Drugs in asthma and COPD Flashcards
MONTELUKAST;
What are indications?
Prophylaxis of asthma
Seasonal allergic rhinitis in asthmatic patients- symptomatic relief
MONTELUKAST;
What is important MHRA warning?
Potentially cause neuropsychiatric symptoms;
Speech impairment
Obsessive compulsive symptoms
MONTELUKAST;
What are important side effects?
Gi upset
headache
upper respiratory tract infections
Risk of churg-strauss syndriome (eosinophilic granulomatosis)
Associated with reduction or withdrawal of oral steroid therapy.
MONTELUKAST;
What are dosages
10mg daily in evening
6-14yrs
5mg OD in evening
6months to 5 years;
4mg once daily, in evening
MONTELUKAST;
What are different formulations?
Chewable tablets
granules- can be swallowed or mixed with cold/soft food not liquids
MONTELUKAST;
What are signs of churg-strauss syndrome?
Worsening pulmonary symptoms
cardiac complications
peripheral neuropathy
ANTIMUSCARINICS BRONCHODILATORS;
What are indications?
COPD
SAMA- relive acute breathlessness
LAMA- Used to prevent breathlessness and exacerbation
Severe asthma
What is mechanism of action?
binds to muscarinic receptors where they acts as competitive inhibitors of acetylcholine.
Why are side effects and interactions not an issue?
as very little drug enters systemic circulation in inhaled therapy, side effects and interactions are less likely than with oral/IV antimuscarinics
What are important warnings?
Caution;
angle-closure glaucoma
arrhythmias
Urinary retention
Generally fine with inhalation.
What are dosages for LAMA?
Ipatropium 40mcg inhaled 6 hourly
higher doses are given via nebuliser
What are dosages for SAMA?
Once of twice daily
can be given as dual or triply therapy
(LABA+LAMA+ICS) or (LABA +LAMA)
What are examples?
glycopyronium
ipatropium
tiotropium
umeclidinium
