Drugs for Allergy and Asthma Flashcards
Beta-2 Agonst MOA
Stimulate adenylyl cyclase causing ↑ of cAMP resulting in bronchodilation and also inhibits release of mediators from mast cells
Beta-2 Agonist ROA
- Inhalation
- Oral
- SC (Terbutaline)
Beta-2 Agonist Clinical Use
Symptom relief of bronchospasm in acute asthma attacks
Beta-2 Agonist SE
- Skeletal muscle tremors
- Tachycardia
- Anxiety, restlessness, apprehension
Theophylline MOA
- Inhibits cAMP phosphodiesterases causing ↑ of cAMP
2. Competitive antagonist at adenosine receptors
Theophylline ROA
- Oral
2. Slow IV over 40 mins
Theophylline Clinical Use
Maintenance therapy for chronic asthma - rarely used though due to SE
Theophylline SE
- Narrow therapeutic window
- Convulsions
- Tachycardia
- Circulatory collapse
Ipratropium MOA
Competitively blocks the muscarinic receptors in the airways
Ipratropium ROA
- Inhalation
Ipratropium Clinical Use
Alone or in combination with beta-2 adrenergic agonists in acute asthma
Ipratropium SE
Minimal, if dosage is to high may cause atropine like effects
Corticosteroids MOA
Reduce the synthesis of arachidonic acid by phospholipase A2 which inhibits the release of leukotrienes and prostaglandins
Corticosteroids ROA
- Inhalation
- Oral
- IV
Corticosteroids Clinical Use
Maintenance therapy for chronic asthma
Corticosteroids SE
- Short term- increaesd energy, insomnia, hunger, agitation and mood alterations
- Long term- osteoporosis, cataracts, myopathy, hypothalamic – pituitary adrenal axis suppression, depression
Cromolyn MOA
Decrease in the release of mediators such as histamine and leukotrienes
Cromolyn ROA
Inhalation
Cromolyn Clinical Use
Prophylactic therapy for preventing bronchospasm
Cromolyn SE
Occasional coughing
Zafirlukast and Montelukast MOA
- Antagonist at the LTD4 leukotriene receptor
2. The LTE4 receptor is also blocked
Zafirlukast and Montelukast ROA
Oral
Zafirlukast and Montelukast Clinical Use
Prophylactic therapy for preventing bronchospasm
Zafirlukast and Montelukast SE
- Headache
2. Nausea
Zileuton MOA
Inhibits 5- lipooxygenase to decrease production of leukotrienes
Zileuton ROA
Oral
Zileuton Clinical Use
Prophylactic therapy for preventing bronchospasm
Zileuton SE
Contraindicated in patients with hepatic disease
What is the difference in the pharmokinetics of 1st and 2nd generation antihistamines?
1st generation – cause significant sedation. They are lipophilic and cross the blood brain barrier.
2nd generation- These were developed to avoid the central nervous system effects. May be associated with weight gain though.
What is the first line treatment in patients with nasal rhinitis due to allergy?
Glucocorticoid Nasal Sprays
What are the 1st generation antihistamines?
Diphenhydramine
Chlorpheniramine
What are the 2nd generation antihistamines?
Fexofenadine
Loratadine
Cetirizine
Doxepin
What are some of the short acting beta-2 agonists used in treating asthma?
- Albuterol (Proventil®)
- Terbutaline (Brethaire®)
- Metaproterenol (Metaprel®)
- Bitolterol (Tornalate®)
What are some of the long acting beta-2 agonists?
- Salmeterol
- Formoterol
- Vilanterol
What are the SE of decongestants?
- hypertension
- insomnia
- irritability
- headache
