Exam 1 Flashcards
Short Acting Beta Agonists (SABA)
Albuterol:
-short acting beta 2 agonist that relaxes bronchial smooth muscle
- Used for treatment of bronchospasm
- Onset: within 10 mins
- Duration: 4-6 hrs
- Adverse effects: excitement, nervousness, tremor, bronchospasm, tachycardia
Long Acting Beta Agonist (LABA)
Formoterol:
-long acting beta 2 agonist that relaxes bronchial smooth muscle
- Used for long term prevention of bronchospasm
- Onset: within 3 mins, but peaks within 1-3 hrs
- Duration: 12 hrs
- Adverse effects: excitement, nervousness, tremor, bronchospasm, tachycardia
- SHOULD NOT BE USED FOR TREATMENT OF ACUTE ASTHMA EXACERBATIONS*
Short Acting Anticholinergics (SAMA)
Ipratropium:
-blocks the action of acetylcholine on bronchial smooth muscle which causes bronchodilation
- Used for COPD maintenance, off-label asthma exacerbations
- Onset: within 15 mins
- Duration: Neb 4-5hrs, MDI 2-4 hrs
- Adverse effects: bronchitis, headache, dizziness, anticholinergic effects
Long Acting Anticholinergics (LAMA)
Tiotropium:
-blocks the action of acetylcholine on bronchial smooth muscle which causes bronchodilation
- Used for COPD/asthma maintenance
- Half-life: 25-44 hrs
- Adverse effects: bronchitis, headache, dizziness, anticholinergic effects
Inhaled Corticosteroids (ICS)
Budesonide:
-Used for COPD/asthma maintenance
- Onset: Neb 2-8 days, Inhaler 24 hrs
- Adverse effects: otitis media, respiratory infections, thrush, immunosuppression
- NOT USED IN ACUTE RESPIRATORY DISTRESS*
Systemic IV steroid
Solumedrol:
-Used for COPD/asthma exacerbations
- Onset: 1 hr
- Adverse effects: immunosuppression, hyperglycemia
- Monitor response and glucose
Oral Systemic Glucocorticoid
Prednisone:
-Used for long term management of severe COPD/asthma, acute asthma/COPD exacerbations
-Adverse effects: (dry mouth, throat irritation, hoarseness)
(headache, euphoria, confusion, depression) (hyperglycemia, GI distress, hypertension) (electrolyte imbalance, fluid retention) (osteoporosis, psychosis, superinfections)
Magnesium sulfate
- Classification: Electrolyte supplement
- Uses: off labeled treatment of severe asthma exacerbations
- Onset: IV immediate
- Adverse effects: flushing, hypotension
Epinephrine
- Classification: alpha/beta agonist
- Uses: severe bronchospasm in asthma exacerbations
- Onset: SQ 5-10 mins
- Adverse effects: cardiovascular effects
- Monitor cardiopulmonary response
Xolair
- Classification: IgG monoclonal antibody
- inhibits IgE binding to IgE receptors on mast cells and basophils
- for pts whose asthma is triggered by allergens
- Onset: 12-16 weeks
- Half-life: 26 days
- Adverse effects: headaches, local injection site reactions
- Monitor for anaphylactic/hypersensitivity reactions, monitor baseline IgE, monitor for signs of infection (bc it has immunosuppressant affects)
Leukotriene Receptor Antagonist
Singulair
-leukotriene receptor plays a role in promoting the associated airway edema, smooth muscle contraction and altered cellular activity associated with inflammatory process of asthma
- Uses: asthma maintenance
- Duration: 24 hrs
- Adverse effects: headache, dizziness, fatigue, nausea, and neuropyschiatric events
- Monitor mood or behavior changes including suicidal thoughts/actions
Mucolytics
Acetylcysteine
-Uses: adjunct therapy in pts with abnormal viscous secretions like COPD/bronchial asthma
- Onset: 5 -10 mins
- Adverse effects: chest tightness, hypotension, rash, GI symptoms, bronchospasm
- Likely will increase bronchial secretions*
First generation antihistamines
Cause drowsiness
Ex: diphenhydramine (Benadryl)
Avoid use with MAOIs, CNS depression with use of alcohol, barbituates, hypnotics and opioids
Second generation antihistamines
Less drowsiness
Ex: cetirizine, loratadine, desloratadine, fexofenadine
Half life: 3-30 hrs
Decongestants
Stimulate alpha adrenergic receptors causing vasoconstriction of capillaries in mucosa allowing less fluid secretion
Long term use can cause rebound nasal congestion
