Drugs for asthma and COPD Flashcards
Non-selective adrenergic agonists that can be used for asthma and COPD
Epinephrine
Ephedrine
Isoproterenol
Adverse effects of Epinephrine
Tachycardia
Arrhythmias
Angina pectoris - worsen
Treatment of acute vasodilation and bronchospasm of anaphylaxis
Epinephrine
Drug with a similar mechanism to epinephrine, but with a longer activity
Ephedrine
Mechanism of epinephrine
Stimulates alpha, beta-1, and beta-2 receptors
Mechanism of isoproterenol
Stimulates beta-1 and beta-2
Side effect of isoproterenol
Arrhythmias
Short acting beta-2 agonists used for asthma and COPD
Albuterol
Terbutaline
Levalbuterol
Most widely used sympathomimetics for the treatment of acute bronchoconstriction
Albuterol
Terbutaline
Long acting beta-2 agonists used for asthma and COPD
Salmeterol
Formoterol
Bambuterol
Used only in combination with inhaled corticosteroid for asthma, offering complementary synergistic actions
LABAs
May be used alone in COPD or with anticholinergics or inhaled corticosteroids
LABAs
Risk with high dose or prolonged use of LABAs
Hypokalemia
Methylxanthine drugs used as add on therapy in pts with severe asthma or COPD
Theophylline
Theobromine
Aminophylline
Drug class that inhibits PDE enzymes to increase concentrations of IC cAMP. Used in asthma and COPD
Methylxanthine drugs
Asthma and COPD drug class the enhances histone deacetylation to inhibit inflammatory gene transcription
Methylxanthine drugs
Drug class that improves contractility of skeletal muscle and reverses diaphragm fatigue in COPD
Methylxanthine drugs
Adverse effects of methylxanthine drugs
Nervousness and tremor
Medullary stimulation, convulsions, and death
Tachycardia and arrhythmias
Increase CO and TPR
Contraindications of methylxanthine drugs
Metabolized by CYP450 and narrow therapeutic index
Selective phosphodiesterase 4 inhibitor used in severe COPD
Roflumilast
Antimuscarinic agents used mostly in COPD
Ipratropium
Tiotropium
Used in COPD for pts intolerant of beta-agonists
Antimuscarinic agents
Added in combination to inhaled corticosteroid/LABA to provide additional bronchodilation in pts with persistent airflow obstruction
Tiotropium
Adverse effects of antimuscarinic agents
Dry mouth
Urinary retention
Increased risk of dementia in elderly
Inhaled corticosteroids
Mometasone
Fluticasone
Budesonide
Beclomethasone
Triamcinolone
Adverse effects of inhaled corticosteroids
Oral candidiasis
Vocal cord changes
Mechanism of inhaled corticosteroids
Alters gene expression and reduces inflammatory mediators
Systemic corticosteroids used for asthma and COPD
Prednisone
Methylprednisolone
Hydrocortisone
Drug class that upregulates expression of beta-adrenergic receptors
Corticosteroids
Risk with chronic use of steroids
Osteoporosis
Cataracts
Leukotriene pathway inhibitors
Zileuton
Zarfirlukast
Montelukast
5-lipoxygenase inhibitor used for aspirin induced asthma
Zileuton
Asthma medication that requires monitoring of LFTs
Zileuton
LTD4 receptor (CysLT1) antagonists used in mild asthma and aspirin induced asthma
Zarfirlukast
Montelukast
Humanized monoclonal antibody to human IgE that inhibits its binding to mast cells
Omalizumab
Mast cell stabilizers used in asthma and allergic rhinitis
Cromolyn
Nedocromil
