Drugs for Asthma and COPD Flashcards
MOA montelukast
binds with high affinity and selectivity to the CysLT1 receptor and inhibits the actions of LTD4 at that receptor (without any agonist activity)
benefits of ipratropium
poorly absorbed after aerosol administration and therefore is relatively free of systemic atropine-like effects
cautions/warnings of budesonide
drug should NOT be used for status asthmaticus or acute episodes of asthma, pts with hypersensitivity to milk proteins also should not take it
MOA terbutaline
short acting beta 2 agonist (SABA)
contraindications/warning albuterol
paradoxical bronchospasm, deterioration of asthma, CV effects, immediate hypersensitivity rxns
indications terbutaline
prophylaxis of bronchospasm associated with asthma, bronchitis, and emphysema
indications for ipratropium
bronchodilator for maintenance tx of bronchospasm associated with COPD (chronic bronchitis and emphysema)
cautions/warnings of mometasone
NOT used for status asthmaticus or acute eipsodes of asthma, not used for pts with hypersensitivity to milk proteins
MOA metaproterenol
short acting beta 2 agonist (SABA)
indications for budesonide
maintenance tx for asthma as prophylactic therapy in pts 6 yrs or older
cautions/warnings Zilueton
NOT used for acute asthma attacks, not recommended in cases with active liver dz or persistent hepatic function enzyme elevations are more than 3x normal limit
indications for indacaterol and vilanterol
treat breathing problems caused by COPD like chronic bronchitis and emphysema
indications for mometasone
maintenance tx of asthma as prophylactic therapy in pts 4 yrs or older
indications for fluticasone
maintenance tx of asthma as prophylactic therapy in pts 4 yrs or older
cautions/warnings prednisone
may lead to hypothalamic-pituitary-adrenal (HPA) axis suppression, monitor patients for Cushing’s syndrome and hyperglycemia
who can take levalbuterol
4 yrs and older
indications of beclomethasone
maintenance tx for asthma and prophylactic therapy in pts 5 yrs or older, also used in tx for pts who require oral corticosteroid therapy to reduce or eliminate the need for the systemic corticosteroids
indications for salmeterol
treatment of asthma and prevention of exercise induced bronchospasm in pts 4 yrs and older, maintenance of bronchospasm in pts with COPD
how are oral corticosteroids administered
with SABAs to treat moderate to severe asthma flare ups
indicates for prednisone
anti-inflammatory or immunosuppressive agent for many infectious diseases and organ transplants; treatment for endocrine conditions and for palliation of certain neoplasms
MO pirbuterol
short acting beta 2 agonist (SABA)
indications for levalbuterol
treatment or prevention of bronchospasm with reversible obstructive dz
MOA fometerol
long acting beta 2 agonist (SABA)
cautions/warning pirbuterol
CV effects in some pts
compare oral vs inhaled corticosteroids side effects
oral corticosteroids are more likely to cause side effects
MOA levalbuterol
short acting beta 2 agonist (SABA)
contraindications/warning for fomoterol
do not use W/O concomitant use of long term asthma control med like inhaled corticosteroid, increased risk of asthma related hospitalization and death
MOA Zileuton
inhibits leukotriene LTB4, LTC4, LTD4, and LTE4 formation by directly inhibiting lipoxygenase in the arachidonic acid pathway
MOA zafirlukast
competitive receptor antagonist of leukotriene D4 and E4 (LTD4 and LTE4) which are components of slow reacting substance of anaphylaxis (SRSA)
indications for ciclesonide
maintenance tx of asthma as prophylactic therapy in pts 12 yrs or older
indications for tiotropium
long term, once daily maintenance tx of bronchospasm associated with COPD
indicates for metaproterenol
bronchodilator for bronchial asthma and for reversible bronchospasm that occurs in bronchitis and COPD
MOA albuterol
short acting beta 2 agonist (SABA)
indications of Zileuton
used as prophylaxis and chronic tx of asthma in adults and children 12 yrs and older
cautions/warnings Omalizumab
anaphylaxis (administer only in a healthcare setting)
cautions/warnings of traimcinolone
NOT for acute bronchospasm, NOT for status asthmaticus or acute episodes of asthma, when pts are transferring from systemically active corticosteroids –> traimcinolone, need to be careful because there have been deaths due to adrenal insufficiency
indications for use of albuterol
asthma, acute bronchitis, COPD, bronchiolitis
all LABAs must be used in concomitant use with ____
long term asthma control med like an inhaled corticosteroid
indications for pirbuterol
prevention and reversal of bronchospasm
what pts can take pirbuterol
12 yrs and older
what must happen after withdrawal from systemic corticosteroids
a number of months for recovery of hypothalamic-pituitary adrenal (HPA) function
indications zafirlukast
prophylaxis and chronic tx of asthma in adults and children 5 yrs and older
cautions/warnings of flunisolide
NOT used for status asthmaticus or acute episodes of asthma
indications for flunisolide
maintenance tx of asthma as prophylactic therapy in pts 6 yrs or older, indicated for pts requiring oral corticosteroid therapy b/c adding flunisolide therapy will reduce or eliminate that need
MOA olodaterol
long acting beta 2 agonist (SABA)
MOA of theophylline
1) blocks PDE, which increases cAMP and causes bronchodilation
2) blocks adenosine, which blocks bronchoconstriction
cautions/warnings of ciclesonide
NOT used for acute bronchospasm, pts can get candida infections of mouth and pharynx, other infections
cautions/warning levalbuterol
paradoxical bronchospasm
cautions/warnings of beclomethasone
when pts are transferring from systemically active corticosteroids –> beclamethasone, need to be careful because there have been deaths due to adrenal insufficiency
cautions/warnings montelukast
not indicated for reversal of bronchospasm in acute asthma attacks including status asthmaticus
major effects of corticosteroids
switch off the transcription of multiple activated genes that encode inflammatory proteins like cytokines, chemokines, adhesion molecules, and inflammatory enzymes
indications for olodaterol
long term, once daily maintenance bronchodilator tx of airflow obstruction in pts with COPD (chronic bronchitis, and emphysema)
indications for aclidinium
long term maintenance tx of bronchospasm associated with COPD
indications montelukast
treat allergies and prevent asthma attacks
risks of long acting beta agonists
asthma related deaths and asthma related hospitalizations
MOA leukotriene antagonists (montelukast, zafirlukast, zileuton)
bind to cysteinyl leukotriene (CysLT) receptors and blocks their activation and the subsequent inflammatory cascade which causes sx associated with asthma and allergic rhinitis
indications for fomoterol
maintenance tx for broncoconstriction in pts with COPD
what is the only beta 2 agonist available by subcutaneous injection
terbutaline
cautions/warnings terbutaline
not recommended for pts with tocolysis (uterine contractions)
cautions/warnings of fluticasone
NOT used for acute bronchospasm, pts can get candida infections of mouth and pharynx
cautions/warning metaproterenol
CV effects in some pts, can produce paradoxical bronchospasm
adverse effects terbutaline
headache, nausea, tachycardia, palpitations
adverse effects albuterol
HA, dizziness, insomnia, dry mouth, cough
MOA salmeterol
long acting beta 2 agonist (SABA)
what pts can take terbutaline
12 years and older
who can take fomoterol
5 yrs and older as an add on to long term asthma control medication (inhaled corticosteroid)
cautions/warnings zafirlukast
hepatotoxicity
indications for Omalizumab
moderate to severe persistent asthma in pts 6 yrs and older with positive skin test or in vitro reactivity to a perennial aeroallergen and sx that are not adequately controlled with ICS, also for chronic idiopathic urticaria
MOA Omalizumab
anti-IgE antibody
cautions/warning atropine
in CAD patients dose needs to be 2-3 mg to avoid atropine-induced tachycardia
indications for triamcinolone
maintenance tx of asthma as prophylactic therapy, indicated for pts requiring oral corticosteroid therapy b/c adding triamcinolone therapy will reduce or eliminate that need
with what pts must you use extreme caution when prescribing theophylline
pts with active peptic ulcer dz, seizure disorders, and cardiac arrhythmias
MOA indacaterol and vilanterol
long acting beta 2 agonist (SABA)
