asthma medications

Question 1

Short-acting Beta-2 Agonists

Answer 1

Medications: albuterol (proventil), levalbuterol (Xopenex)
Routes: inhaler or nebulizer
Rescue or Maintenance? RESCUE
Action: bronchodilator – relieves bronchospasm
S/E: tachycardia, palpitations, anxiety, tremor, insomnia
Notes: do not use with beta blockers

Question 2

Long-acting Beta-2 agonists

Answer 2

Medications: salmetrol (Serevent), albuterol/salbutamol (VoSpire)
Routes: inhaled (salmetrol), oral ER
Rescue or Maintenance? MAINTENANCE
Action: bronchodilator – relieves bronchospasm
S/E: tachycardia, palpitations, anxiety, tremor, insomnia
Notes: do not use with beta blockers

Question 3

Anticholinergics

Answer 3

Medications: ipratropium (Atrovent)
Routes: inhaler or nebulizer
Rescue or Maintenance? RESCUE
Action: bronchodilator – bronchial smooth muscle relaxation
S/E: dry mouth, palpitations, broncospasm;
Notes: used when pt cant tolerate beta2 agonist or has COPD

Question 4

Methylxanthines

Answer 4

Medications: theophylline (Theo-Dur, Slo-Bid)
Routes: oral ER
Rescue or Maintenance? MAINTENANCE
Action: bronchodilator – bronchial smooth muscle relaxation
S/E: toxicity - tachycardia, arrhythmias, seizures
Notes: monitor serum levels Q6-12 mo (monitor therapeutic levels)

Question 5

Systemic Corticosteroids

Answer 5

Medications: methylprednisone (Solumedrol – IV); prednisone (oral)
Routes: IV, oral
Rescue or Maintenance? RESCUE (high dose pred; low = maintenance)
Action: anti-inflammatory – decreases bronchial inflammation and suppresses the immune system
S/E: hyperglycemia, decreased immune function, agitation, osteoporosis

Question 6

Inhalation Corticosteroids

Answer 6

Medications: beclomethasone (Beclovent, Vanceril), triamcinolone (Azmacort), Fluticasone (Flovent)
Routes: inhaler
Rescue or Maintenance? MAINTENANCE
Action: anti-inflammatory – decreases bronchial inflammation and suppresses the immune system
S/E: oral candidiasis, hyperglycemia, decreased immune function, agitation, osteoporosis
Notes: rinse mouth after use

Question 7

Leukotriene modifiers

Answer 7

Medications: montelukast (Singulair), zafirlukast (Accolate), zileuton (Zyflo)
Routes: oral
Rescue or Maintenance? MAINTENANCE
Action: anti-inflammatory; inhibits leukotriene formation, thus decreasing inflammation and mucous production
S/E: HA, Nausea, nasal congestion

Question 8

Mast Cell Stabilizers

Answer 8

Medications: cromolyn (Intal), nedocromil (Tilade)
Routes: inhaled or nebulizer
Rescue or Maintenance? MAINTENANCE
Action: anti-inflammatoryl decreases release of histamine and blocks overall inflammatory response
S/E: throat irritation, bronchospasm, cough, itchy watery eyes, sneezing

Question 9

Combination: CORTICOSTEROID and BETA 2 AGONIST

Answer 9

Medications: fluticasone + salmeterol (Advair); budesonide + formoterol (Symbicort)
Routes: inhaler
Rescue or Maintenance? MAINTENANCE
Action: bronchodilator and anti-inflammatory
S/E: cort + beta2 + HA, throat irritation, URI, thrush
Notes: rinse mouth out after use

Question 10

Combination: ANTICHOLINERGIC and BETA 2 AGONIST

Answer 10

Medications: ipratropium + albuterol (Combivent)
Routes: inhaled
Rescue or Maintenance? MAINTENANCE
Action: bronchodilator and antiinflammatory
S/E: antichol + beta2