Bronchodilators, Martin DSA Flashcards
short acting beta 2 agonists
albuterol,! levalbuterol!
pirbuterol
long acting beta 2 agonists
formoterol!
salmeterol!
indacaterol
arformoterol
What is mechanism of action for beta agonists
increase cAMP so decrease intracell Ca, Sm mm relazation and inhibition of mediator release from mast cells
what is salmeterol used for
prevention nighttime asthma attacks and prophylactic bronchodilaiton
What is best combination to control escalating asthma
long term beta agonist with an inhaled corticosteroid
side effects of oral beta agonists
skel muscle tremor, muscle cramps, tachyarrhythmias, metabolic disturbances
What are the anticholinergic bronchodilators
ipratropium bromide
triotropium
quaternary amines
what are ipratropium and tiotropium used to Tx
COPD
describe difference in dosing of ipratropium and tiotropium
iprotropium bronchodilation may last up to 6 hours
tiotropium dosed once per day
What combination with ipratropium is used for severe asthma exacerbations exist
albuterol and ipratropium bromide
What asthma drug is used intranasaly to decrease secretions
ipratropium
What are Tx benefits of theophylline
bronchodilation
but also stimulates CNS, cardiac, modest peripheral vasodilation and improved skel m contractility
thiazide like diuresis
what must you monitor if administer theophylline
plasam drug levels
when theophylline blood levels reach 15 mcg/mL what side effects may occurq
vomiting, abdominal discomfort, headache and anxiety
What is Roflumilast and what is it used for
PDE4 inhibitor approbed for COPD exacerbations
increased cAMP
What are sideeffects of roflumilast
nausea and diarrhea
psych symptoms and weight loss
What corticosteroids have been approved for asthma
beclomethasone dipropionate budesonide dipropionate cyclesonide fluticason flunisolide mometasone furoate
What oral corticosteroids are used for asthma
prednisome, methylprenisolone, prenisolone
What corticosteroids have been approved for seasonal and allergic rhinitis
budesonide sipropionate
fluticasone propionate
mometasone furoate
what is mech of action of corticosteroids
bind intracell cortisol R that negatviely regulate gene trancription
inhibit release of cytokinda, vasoactive and chemoattractive factors, enzymes and dec mobilizaiton of leikocytes
anti-inflammatory
What is a concern with corticosteroids in children
growth retardation
what are the adverse effects with long term daily use oral corticosteroids
glucose intolerance, weight gain, inc BP, osteoporosis, cataracts, immunosuppression, mood disorder
What is cromolyn sodium used for
inhibits release of histamine and other autocoids from mast cells and indirectly inhibits Ag-induced bronchospasm
What is Therapeutic use of cromolyn sodium
prophylactic asthma attacks, not ongoing bronchospasm
What are the anti-leukotriene drugs
montelukast, zafirlukast, zileuton
What anti leukotriene blocks synthesis? block R?
zileuton blocks synthesis
montelukast and zafirlukast block LTD4 Receptor
What is omalizumab
monoclonal Ab against IgE
have serious life threatening HS reaction to drug
What is Tx for allergic thinitis
topical corticosteroids and aqueous nasal spray or cromolyn sodium
What is a problem with alpha adrenergic agonists used for nasal decongestants
rebound congestion
What are the sympathomimetic agents for nasal decongestant
phenyleprhine and pseudoephedrine
monothterapy with inhaled corticosteroids is not approved for what
COPD
What is the new type therapy for cOPD
triple. corticosteroid, beta agonist and tiotropium
What are major indications for anttitussives
acutre control of nonproductive cough
What are the antitissuive drugs
opoids: codeine and dextromethorphan- less side effects
non-opoids: benzonatate, diphenhydramine
how do opoids prevent coughing
act on CNS and suppress cough reflex
what are advserse effects of opoid antitussives
CNS- euphoria, depression of respiratory and vasomotor
GI- constipation, nausea, vomiting
GU- urinary hestancy or retention
Drug-Drug: additive CNS depression with sedative hy[notics, phenothiazines and tricyclic antidepressants
what is mech of non-opoid antitussives
act directly on nerve endings in pharynx
What is indications for non-popooid antitussives
control of minor transient cough
how do mucolytics work
facilitate depolymeriztation of mucopolysaccharides in dried airway secretions
what are the expectorant drugs
guafenesin and potassium iodied and iodinated glycerol
What is use of recombinant DNAse
nebulizer solution for Tx CF
maybe in COPD excacerbations
