drug for asthma and COPD Flashcards
prototype drug for glucocorticoid
beclomethasone
prednisone
prototype drug for monoclonal antibodies
omalizumab ( anti igE anitbody )
prototype drug for phosphodiesterase 4 inhibitors
roflumilast
prototype drug for bronchodilators - anticholinergic drug
ipratropium ( short acting )
tiotropium ( long acting )
prototype drug for bronchodilators - Beta2 adrenergic agonists
albuterol ( short acting )
Salmeterol ( long acting)
formonterol
prototype drug for bronchodilators - methylxanthine
theophylline
MOA of glucocorticoid
reduce respiratory symptom by suppressing inflammation via
decrease synthesis and release of the inflammatory mediators( leukotriene, histamine and prostaglandins
decrease infiltration and activity of the inflammatory cells
decrease edema of the airway mucosa
may increase brachial beat receptors and responsiveness to beta agonists
therapeutic use of glucocorticoid
asthma prophylaxis and management of COPD exacerbation
adverse effect of glucocorticoid
oropharyngeal candidiasis
dysphonia ( hoarseness)
adrenal suppression ( children with low BMI has higher risk)
grown suppression
bone loss
inc risk of cataract and glaucoma
inhaled glucocorticoid should be administered on a __________, dose should be _____-
regular schedule,
does should be keep low as possible
when using oral glucocorticoid for asthma the initial dosing are usually
higher aiming to bring symptoms under control and gradually dec dosage
MOA of leukotriene receptor antagonist ( LTRAs) - Montelukast ( singulair )
second line therapy for asthma maintenance
suppress the effect of leukotriene - compounds that promotes smooth muscle constriction, blood vessel permeability, and inflammatory cells
decrease bronchoconstiction and mucus secretion
LTRAs adverse effect
Liver injury, suicidal thoughts, depression, hallucinations, irritability
the adverse effect of zileuton
liver injury
ALT should be monitored
MOA of cromolyn
suppressed bronchial inflammation, used for prophylaxis tx in patients with mild and moderate asthma
Cromolyn does not cause brochialdialtion
it stabilizes the cytoplasmic membrane in the mast cell, preventing the release of histamine and another mediator as well as inhibiting other inflammatory cells
therapeutic use of cromolyn
chronic asthma as an alternative to inhaled glucocorticoid
excerse induce bronchospasm
allergic rhinitis
Administer 15 mins before exercise and exposure to participating factors.
Long-term use should be administered on a regular schedule.
Omalizumab - monoclonal antibody
Second-line agent for allergy relater asthma only when other options failed due to risk for anaphylaxis and cancer
SQ injection only
MOA of Omalizumab
forms complex with free igE hence reducing the amount of igE available to bind with receptors on mast cells and limiting the release of histamine and leukotrienes
adverse effect of omalizumab
due to igE suppression - viral infection, upper respiratory infection, sinusitis pharyngitis
malignancy, anaphylaxis
interleukin 4 receptor alpha antagonist - dupilumab
IgG antibody binds to the IL4 RA subunit, inhibits the singling, and inhibits the IL4 cytokine-induced inflammatory response
tx eosinophilic asthma and atopic dermatitis
mehylxanine
theophylline, caffeine
acts on CNS cause excitation, and bronchodialtion,
theophylline
MOA- relaxing the bronchi smooth muscle by blocking adenosine receptors
therapeutic use - chronic stable asthma
prolong effect most appropriate for nocturnal attacks
adverse effect - N/V/D insomnia, restlessness
theophylline toxicity
N/V/D insomnia, restlessness
severe dysthymia, convulsion
tx lidocaine, IV benzodiazepine
