Drugs for Asthma and COPD

Question 1

antiinflammatory drugs

Answer 1

glucocorticoids; ex beclomethasone prednisone

Question 2

other anti-inflammatory drugs

Answer 2

cromolyn

zafirlukast

Question 3

bronchodilators: beta 2 AA

Answer 3

albuterol

salmeterol

Question 4

bronchodilators: methylxanthines

Answer 4

theophylline

Question 5

anticholinergic drugs

Answer 5

ipratropium

Question 6

SABA

Answer 6

short actin beta 2; albuterol; quick relief only

Question 7

ICS (inhaled corticosteroid)

Answer 7

fluticasone

Question 8

LABA

Answer 8

long-acting beta 2; salmeterol

Question 9

about glucocorticoids

Answer 9

most effective long term inflammation control; inhaled most common; decreases inflammation, hyperactivity, mucous;

Question 10

glucocorticoids inflammatory effects

Answer 10

decreased release of inflammatory mediators; decreased activity of inflammatory cells; decreased edema of the airway

Question 11

glucocorticoids adverse effects

Answer 11

adrenal suppression
thrush in mouth(inhale)
slow growth 
hyperglycemia (ORAL)
bone loss
TAPER SLOW or ADDISONS

Question 12

Glucocorticoid-Long-Acting Beta2-Agonist Combinations

Answer 12

fluticasone/salmeterol
corticosteroid and long beta 2
not a rescue med
immune suppression or thrush
rinse
for maintenance

Question 13

Adrenal Cortex Hormones

Answer 13

Corticosteroids (glucocorticoids and mineralocorticoids)
increase CUSHIN
decrease ADDISONS

Question 14

Prednisone (oral)

Answer 14

IMMUNE SUPPRESS (infection)
NSAID increases GI bleed
hyperglycemia
Tapered (if not addisons)

Question 15

Leukotriene Modifiers

Answer 15

Zileuton
Zafirlukast
Montelukast
Suppress leukotriene; decrease inflammations & mucous; smooth dilation

Question 16

Leukotriene Modifiers side effects

Answer 16

Depression/anxiety
Suicidal ideation
Hepatitis
(second line) (maintenance)

Question 17

Mast Cell Stabilizers

Answer 17

stop bronchial inflammation
no dilation
schedule/prophylactic
Cromolyn

Question 18

Cromolyn

Answer 18

Safest of all antiasthma meds

Side effects:
Cough
Bronchospasm

Question 19

Beta2-Adrenergic Agonists

Answer 19

Bronchodilator (sympathomimetic)

not 4 inflammation; alone for mild asthma; SABA albuterol; LABA salmeterol; prevent excerise constriction

Question 20

Albuterol

Answer 20

SABA rescue 
1st line
contriction
increase pp bp
anticholinergic 
immediate

Question 21

salmeterol

Answer 21

LABA
in combo
mono link to death

Question 22

albuterol side effects

Answer 22

Adrenergic side effects
Tachydysrhythmias
Angina
Seizures----
Cardiac arrest------

Question 23

Theophylline-oral or IV

Answer 23

CNS stimulant
dilation
caffeine cause toxicity 
not 1st choice
10-20 TR

Question 24

Theophylline side effects

Answer 24

N/V/diarrhea
Insomnia
Tachycardia
Seizures

Question 25

Anticholinergics-Ipratropium 4x a day

Answer 25

prevents constriction and relieves spasm; drys;

Question 26

Ipratropium (4x day) side effects

Answer 26

dry mouth
increased IOP
heart attack
stroke 
death

Question 27

Anticholinergics-Tiotropium

Answer 27

longer; with doses, dilation gets better plateau aft 8 days; COPD, not asthma; maintenance; drys; once

Question 28

Tiotropium side effects

Answer 28

Dry mouth

Can cause cardiovascular events, but unlikely

Question 29

Beta2-Adrenergic Agonist-Anticholinergic Combination

Answer 29

Albuterol/ipratropium (DuoNeb)

stimulates adrenergic and bocks cholinergic

Question 30

Dry-Powder Inhaler
fluticasone/salmeterol (Advair-prophylaxis)
Twice Daily

Answer 30

wait 1 full minute between puffs inhale prior to activating; must rinse mouth to prevent thrush

Question 31

Respimats

Answer 31

fine-sized particles

Creates a very fine mist, like a fog machine

Question 32

Nebulizers

Answer 32

converts liquid drug into a mist (take several minutes)

Don’t require hand-breath

Question 33

Emergency Treatment for 
Asthma and COPD Exacerbation

Answer 33

albuteril/ipratroprium bromide (SABA/anticholinergic)

IM/IV glucocorticoids (methylprednisolone)

oxygen