Chapter 27 Respiratory Flashcards
Fluticasone (Flovent, Flonase)
- Corticosteroid
- Inhalation route preferred
- ADE: oral thrush
Prednisone
- Systemic Steroid
- Status
Cromolyn Sodium
- Mast cell stabilizer
- ophthalmic solution
- treat seasonal conjunctivitis
- ADE: uniquely nontoxic
Montelukast (Singulair)
- Leukotriene receptor antagonist
- one dose per day
- inhibit early and late phase bronchoconstriction
- useful in allergic asthma and ASA sensitive
- prevents exercise induced asthma if taken 2 hours prior
- highest benefit in children
- no CYP450 interaction
Zafirlukast (Accolate)
- Leukotriene receptor antagonist
- inhibit early and late phase bronchoconstriction
- useful in allergic asthma and ASA sensitive
- prevents exercise induced asthma if taken 2 hours prior
- highest benefit in children
Zileuton (Zyflo)
- leukotriene synthesis inhibitor
- may be more effective in severe asthma
- monitor LFTs (caution in heavy EtOH users)
- approved for 12 and older
- oral administration
- ADE: flu like, headache, drowsiness, dyspepsia
Roflumilast (Daliresp)
- phosphodiesterase inhibitor
- reduces risk of COPD exacerbation in pt with chronic bronchitis
- once daily oral use
- ADE: diarrhea, nausea, weight gain, anxiety, insomnia, depression
Albuterol (Proventil, Ventolin)
- SABA
- rapid acting for acute bronchospasm
- oral formulation and MDI
- ADE: tachycardia, tremor, nervousness
Arformoterol (Brovana)
- LABA
- not for acute bronchospasm (black box)
- prevent nocturnal exacerbation
- prevent late phase bronchoconstriction
- ADE: tachycardia, tremor, nervousness
Formoterol (Foradil)
- LABA
- not for acute bronchospasm (black box)
- prevent nocturnal exacerbation
- prevent late phase bronchoconstriction
- ADE: tachycardia, tremor, nervousness
Salmeterol (Serevent)
- LABA
- not for acute bronchospasm (black box)
- prevent nocturnal exacerbation
- prevent late phase bronchoconstriction
- ADE: tachycardia, tremor, nervousness
Ipratropium (Atrovent)
- muscarinic receptor antagonist
- primarily used in COPD
- for asthma better if combined with B2 agonist
- parasympatholytic (blocks vagus nerve)
- 1st line for mild COPD
- ADE: dry mouth
Tiotropium (Spiriva)
- muscarinic receptor antagonist
- increases lung function for 24 hours with 1 pill/day
- longer acting
- primarily used in COPD
- for asthma better if combined with B2 agonist
- parasympatholytic (blocks vagus nerve)
- 1st line for mild COPD
- ADE: dry mouth
Umeclidinium (Incruse Ellipta)
- muscarinic receptor antagonist
- longer acting
- primarily used in COPD
- for asthma better if combined with B2 agonist
- parasympatholytic (blocks vagus nerve)
- 1st line for mild COPD
- ADE: dry mouth
Theophylline (Theo-Dur)
- methylxanthine (stimulant)
- prevent bronchospasm in asthma and emphysema
- used in neonatal apnea
- NTI drug reserved for those unresponsive to other drugs
- ADE: GI, cardiac stimulation, CNS stimulation, seizures/arrhythmias at high serum levels
Omalizumab (Xolair)
- IgE antagonist
- moderate to severe allergic asthma
- subcutaneous q 2-4 weeks
- anaphylaxis risk that never goes away
Codeine
- schedule V
- potent antitussive
- analgesia, sedation
Dextromethorphan
- OTC and most widely used antitussive
- lacks sedation, euphoria, & analgesia except at very high doses
Hydrocodone
- schedule V
- potent antitussive
- analgesia, sedation
Guaifenesin (Mucinex)
- expectorant
- OTC, oral
- may reduce surface adhesiveness of secretions
- may reduce coughing
- useful for thick secretions, sinusitis, dry/nonproductive coughing
Fexofenadine (Allegra)
- long acting, non sedating antihistamine
- manage rhinitis
Azelastine (Astelin)
- topical antihistamine
- treat ocular s/s inflammation, itching, allergic conjunctivitis
Olopatadine (Patanase)
- topical antihistamine
- treat ocular s/s inflammation, itching, allergic conjunctivitis
Budesonide (Pulmicort)
- Corticosteroid
- Inhalation route preferred
- ADE: oral thrush
Beclomethasone (Qvar)
- Corticosteroid
- Inhalation route preferred
- ADE: oral thrush
Mometasone (Asmanex)
- Corticosteroid
- Inhalation route preferred
- ADE: oral thrush
Triamcinolone (Azmacort)
- Corticosteroid
- Inhalation route preferred
- ADE: oral thrush
Fluticasone-Salmeterol (Advair)
- ICS/LABA
- Inhalation route preferred
- ADE: oral thrush
Budesonide-Formoterol (Symbicort)
- ICS/LABA
- Inhalation route preferred
- ADE: oral thrush
Mometasone-Formoterol (Dulera)
- ICS/LABA
- Inhalation route preferred
- ADE: oral thrush
Lodoxamide (Alomide)
- non steroidal mast cell stabilizer
- prevents degranulation and are largely prophylactic
- low oral bioavailability and must be inhaled
- improvement after several weeks
- uniquely nontoxic
Nedocromil (Alocril)
- non steroidal mast cell stabilizer
- prevents degranulation and are largely prophylactic
- low oral bioavailability and must be inhaled
- improvement after several weeks
- uniquely nontoxic
Levalbuterol (Xopenex)
- SABA
- treat acute bronchospasm
- ADE: tachycardia, tremor, nervousness
Pirbuterol (Maxair)
- SABA
- treat acute bronchospasm
- ADE: tachycardia, tremor, nervousness
Terbutaline (Brethine)
- SABA
- treat acute bronchospasm
- oral formulation and MDI
- ADE: tachycardia, tremor, nervousness
Olodaterol (Striverdi)
- LABA
- not for acute bronchospasm (black box)
- ADE: tachycardia, tremor, nervousness
Ciclesonide (Omnaris)
- corticosteroid
- treat allergic rhinitis
Loratadine (Claritin)
- non sedating antihistamine
- treat rhinitis
Cetirizine (Zyrtec)
