Asthma Pharm Flashcards
Step Up Therapy
Start treatment at step appropriate to asthma severity at time of evaluation
Goal not achieved- gradually step up therapy until successful
Step Down Therapy
Treat exacerbation symptoms with aggressive management
Gradual reduction of long-term-control meds to lowest level possible
Types of Long-Term Control
Anticholinergics Corticosteroids Mast cell-stabilizing agents Leukotriene modifiers Methylxanthines LABA
Administration Techniques
MDI
Nebulizer
Inhaled powder
Systemic administration
Beta-2 agonists
Produce airway dilation
Stimulation of beta-adrenergic receptors
Decrease release of mediators
Short-acting Beta 2 Agonists
Acute attack
Prevention of exercise-induced bronchospasm
Long-acting Beta 2 Agonists
Prevention
Maintenance therapy
Examples of Short Acting B2 Agonist
Albuterol Proventil Ventolin Terbutaline (Brethine) Bitolterol (Tornalate) Pirbuterol (Maxair)
Adverse Effects of Beta-2 Agonists
Tachycardia Tremor Hypokalemia Headache Hyperglycemia Increased lactic acid
Examples of Long Acting Beta-2 Agonists
Salmeterol (Serevent)
Formoterol (Foradil)
Levalbuterol (Xopenex)
Fenoterol (Berotec)
What are LABA’s used for?
Maintenance therapy
Slower onset, long-lasting
Anticholinergics Antimuscarinic Agents
Ipratropium bromide (Atrovent) Tiotropium (Spiriva)
What can Ipratropium bromide enhance?
Bronchodilation achieved by beta-agonists
Types of Methylxanthines
Theophylline
Aminophylline
What is Theophylline for?
Maintenance therapy
Theophylline SE
Insomnia Nervousness N/V Anorexia Headache Tachycardia Seizures Cardiac arrhythmias
Theophylline Immediate Release Products
Slo-Phyllin Theolair Quibron-T Elixophillin Bronkodyl Theophylline generics
Theophylline Sustained Release Products
Slo-bid Gyrocaps Theo-24 Theobid Theo-Dur THeospan-SR Theophylline SR generics
MOA of Corticosteroids
Reduce airway inflammation
Inhaled Steroids
Reduce airway reactivity
SE of Corticosteroids
Thrush Dysphonia Adrenal suppression (LD) Cataract formation (LD) Decreased growth in children (LD) Interference with bone metabolism (LD) Purpura (LD)
Examples of Corticosteroids
Fluticasone (Flovent) Budesonide (Pulmicort) Beclomethasone (Vanceril, Beclovent, QVAR) Triamcinolone (Azmacort) Flunisolide (Aerobid, Aerobid-M)
Budesonide (Pulmicort)
First nebulizer steroid
Greater number symptom free days
Decreased B-agonist need
Reduced hospitalization rates
Examples of PO Steroids for Acute Treatment
Methylprednisolone
Prednisone