CH 40: Asthma and pulmonary Flashcards
muscular, elastic structures whose diameter, or lumen, varies with the contraction or relaxation of smooth muscle.
bronchioles
bronchioles are regulated by:
SNS and PNS
causes bronchiolar smooth muscle to relax, the airway diameter to increase, and bronchodilation to occur
beta2-adrenergic receptors
sympathetic branch activates:
beta2-adrenergic receptors
parasympathetic branch causes:
bronchiolar smooth muscle to contract, the airway
diameter to narrow, and bronchoconstriction to occur
some of the most frequently prescribed drugs for treating pulmonary disorders
bronchodilators
chronic pulmonary disease with inflammatory and bronchospasm components.
asthma
stimulates the secretion of histamine and other inflammatory mediators, which increases mucus and edema in the airways
acute inflammatory response
the most common chronic illness in childhood, accounting for 13.8 million missed school days each year.
asthma
goal of pharmacotherapy for asthma
Stop bronchospasm
Reduce the frequency of asthma attacks
preferred drug for relief of acute symptoms
SABAs for bronchodilation
alternate drugs for those who cannot tolerate SABAs
anticholinergics for bronchodilation
oral drugs are used for short periods to reduce the frequency of acute exacerbations
corticosteroids: systemic for anti-inflammatory
preferred drugs for long-term asthma management
oral doses may be requires for severe, persistent asthma
corticosteroids: inhaled
alternative drugs to control mild, persistent asthma or exercise-induced asthma
mast cell stabilizers
alternative drugs to control mild, persistent asthma or as adjunctive therapy with inhaled corticosteroids
leukotriene modifiers
used in combination with inhaled corticosteroids for prophylaxis of moderate to sever persistent asthma
LABAs
used in combination with inhaled corticosteroids for prophylaxis of mild to moderate persistent asthma
methylxanthines
used of adjunctive therapy for patients who have allergies and severe, persistent asthma
immunomodulators
albuterol (SABAs) therapeutic effects
Bronchodilation
Act on beta2 in the lungs
Also act on beta1 in the heart
Rescue drug for an acute attack
Facilitates drainage of mucus
Inhibits release of other inflammatory chemicals from mast
cells
albuterol (SABAs) adverse effects
Headache,
dizziness,
tremor,
nervousness,
throat irritation,
drug tolerance
Tachycardia,
dysrhythmias,
hypokalemia,
hyperglycemia,
paradoxical bronchoconstriction,
increased risk for asthma-related death (LABAs)
albuterol (SABAs) what to monitor and precautions
assess respiratory status before and after
advise patients not to use LABAs for rescue medication
inhaled ipratropium (anticholinergics) therapeutic effects
Treatment of chronic asthma
Block the PNS and stimulates the SNS that results in
bronchodilation
inhaled ipratropium (anticholinergics) adverse effects
Headache,
cough,
dry mouth,
bad taste,
paradoxical bronchospasm
Pharyngitis,
paradoxical bronchospasm,
worsening of urinary retention
inhaled ipratropium (anticholinergics) what to monitor
Dry mouth,
headache,
cough,
GI distress,
and anxiety
Assess respiratory status before and after
inhaled ipratropium (anticholinergics) safety precautions
When administered with other inhalation medication, adminster adrenergic bronchodilators first
Methylxanthines/ Theophylline (LABA) adverse effects
Nervousness,
tremors,
dizziness,
headache,
nausea,
vomiting,
anorexia
Tachycardia,
dysrhythmias,
hypotension,
seizures,
circulatory failure,
respiratory arrest
Methylxanthines/ Theophylline (LABA) what to monitor and safety
Nervousness and insomnia
Interactions with other drugs
Have a narrow safety margin
Most potent of anti-inflammatory substances
Corticosteroids (glucocorticoids)
mediators of the immune response that are involved in allergic and asthmatic reactions.
leukotrienes
Beclomethasone (Inhaled Corticosteroids) therapeutic effects
Prevention of asthma attacks
Decrease activation of inflammatory cells
Diminish mucus production and reduce airway obstruction
Beclomethasone (Inhaled Corticosteroids) adverse effects
Hoarseness,
dry mouth,
cough,
sore throat
Oropharyngeal candidiasis,
hypercorticism,
hypersensitivity reactions
Beclomethasone (Inhaled Corticosteroids) what to monitor and safety
Hoarseness and oropharyngeal candidiasis
Adrenal gland atrophy,
PUD
Hyperglycemia
Growth retardation in children
cataracts
Can mask the signs and symptoms of infection
montelukast (leukotriene modifier) therapeutic effects
prevention of asthma attacks
prevents airway edema
montelukast (leukotriene modifier) adverse effects
Headache,
nausea,
diarrhea,
throat pain,
weight loss (roflumilast)
Liver toxicity (zileuton),
increased AST,
psychiatric events including suicidality (roflumilast)
montelukast (leukotriene modifier) what to monitor and safety
Respiratory status
Changes in behavior
Rash
Oral candidiasis
Suicidal ideation and depression
Steven johnson syndrome
NOT FOR ACUTE ATTACKS
designed to attach to a specific receptor on a target cell or molecule.
treating asthma and COPD
monoclonal antibodies
treatment of COPD
There is no cure – treat the symptoms and slow progression of the disease
encourage patient to stop smoking
