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Asthma Medications Flashcards

1
Q

Epinephrine

A
  • bronchodilator
  • nonselective agonists of both beta-1 and beta-2 adrenoreceptors
  • relaxes bronchial smooth muscle
  • inhibits the release of bronchoconstricting substances from mast cells
  • use in asthma has been larely supplanted by the development of less cardiotoxic, beta-2 selective agents
  • toxicities include tachycardia, arrhythmias, and worsening of angina pectoris
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2
Q

Ephedrine

A
  • bronchodilator
  • nonselective agonists of both beta-1 and beta-2 adrenoreceptors
  • relaxes bronchial smooth muscle
  • inhibits the release of bronchoconstricting substances from mast cells
  • use in asthma has been larely supplanted by the development of less cardiotoxic, beta-2 selective agents
  • toxicities include tachycardia, arrhythmias, and worsening of angina pectoris
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3
Q

Isoproterenol

A
  • bronchodilator
  • nonselective agonists of both beta-1 and beta-2 adrenoreceptors
  • relaxes bronchial smooth muscle
  • inhibits the release of bronchoconstricting substances from mast cells
  • use in asthma has been larely supplanted by the development of less cardiotoxic, beta-2 selective agents
  • toxicities include tachycardia, arrhythmias, and worsening of angina pectoris
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4
Q

Albuterol

A
  • short-acting beta-2 Selective Adrenoreceptor Agonist (SABA)
  • relaxes bronchial smooth muscle
  • inhibits the release of bronchoconstricting substances from mast cells
  • maximal broncodilation achieved in 15-30 min and persists for 3-4 hrs
  • used for relief of acute asthma symptoms and bronchospasm
  • inhalation is the preferred route of delivery for maximal local effect on airway smooth muscle with minimal systemic toxicity
  • appear to be safe and effective when taken on an “as needed” basis for relief of symptoms
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5
Q

Terbutaline

A
  • short-acting beta-2 Selective Adrenoreceptor Agonist (SABA)
  • relaxes bronchial smooth muscle
  • inhibits the release of bronchoconstricting substances from mast cells
  • maximal broncodilation achieved in 15-30 min and persists for 3-4 hrs
  • used for relief of acute asthma symptoms and bronchospasm
  • inhalation is the preferred route of delivery for maximal local effect on airway smooth muscle with minimal systemic toxicity
  • appear to be safe and effective when taken on an “as needed” basis for relief of symptoms
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6
Q

Metaproterenol

A
  • short-acting beta-2 Selective Adrenoreceptor Agonist (SABA)
  • relaxes bronchial smooth muscle
  • inhibits the release of bronchoconstricting substances from mast cells
  • maximal broncodilation achieved in 15-30 min and persists for 3-4 hrs
  • used for relief of acute asthma symptoms and bronchospasm
  • inhalation is the preferred route of delivery for maximal local effect on airway smooth muscle with minimal systemic toxicity
  • appear to be safe and effective when taken on an “as needed” basis for relief of symptoms
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7
Q

Pirbuterol

A
  • short-acting beta-2 Selective Adrenoreceptor Agonist (SABA)
  • relaxes bronchial smooth muscle
  • inhibits the release of bronchoconstricting substances from mast cells
  • maximal broncodilation achieved in 15-30 min and persists for 3-4 hrs
  • used for relief of acute asthma symptoms and bronchospasm
  • inhalation is the preferred route of delivery for maximal local effect on airway smooth muscle with minimal systemic toxicity
  • appear to be safe and effective when taken on an “as needed” basis for relief of symptoms
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8
Q

Salmeterol

A

-long-acting beta-2 selective agonist (LABA)
-*** a partial agonist of beta-2 adrenoreceptors
-relaxes bronchial smooth muscle
inhibits the release of bronchoconstricting substances from mast cells
-duration of action is >12 hours, due to high lipid solubility
-useful in cases of refractory or severe asthma
-not recommended as monotherapy (no anti-inflammatory actions), but work well in combination with inhaled corticosteroids
-chronic use is associated with a small bust statistically significant increase in the low risk of a fatal asthma attack, particularly for African Americans

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9
Q

Formoterol

A

-long-acting beta-2 selective agonist (LABA)
-relaxes bronchial smooth muscle
inhibits the release of bronchoconstricting substances from mast cells
-duration of action is >12 hours, due to high lipid solubility
-useful in cases of refractory or severe asthma
-not recommended as monotherapy (no anti-inflammatory actions), but work well in combination with inhaled corticosteroids
-***Performist preparation of formoterol is only approved for the treatment of chronic COPD symptoms
-chronic use is associated with a small bust statistically significant increase in the low risk of a fatal asthma attack, particularly for African Americans

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10
Q

Arformoterol

A

-long-acting beta-2 selective agonist (LABA)
-relaxes bronchial smooth muscle
inhibits the release of bronchoconstricting substances from mast cells
-duration of action is >12 hours, due to high lipid solubility
only approved for the treatment of chronic COPD symptoms
-chronic use is associated with a small bust statistically significant increase in the low risk of a fatal asthma attack, particularly for African Americans

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11
Q

Vilanterol

A

-long-acting beta-2 selective agonist (LABA)
-relaxes bronchial smooth muscle
-***only available as a combination with a corticosteroid
inhibits the release of bronchoconstricting substances from mast cells
-duration of action is >12 hours, due to high lipid solubility
only approved for the treatment of chronic COPD symptoms
-chronic use is associated with a small bust statistically significant increase in the low risk of a fatal asthma attack, particularly for African Americans

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12
Q

Theophylline

A
  • methylxanthine drug
  • inhibit the phosphodiesterase that converts cyclic AMP to AMP
  • antagonist of mast cell adenosine receptors
  • bronchodilation and relaxation of airway smooth muscle
  • relieves airflow obstruction in acute asthma and reduces severity of symptoms
  • improves contractility of isolated skeletal muscle and reverses fatigue of the diaphragm in COPD patients
  • because of toxicity issues, now reserved for patients who respond poorly to an inhaled corticosteroid combined with an “as needed” beta-2 agonist
  • toxicities mandate occasional measurement of plasma levels of the drug
  • plasma level >20 mg/L can lead to anorexia, nausea, vomiting, abd discomfort, headache, anxiety
  • plasma level >40 mg/L can lead to seizures and arrhythmias
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13
Q

Aminophylline

A
  • methylxanthine drug
  • ethylenediamine salt of theophylline
  • inhibit the phosphodiesterase that converts cyclic AMP to AMP
  • antagonist of mast cell adenosine receptors
  • bronchodilation and relaxation of airway smooth muscle
  • relieves airflow obstruction in acute asthma and reduces severity of symptoms
  • improves contractility of isolated skeletal muscle and reverses fatigue of the diaphragm in COPD patients
  • because of toxicity issues, now reserved for patients who respond poorly to an inhaled corticosteroid combined with an “as needed” beta-2 agonist
  • toxicities mandate occasional measurement of plasma levels of the drug
  • plasma level >20 mg/L can lead to anorexia, nausea, vomiting, abd discomfort, headache, anxiety
  • plasma level >40 mg/L can lead to seizures and arrhythmias
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14
Q

Atropine

A
  • muscarinic receptor Antagonist (MA)
  • antagonize the effect of acetylcholine at muscarinic receptors
  • bronchodilation through inhibition of the parasympathetic pathways associated with bronchoconstriction
  • potential toxicities have limited the use of atropine
  • urinary retention, tachycardia, loss of visual accommodation, agitation
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15
Q

Ipratropium Bromide

A
  • muscarinic receptor Antagonist (MA)
  • antagonize the effect of acetylcholine at muscarinic receptors
  • bronchodilation through inhibition of the parasympathetic pathways associated with bronchoconstriction
  • ipratropium bromide alone or in combination with albuterol (e.g. Combivent and DuoNeb) are useful int he treatment of acute severe asthma and acute COPD symptoms (the combination is synergistic)
  • reduced toxicity relative to atropine, due to selective airway delivery, with minimized potential for absorption into the circulation and entry into the CNS
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16
Q

Tiotropium Bromide

A
  • muscarinic receptor Antagonist (MA)
  • antagonize the effect of acetylcholine at muscarinic receptors
  • bronchodilation through inhibition of the parasympathetic pathways associated with bronchoconstriction
  • long-acting muscarinic antagonist (LAMA)
  • only approved for the treatment chronic COPD symptoms
  • reduced toxicity relative to atropine, due to selective airway delivery, with minimized potential for absorption into the circulation and entry into the CNS
17
Q

Aclidinium Bromide

A
  • muscarinic receptor Antagonist (MA)
  • antagonize the effect of acetylcholine at muscarinic receptors
  • bronchodilation through inhibition of the parasympathetic pathways associated with bronchoconstriction
  • long-acting muscarinic antagonist (LAMA)
  • only approved for the treatment chronic COPD symptoms
  • reduced toxicity relative to atropine, due to selective airway delivery, with minimized potential for absorption into the circulation and entry into the CNS
18
Q

Itratropium Bromide-Albuterol

A

-MA in combination with SABA

19
Q

Beclomathesone

A
  • corticosteroid
  • inhibit the production of inflammatory cytokines
  • alleviate airway obstruction by inhibiting mucosal inflammation in asthmatic airways
  • reduce bronchial reactivity
  • reduce the frequency of asthma exacerbation if administered chronically
  • potentiate the effects of beta-2 agonists
  • inhalation treatment most effective way to minimize systemic absorption and potential for adverse effects
  • first-line agents for the treatment of moderate chronic asthma together with an “as needed” beta-2 agonist
  • toxicity: oropharyngeal candidiasis; low risk of osteoporosis and cataracts in adults; reduction in growth rate of 1 cm in children during 1st year, but none thereafter
20
Q

Budesonide

A
  • corticosteroid
  • inhibit the production of inflammatory cytokines
  • alleviate airway obstruction by inhibiting mucosal inflammation in asthmatic airways
  • reduce bronchial reactivity
  • reduce the frequency of asthma exacerbation if administered chronically
  • potentiate the effects of beta-2 agonists
  • inhalation treatment most effective way to minimize systemic absorption and potential for adverse effects
  • first-line agents for the treatment of moderate chronic asthma together with an “as needed” beta-2 agonist
  • toxicity: oropharyngeal candidiasis; low risk of osteoporosis and cataracts in adults; reduction in growth rate of 1 cm in children during 1st year, but none thereafter
21
Q

Flunisolide

A
  • corticosteroid
  • inhibit the production of inflammatory cytokines
  • alleviate airway obstruction by inhibiting mucosal inflammation in asthmatic airways
  • reduce bronchial reactivity
  • reduce the frequency of asthma exacerbation if administered chronically
  • potentiate the effects of beta-2 agonists
  • inhalation treatment most effective way to minimize systemic absorption and potential for adverse effects
  • first-line agents for the treatment of moderate chronic asthma together with an “as needed” beta-2 agonist
  • toxicity: oropharyngeal candidiasis; low risk of osteoporosis and cataracts in adults; reduction in growth rate of 1 cm in children during 1st year, but none thereafter
22
Q

Fluticasone

A
  • corticosteroid
  • inhibit the production of inflammatory cytokines
  • alleviate airway obstruction by inhibiting mucosal inflammation in asthmatic airways
  • reduce bronchial reactivity
  • reduce the frequency of asthma exacerbation if administered chronically
  • potentiate the effects of beta-2 agonists
  • inhalation treatment most effective way to minimize systemic absorption and potential for adverse effects
  • first-line agents for the treatment of moderate chronic asthma together with an “as needed” beta-2 agonist
  • toxicity: oropharyngeal candidiasis; low risk of osteoporosis and cataracts in adults; reduction in growth rate of 1 cm in children during 1st year, but none thereafter
23
Q

Mometasone

A
  • corticosteroid
  • inhibit the production of inflammatory cytokines
  • alleviate airway obstruction by inhibiting mucosal inflammation in asthmatic airways
  • reduce bronchial reactivity
  • reduce the frequency of asthma exacerbation if administered chronically
  • potentiate the effects of beta-2 agonists
  • inhalation treatment most effective way to minimize systemic absorption and potential for adverse effects
  • first-line agents for the treatment of moderate chronic asthma together with an “as needed” beta-2 agonist
  • toxicity: oropharyngeal candidiasis; low risk of osteoporosis and cataracts in adults; reduction in growth rate of 1 cm in children during 1st year, but none thereafter
24
Q

Triamcinolone Acetonide

A
  • corticosteroid
  • inhibit the production of inflammatory cytokines
  • alleviate airway obstruction by inhibiting mucosal inflammation in asthmatic airways
  • reduce bronchial reactivity
  • reduce the frequency of asthma exacerbation if administered chronically
  • potentiate the effects of beta-2 agonists
  • inhalation treatment most effective way to minimize systemic absorption and potential for adverse effects
  • first-line agents for the treatment of moderate chronic asthma together with an “as needed” beta-2 agonist
  • toxicity: oropharyngeal candidiasis; low risk of osteoporosis and cataracts in adults; reduction in growth rate of 1 cm in children during 1st year, but none thereafter
25
Q

Budesonide-Formoterol

A
  • corticosteroid
  • combination with LABA
  • inhibit the production of inflammatory cytokines
  • alleviate airway obstruction by inhibiting mucosal inflammation in asthmatic airways
  • reduce bronchial reactivity
  • reduce the frequency of asthma exacerbation if administered chronically
  • potentiate the effects of beta-2 agonists
  • inhalation treatment most effective way to minimize systemic absorption and potential for adverse effects
  • first-line agents for the treatment of moderate chronic asthma together with an “as needed” beta-2 agonist
  • useful in the chronic treatment of refractory and severe asthma that is poorly controlled by standard doses of inhaled corticosteroid alone
  • toxicty: oropharyngeal candidiasis; low risk of osteoporosis and cataracts in adults; reduction in grwoth rate of 1 cm in children during 1st year, but none thereafter
  • chronic use of combinations with LABAs is associated with a small but statistically significant increase in the low risk of a fatal asthma attack, particularly for African Americans
26
Q

Fluticasone-Salmeterol

A
  • corticosteroid
  • combination with LABA
  • inhibit the production of inflammatory cytokines
  • alleviate airway obstruction by inhibiting mucosal inflammation in asthmatic airways
  • reduce bronchial reactivity
  • reduce the frequency of asthma exacerbation if administered chronically
  • potentiate the effects of beta-2 agonists
  • inhalation treatment most effective way to minimize systemic absorption and potential for adverse effects
  • first-line agents for the treatment of moderate chronic asthma together with an “as needed” beta-2 agonist
  • useful in the chronic treatment of refractory and severe asthma that is poorly controlled by standard doses of inhaled corticosteroid alone
  • toxicty: oropharyngeal candidiasis; low risk of osteoporosis and cataracts in adults; reduction in grwoth rate of 1 cm in children during 1st year, but none thereafter
  • chronic use of combinations with LABAs is associated with a small but statistically significant increase in the low risk of a fatal asthma attack, particularly for African Americans
27
Q

Fluticasone-Vilanterol

A
  • corticosteroid
  • combination with LABA
  • inhibit the production of inflammatory cytokines
  • alleviate airway obstruction by inhibiting mucosal inflammation in asthmatic airways
  • reduce bronchial reactivity
  • reduce the frequency of asthma exacerbation if administered chronically
  • potentiate the effects of beta-2 agonists
  • inhalation treatment most effective way to minimize systemic absorption and potential for adverse effects
  • first-line agents for the treatment of moderate chronic asthma together with an “as needed” beta-2 agonist
  • *** only approved for the treatment of chronic COPD sxs
  • toxicty: oropharyngeal candidiasis; low risk of osteoporosis and cataracts in adults; reduction in grwoth rate of 1 cm in children during 1st year, but none thereafter
  • chronic use of combinations with LABAs is associated with a small but statistically significant increase in the low risk of a fatal asthma attack, particularly for African Americans
28
Q

Zileuton

A
  • antileukotrienes
  • inhibits 5-lipoxygenase, thereby inhibiting leukotriene synthesis
  • inhibit the mucosal hypersecretion, bronchial reactivity, and mucosal edema produced by leukotrienes
  • anti-inflammatory effects are less pronounced than those of corticosteroids, but are equally efective at reducing the frequency of exacerbations
  • effective in blocking airway responses to exercise and antigen challenge
  • second-line agents for the treatment of chronic moderate asthma together with an “as needed” beta-2 agonist
  • can be taken orally, and is therefore useful for patients that comply poorly with inhaled therapies
  • appear to have little toxicity
  • has been associated with a few reports of liver toxicity
29
Q

Zafirlukast

A
  • antileukotrienes
  • antagonize the binding of leukotriene D4 (LTD4) to its receptor
  • inhibit the mucosal hypersecretion, bronchial reactivity, and mucosal edema produced by leukotrienes
  • anti-inflammatory effects are less pronounced than those of corticosteroids, but are equally efective at reducing the frequency of exacerbations
  • effective in blocking airway responses to exercise and antigen challenge
  • second-line agents for the treatment of chronic moderate asthma together with an “as needed” beta-2 agonist
  • can be taken orally, and is therefore useful for patients that comply poorly with inhaled therapies
30
Q

Montelukast

A
  • antileukotrienes
  • antagonize the binding of leukotriene D4 (LTD4) to its receptor
  • inhibit the mucosal hypersecretion, bronchial reactivity, and mucosal edema produced by leukotrienes
  • anti-inflammatory effects are less pronounced than those of corticosteroids, but are equally efective at reducing the frequency of exacerbations
  • effective in blocking airway responses to exercise and antigen challenge
  • second-line agents for the treatment of chronic moderate asthma together with an “as needed” beta-2 agonist
  • can be taken orally, and is therefore useful for patients
31
Q

Omalizumab

A
  • anti-IgE agent
  • monoclonal antibody that targets IgE and inhibits IgE binding to mast cells and basophils
  • subcutaneous administration lowers plasma IgE to undetectable levels
  • lessens the frequency and severity of asthma attacks
  • reduces corticosteroid requirements
  • useful in patients with chronic severe asthma inadequately controlled by corticosteroid-LABA combination therapy
  • anaphylaxis and malingnant neoplasms occur infrequently

Asthma Medications (1 decks)

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