c40-mod6

Question 1

Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER) classes

Answer 1

Therapeutic Class: Bronchodilator

Pharmacologic Class: Beta2-adrenergic agonist

Question 2

Actions and Uses of Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER)

Answer 2

1) Albuterol is a SABA that is used to relieve the bronchospasm of asthma. Its rapid onset and excellent safety profile have made inhaled albuterol a preferred drug for the termination of acute bronchospasm.
2) drug facilitates mucus drainage and can inhibit the release of inflammatory chemicals from mast cells.
3) When inhaled 15 to 30 minutes prior to physical activity, it can prevent exercise-induced bronchospasm. Short-acting beta2 agonists such as albuterol are not recommended for asthma prophylaxis.
4) Oral forms of albuterol include immediate-release and extended-release tablets (VoSpire) and an oral solution. The oral forms have a longer onset of action and are not suitable for terminating acute asthma attacks.

Question 3

Adverse Effects of Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER)

Answer 3

1) Serious adverse effects from inhaled albuterol are uncommon.
2) Some patients experience palpitations, headaches, throat irritation, tremor, nervousness, restlessness, and tachycardia.
3) Less common adverse reactions include insomnia and dry mouth.
4) Uncommon adverse effects include chest pain, paradoxical bronchospasm, and allergic reactions.

Question 4

Contraindications of Albuterol (ProAir HFA, Proventil, HFA, Ventolin HFA, VoSpire ER)

Answer 4

Use is contraindicated in patients with hypersensitivity to the drug. Because albuterol may exhibit cardiovascular effects in some patients, caution is required when administering these drugs to persons with a history of cardiac disease or hypertension (HTN).

Question 5

Ipratropium (Atrovent) classes

Answer 5

Therapeutic Class: Bronchodilator

Pharmacologic Class: Anticholinergic

Question 6

actions + uses of Ipratropium (Atrovent) classes

Answer 6

1) anticholinergic drug that is delivered by the inhalation and intranasal routes. The inhalation form is approved to relieve and prevent the BRONCHOSPASM that is characteristic of asthma and COPD. When combined with albuterol (Combivent Respimat), it is a first-line drug for treating bronchospasms due to COPD, including bronchitis and emphysema.
2) Although it has not received U.S Food and Drug Administration (FDA) approval for the treatment of asthma, it is prescribed off-label for the disorder.
3) The primary role of ipratropium is as an ALTERNATIVE to SABAs and for patients experiencing severe asthma exacerbations.
4) sometimes combined with beta agonists or corticosteroids to provide additive bronchodilation.
5) The nasal spray formulation of ipratropium is approved for the symptomatic relief of runny nose associated with the common cold and allergic rhinitis. The drug inhibits nasal secretions but does not have decongestant action. Treatment is limited to 3 weeks.

Question 7

Administration Alerts of Ipratropium (Atrovent)

Answer 7

The proper use of the MDI is important to the effective delivery of drug. Observe and instruct the patient in proper use.

Wait 2–3 minutes between dosages.

Avoid contact with eyes; otherwise, blurred vision may occur.

Question 8

Adverse Effects of Ipratropium (Atrovent)

Answer 8

1) Because very little is absorbed by the lungs, ipratropium produces few systemic adverse effects.
2) Irritation of the upper respiratory tract may result in cough, drying of the nasal mucosa, or hoarseness.
3) It produces a bitter taste, which may be relieved by rinsing the mouth after use.
4) Intranasal administration may cause epistaxis and excessive drying of the nasal mucosa.

Question 9

contraindications of Ipratropium (Atrovent)

Answer 9

Ipratropium is contraindicated in patients with hypersensitivity to soya lecithin or related food products such as soybean and peanut. Soya lecithin is used as a propellant in the inhaler.

Question 10

Beclomethasone (Qvar) classes

Answer 10

Therapeutic Class: Anti-inflammatory drug for asthma and allergic rhinitis

Pharmacologic Class: Inhaled corticosteroid

Question 11

Actions and Uses of Beclomethasone (Qvar)

Answer 11

1) Beclomethasone is a corticosteroid available through aerosol inhalation for asthma (Qvar) or as a nasal spray (Beconase AQ, Qnasl) for allergic rhinitis. Beclomethasone and other drugs in this class are preferred drugs for the long-term management of persistent asthma in both children and adults. Three or four weeks of therapy may be necessary before optimal benefits are obtained.
2) Beclomethasone acts by reducing inflammation, thus decreasing the frequency of asthma attacks. It is not a bronchodilator and should not be used to terminate asthma attacks in progress.
3) Intranasal beclomethasone is effective at reducing the symptoms of allergic rhinitis. Beconase AQ is also approved to prevent recurrence of nasal polyps following surgical removal.

Question 12

Administration Alerts of Beclomethasone (Qvar)

Answer 12

Do not use if the patient is experiencing an acute asthma attack.

Oral inhalation products and nasal spray products are not to be used interchangeably.

Question 13

Adverse Effects of Beclomethasone (Qvar)

Answer 13

1) Inhaled beclomethasone produces few systemic adverse effects.
2) Because small amounts may be swallowed with each dose, the patient should be observed for signs of corticosteroid toxicity. Local effects may include hoarseness, dry mouth, and changes in taste.
3) Inhaled corticosteroid use has been associated with the development of cataracts in adults.
4) Long-term intranasal or inhaled corticosteroids may cause growth inhibition in children.
5) As with all corticosteroids, the anti-inflammatory properties of beclomethasone can mask signs of infections, and the drug is contraindicated if an active infection is present.
6) A significant percentage of patients who take beclomethasone on a long-term basis will develop oropharyngeal candidiasis, a fungal infection in the throat, due to the constant deposits of drug in the oral cavity.

Question 14

Contraindications of Beclomethasone (Qvar)

Answer 14

Beclomethasone is contraindicated in those with hypersensitivity to the drug. The growth of pediatric patients should be monitored carefully, because inhaled corticosteroids may reduce growth velocity in some children.

Question 15

Montelukast (Singulair) classes

Answer 15

Therapeutic Class: Anti-inflammatory drug for asthma prophylaxis

Pharmacologic Class: Leukotriene modifier

Question 16

Actions and Uses of Montelukast (Singulair)

Answer 16

1) used for the prophylaxis of persistent, chronic asthma, exercise-induced bronchospasm, and allergic rhinitis. It prevents airway edema and inflammation by blocking leukotriene receptors in the airways.
2) The drug is given PO and acts rapidly, although it is not recommended for termination of acute bronchospasm. It is the only agent in this class that is approved for pediatric use. To aid in administration, montelukast is available in chewable tablets and as granules that are recommended by the manufacturer to be mixed with applesauce, mashed carrots, or ice cream.

Question 17

Administration Alerts of Montelukast (Singulair)

Answer 17

Do not use to terminate acute asthma attacks.

If preventing exercise-induced bronchospasm, take drug at least 2 hours before the activity.

Question 18

Adverse Effects of Montelukast (Singulair)

Answer 18

Headache is the most common complaint, and nausea and diarrhea are reported by some patients.

Although rare, some patients have experienced serious neuropsychiatric events, including suicidal ideation, hallucinations, aggressiveness, or depression.

Question 19

contraindications of Montelukast (Singulair)

Answer 19

1) The only contraindication is hypersensitivity to the drug.
2) Because a few rare cases of hepatic failure have been reported in patients who are taking montelukast, those with pre-existing hepatic impairment should be treated with caution.