COPD and Asthma Flashcards
List the SABA (Short-Acting Beta Agonist) (TAMPL)
Albuterol Tetrabutline Metaprotenol Pirbuterol Levabuterol
List the LABA (Long-Acting Beta Agonist) (ISOF)
Formoterol Salmeterol Indacaterol Vilanterol Oldaterol
What are the two drugs categories used for asthma
Anti Inflammatory Drugs and Bronchodilators
Categories of drugs that fall under the Anti Inflammatory
Hormone Containing (OCS and ICS)'= Non-Hormone (Lipoxygenase inhibitors and Leukotriene Receptor Blockers )
Categories of drugs that fall under Bronchodilators
Methylxanthines
Beta 2 agonists
Anticholinergics drugs
What is the primary MOA of Beta 2 agonist
The primary action of β2-agonists is to relax airway smooth-muscle cells of all airways, where they act as functional antagonists,
reversing and preventing contraction of airway smooth-muscle cells by all known bronchoconstrictors.
Clinical indications of Albuterol
Asthma
Acute Bronchitis
COPD
Bronchiolitis
Adverse effects of Albuterol
Headache Dizziness Insomnia, dry mouth and cough
Contraindications of Albuterol
Paradoxical Bronchospasm, Deterioration of Asthma, CV effects,
Immediate Hypersensitivity Reactions
Only β2drug available by subcutaneous injection
Terbutaline
Clinical Indications for Tetrabutaline
treatment or prophylaxis of bronchospasm associated with asthma, bronchitis and emphysema
in patients 12 years old and older.
Warnings and Adverse Effect of Tetrabutaline
Not recommended as a medication for tocolysis (suppression of pre-mature labor)
Adverse Effects: headache, nausea, tachycardia and palpitations.
Clinical Indications for Metaproterenol
Used as a bronchodilator for bronchial asthma and for reversible bronchospasm which may occur in association with bronchitis and COPD.
Cautions and warnings associated with Metaproterenol
- a significant cardiovascular effect in some patients.
- paradoxical bronchospasm(which can be life threatening).
Clinical Indications for Pirbuterol
Used in the prevention and reversal of bronchospasm in patients 12 years of age and older
with reversible bronchospasm including asthma. It may be used with or without
concurrent theophylline and/or corticosteroid therapy
Cautions and warnings associated with Pirtuberol
Cardiovascular: like other inhaled beta adrenergic agonists, can produce a clinically significant
cardiovascular effect in some patients, as measured by pulse rate, blood pressure and/or symptoms.
Clinical Indications for Levabuterol
For the Kiddos Used in treatment or prevention of bronchospasm in patients 4 years of age and older with reversible obstructive airway disease.
Cautions and warnings associated with Levabuterol
Life-threatening paradoxical bronchospasm may occur. Much like with albuterol
Clinical Indications for Fomoterol
-Treatment of asthma in patients ≥5 years as an add-onto a long- term asthma control medication such as an inhaled corticosteroid.
Drugs used for the Maintenance treatment of bronchoconstriction in patients with COPD
Fomoterol
Salmeterol
Cautions and warnings associated with Fomoterol
In asthma, do not use without the concomitant use of a long-term asthma control medication such as an inhaled corticosteroid. Use of LABA’s, increases the risk of asthma-related deaths and asthma-related hospitalizations.
Clinical Indication of Indacaterol and Vilanterol
Used to treat breathing problems caused by COPD, including chronic bronchitis and emphysema.
A long-term, once-daily maintenance bronchodilator treatment of airflow
Olodaterol
How should LABA’s be prescribed
LABA should be used in concomitant use of a long-term asthma control medication such as an inhaled corticosteroid.
a muscarinic antagonist indicated for a temporary blockade of severe or life-threatening muscarinic effects.
Atropine
Side Effects of Atropine
When the recurrent use of atropine is essential in patients with coronary artery disease, the total dose should be restricted to 2 to 3 mg to avoid the detrimental effects of atropine-induced tachycardia on myocardial oxygen demand.
Anticholinergic Drugs that can be used for Asthma and COPD
Atropine
Ipratropium
Tiotropium
Aclidinium
Actions of anticholinergic drugs in COPD
- Atropine-Temporary blockade
- Ipratropium-Maintenance
- Tiotropium-Long-term maintenance
- Aclidinium-Long-term maintenance
a potent atropine analog that is poorly absorbed after aerosol administration and is therefore relatively
free of systemic atropine-like effects.
Ipratropium
Clinical Use for Ipratropium
bronchodilator for maintenance treatment of bronchospasm
Clinical use for Tiotropium
- -An anticholinergic drug indicated for the long-term, once-daily, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD)
- for reducing COPD exacerbations.
Methylxanthines (derived from the Purine Xanthine) used for Asthma and COPD
Theophylline
Theobromine (found in chocolate)
Caffeine
Clinical uses of Methylxanthine
used in the treatment of airways obstruction caused by conditions
Mechanism of Action of Theophylline
- -Smooth muscle relaxation (bronchodilation)
- - Suppression of the response of the airways to stimuli (non-bronchodilator prophylactic effects).
The most effective drug class for controlling asthma
ICS
Drug class that reduces eosinophils in the airways and sputum, and numbers of activated T lymphocytes and surface mast cells in the airway mucosa.
ICS
Mechanism of Action of Corticosteroids
to switch off the transcription of multiple activated genes that encode inflammatory proteins such as cytokines, chemokines, adhesion molecules, and inflammatory enzymes.
first-line therapy for patients with persistent asthma
ICS
