Drugs for asthma and other pulmonary disorders Flashcards
albuterol
Therapeutic Class:
Bronchodilator
Pharmacologic Class:
Beta2-adrenergic agonist
Mechanism of Action:
selectively binds to beta2-adrenergic
receptors in bronchial smooth muscle to cause bronchodilation
Actions and Uses:
Albuterol is a SABA that is used to relieve
the bronchospasm of asthma. Its rapid onset. inhaled albuterol a preferred drug for the termination of acute bronchospasm. the drug also facilitates mucus drainage and can inhibit the release of inflammatory chemicals from mast cells. When inhaled 15 to 30 minutes prior to physical activity, it can prevent exercise-induced bronchospasm.
risks:
-use only the actuator that comes with the
canister.
- pregnancy category C
pharmacokinetics:
onset- 5-15min inhalation; 30min PO
peak- 0.5-2 hrs
duration- 2-6hrs inhalation; 8-12 hrs PO, sustained release
adverse effects:
uncommon. Some patients experience palpitations, headaches, throat irritation, tremor, nervousness, restlessness, and tachycardia. chest pain,
paradoxical bronchospasm, and allergic reactions.
Contraindications:
Use is contraindicated in patients with
hypersensitivity to the drug. Because albuterol may exhibit
cardiovascular effects in some patients, caution is required
when administering these drugs to individuals with a history
of cardiac disease or hypertension (H T N).
Interactions
interactions—>
Drug–Drug:
Concurrent use with beta blockers will inhibit
the bronchodilation effect of albuterol. Patients should also
avoid monoamine oxidase inhibitors (M A O I s) within 14 days of beginning therapy.
lab test:
hypokalemia at high doses
herbal/food: products containing caffeine causing nervesness. tremor, or palpitations
overdose treatment:
dysrhytmias, hypokalemia, and hyperglycemia. In severe cases,
administration of a cardioselective beta-adrenergic
antagonist may be necessary.
Ipratropium
Therapeutic Class: Bronchodilator
Pharmacologic Class: Anticholinergic
Mechanism of action : cause bronchodilation by blocking cholinergic
receptors in bronchial smooth muscle preventing bronchoconstriction
Actions and Uses:
Ipratropium is an anticholinergic drug that is delivered thru inhalation and intranasal routes. The inhalation form is approved to relieve
and prevent the bronchospasm that is characteristic of asthma and COPD.
When combined with albuterol (Combivent Respimat), it is a first-line drug for
treating bronchospasms due to COPD, including bronchitis and emphysema. The
primary role of ipratropium is as an alternative to SABAs and for patients
experiencing severe asthma exacerbations. It is sometimes combined with beta agonists or corticosteroids to provide additive bronchodilation. Treatment is limitied to 3 wks
Risks:
* Wait 2–3 minutes between dosages.
* Avoid contact with eyes; otherwise, blurred vision may occur.
* Pregnancy category B ( no studies have been done but fetal is not at risk)
pharmacokinetics:
onset- 5-15min
peak- 1.5-2hrs
duration- 3-6 hrs
adverse effects:
Because very little is absorbed by the lungs, ipratropium
produces few systemic adverse effects. Irritation of the upper
respiratory tract may result in cough, drying of the nasal mucosa,
or hoarseness. It produces a bitter taste,
interaction–>
drug to drug:
other drugs such as atropine may lead to additive anticholinergic side effects. Ipratropium
should not be used concurrently with the antidiabetic drug
pramlintide because both slow peristalsis and can cause serious
or life-threatening G I symptoms.
lab test:
Unknown
herbal/food:
Unknown
treatment of overdose:
not occur bc very little of the drug is absorbed when given by aerosol
beclomethasone
Therapeutic Class:
Anti-inflammatory drug for asthma and allergic
rhinitis
Pharmacologic Class: Inhaled corticosteroid
Mechanism of action: acts by reducing inflammation
Actions and Uses: Beclomethasone is a corticosteroid available
through aerosol inhalation (Qvar) for asthma or as a nasal spray for allergic rhinitis. Beclomethasone and
corticosteroids are first-line drugs for the long-term management of
persistent asthma in both children and adults. Three or four weeks of
therapy may be necessary before optimal benefits are obtained.
It reduces inflammation=
frequency of asthma attacks. It is not a bronchodilator and should not
be used to terminate asthma attacks in progress.
risks:
*Do not use if the patient is experiencing an acute
asthma attack.
* Oral inhalation products and nasal spray products are
not to be used interchangeably.
* Pregnancy category C.
pharmacokinetics:
onset- 1-4 wks
peak- 30-70 min
duration- unknown
adverse effects:
Because small amounts may be swallowed with each dose, the
patient should be observed for signs of corticosteroid toxicity. Local
effects may include hoarseness, dry mouth, and changes in taste.
Inhaled corticosteroid use has been associated with the development
of cataracts in adults. Long-term intranasal or inhaled corticosteroids
may cause growth inhibition in children.
contraindications:
contraindicated in
those with hypersensitivity to the drug. The growth of
pediatric patients should be monitored carefully because
inhaled corticosteroids may reduce growth velocity in some
children.
interactions—>
unknown for all of them
no for overdose treatment
montelukast
Therapeutic Class:
Anti-inflammatory drug for asthma prophylaxis
Pharmacologic Class: Leukotriene modifier
Mechanism of action: prevents airway edema and inflammation by
blocking leukotriene receptors in airways
Actions and Uses:
used for the prophylaxis of persistent, chronic asthma, exercise-induced bronchospasm, and allergic rhinitis.The drug is given PO and acts rapidly, although it is not recommended for termination of acute
bronchospasm. It is the only agent in this class that is approved for
pediatric use. To aid in administration, montelukast is in form of chewable tablets and as granules that are recommended by the
manufacturer to be mixed with applesauce, mashed carrots, or ice
cream.
risks:
* Do not use to terminate acute asthma attacks.
* If preventing exercise-induced bronchospasm, take drug
at least 2 hours before the activity.
* Pregnancy category B.
pharmacokinetics:
onset- rapid
peak- 3-4 hrs
duration- up to 5.5 hrs
adverse effects:
- headache
-nausea
-diarrhea
- rarely ( serious neurophychiatric event, suicidal ideation, hallucinations)
contraindication:
Hypersensitivity to the drug
interactions—>
drug to drug: exhibits fewer drug to drug interactions
lab test: increase serum alanine aminotransferase (ALT) values
herbal/food: unknown
overdose treatment:
no
