Chapter 31 - Asthma and Bronchoconstriction

Question 1

albuterol (Proventil, Ventolin, Accuneb)

Answer 1

Class: Beta2 Adrenergic Agonists

• MOA: stimulate beta2-adrenergic receptors in the smooth muscle of bronchi and bronchioles
• Use: prevention of bronchospasm, asthma, reversible obstructive airway disease, exercise induced asthma
• Admin: PO, inhalation
• AE: muscle tremor, excessive cardiac and CNS stimulation
• Considered “rescue medication” when given via MDI or inhalation

Question 2

ipratropium (Atrovent)

Answer 2

Class: Anticholinergics

• MOA: block the action of acetylcholine in bronchial smooth muscle; reduces bronchoconstrictive substance release
• Use: bronchoconstriction from asthma, chronic bronchitis, emphysema; rhinorrhea
• AE: Cough nervousness, nausea, GI upset, headache, dizziness. Vary depending on medication used
• Admin: PO, MDI, nebulizer, nasal spray
• Not a rescue drug; patients may have to take between 2 and 4 times a day depending on their severity

Question 3

montelukast (Singulair)

Answer 3

Class: Leukotriene modifiers

• MOA: prevents leukotrienes from binding to its receptors, reducing the bronchoconstriction and inflammation caused by leukotrienes
• Use: long-term treatment of asthma; prevent acute asthma attacks induced by allergens, exercise, cold air, hyperventilation, irritants, NSAIDs
• AE: headache, nausea, diarrhea, infection
• Not effective in relieving acute attacks/not a rescue inhaler – only rescue inhaler is albuterol

Question 4

cromolyn (Nasalcrom)

Answer 4

Class: Mast Cell Stabilizers

• MOA: prevent release of bronchoconstrictive and inflammatory substances in response to allergens and other stimuli (histamine is released from mast cells and drug targets these cells)
• Use: prophylaxis of acute asthma in mild, persistent asthma
• Admin: also in nasal preparation
• AE: dysrhythmias, hypotension, chest pain, restlessness, dizziness, convulsions, anorexia, N/V, sedation
• Not effective in acute bronchospasm or status asthmaticus