Not at all

Perfectly

Theophylline
Theobromine
Caffeine
MOA

PDE inhibition and enchance signaling via increased cAMP and cGMP; relaxes bronchial smooth muscle

How well did you know this?

Not at all

Perfectly

Theophylline
Theobromine
Caffeine
Uses

Reduce inflam and bronchospasm in moderate to sever asthma;

Night sxs

How well did you know this?

Not at all

Perfectly

Theophylline
Theobromine
Caffeine
Impt SE

CNS stimulation/seizures;
Tachycardia/arrhythmias;
Anorexia;
Nausea

How well did you know this?

Not at all

Perfectly

Theophylline
Theobromine
Caffeine
Misc

Low TI
Met by liver
Cimetidine and quinolone inc blood levels

How well did you know this?

Not at all

Perfectly

Roflumilast

Class

Methylxanthine

How well did you know this?

Not at all

Perfectly

Roflumilast

MOA

Selective PDE4 inhibitor

More anti-inflam than bronchodilator

How well did you know this?

Not at all

Perfectly

Roflumilast

Uses

COPD

How well did you know this?

Not at all

Perfectly

Roflumilast

Impt SE

CNS stim/seizures;
Tachycardia/arrhythmias;
Anorexia;
Nausea

How well did you know this?

Not at all

Perfectly

Ipratropium
Tiotropium
Atropine
Class

Antimuscarinic (anticholinergic)

Ipratropium
Tiotropium
Atropine
MOA

Blocks vagal pathways and decrease vagal tone to bronchial smooth muscle;
Blocks reflex bronchoconstriction caused by inhaled irritants

Ipratropium
Tiotropium
Atropine
Uses

First-line for chronic COPD;
Status Asthmaticus (with nebulized B2-agonists)

Ipratropium
Tiotropium
Atropine
Impt SE

Antimuscarinic effects
Acute Angle Glaucoma
Paradoxical Bronchospasm

Tiotropium

Misc

Tiotropium has anti-inflammatory properties and decreases mucus secretions

Aclidinium Bromide

Class

Antimuscarinic

Aclidinium Bromide | MOA

Blocks vagal pathways and decreases vagal tone to bronchial smooth musc; Blocks the reflex bronchoconstriction caused by inhaled irritants

Aclidinium Bromide | Uses

Functionally similar to tiotropium (decreases mucus secretions); First-line for chronic COPD; Status Asthmaticus (with nebulized B2-agonists)

Aclidinium Bromide | Impt SE

Less systemic and CNS SE than other antimuscarinics d/t extremely short circulation half-life

``` Budesonide Fluticasone Propionate Beclomethasone Circlesonide Class ```

Inhaled corticosteroids | anti-inflammatory

``` Budesonide Fluticasone Propionate Beclomethasone MOA ```

Anti-inflam effects; Inhibition of growth factor secretion; Inhibition of arachidonic acid metabolites and plt activation factor; Inhibition of leukocyte accumulation; decreased vascular permeability; Inhibition of mucus GP secretion

Circlesonide | MOA

Same as other corticosteroids, but is a prodrug activated by airway esterase

``` Budesonide Fluticasone Propionate Beclomethasone Circlesonide Uses ```

Cornerstone tx of persistent asthma; Beneficial combo with B2 agonists; Limited role in COPD

``` Budesonide Fluticason Propionate Beclomethasone Circlesonide Impt SE ```

``` Inhaled = thrush; Hoarseness; Dry cough; Mild adrenal suppression (higher doses); Oral = mood swings; Increased appetite; Suppression of adrenocorticotropic hormone secretion (Cushing's) **Circlesonide = less side effects bc onsite activation ```

Sodium Chromoglycate Nedocromil Sodium Class

Anti-inflammatory

Sodium Chromoglycate Nedocromil Sodium MOA

Prevent mast cell degranulation and mediator release from mast cells

Sodium Chromoglycate Nedocromil Sodium Uses

Early/Late phase reaction prophylaxis; | Best results in mild/allergic asthma

Sodium Chromoglycate Nedocromil Sodium Impt SE

Minimal local side effects (cough/throat irritation)

Montelukast Pranlukast Zafirlukast Class & MOA

Leukotriene Inhibitors

Montelukast Pranlukast Zafirlukast Uses

Add-on therapy in mild persistent asthma; Aspirin-induced asthma; Prophylaxis for EI bronchospasm

Montelukast Pranlukast Zafirlukast Misc

Must monitor LFTs

Zileuton | Class

Leukotriene inhibitor

Zileuton | MOA

Inhibits 5-lipoxygenase and blocks leukotriene synthesis

Zileuton | Uses

Same as others: Add-on therapy in mild persistent asthma; Aspirin-induced asthma; Prophylaxis for EI bronchospasm

Zileuton | Impt SE

Liver Toxicity

Omalizumab | Class

Anti-IgE mAB

Omalizumab | MOA

Blocks IgE function

Omalizumab | Uses

Poorly controlled severe asthma

Omalizumab | Misc

Administered SQ injection every 3wks