Exam 1 - Week 2 - Asthma Drug Classes Flashcards
Name SABA (short-acting beta adrenergic agonists)
Albuterol (Proventil, Ventolin, ProAir, Accuneb)
Name inhaled corticosteroids (ICS)
beclomethasone, budesonide, ciclesonide, fluticasone, mometasone
Name LABA (long-acting beta2-adrenergic agonists)
formoterol, salmeterol, vilanterol
Name leukotriene-modifying drugs.
montelukast, zafirlukast, zileuton
Name mast cell stabilizers
Cromolyn
Name methylxanthines
theophylline
Name monoclonal antibodies
omalizumab
Mechanism of action for beta2-adrenergic agonists
Stimulate beta2-adrenergic receptors, increasing production of cAMP. Increased cAMP relaxes airway smooth muscle and increases bronchial ciliary activity.
Mechanism of action for corticosteroids
Reduce airway inflammation by inhibiting or inducing the production of end-effector proteins.
Mechanism of action for leukotriene modifiers
Prevent the first and second steps in the conversion of arachidonic acid to the bronchoconstrictor and proinflammatory cysteinyl leukotrienes
Mechanism of action for methylxanthines
Relax bronhcial smooth muscle, enhance diaphragmatic contractility, and have a slight anti-inflammatory effect
Mechanism of action for omalizumab
A recombinant humanized monoclonal anti-IgG antibody, selectively binds to circulating IgEforming immune complexes that prevent IgE from binding to high affinity IgE receptors on the surface of mast cells and basophils
What do ALL asthmatic patients require despite severity?
SABA (rescue)
Vaccine considerations for asthmatic patients
ALL asthmatics should receive annual flu vaccine.
Immunocompetent childrenage 6-18 and adults 19 years of age and older should receive 23-valent.
12-valent reserved for pts receiving long-term systemic CS
What is at-home management of an acute exacerbation of asthma?
2-6 puffs of SABA, can repeat in 20 minutes, then q3-4hrs for next 24-48 hours, if that does not help go to ED
If this does not help, a short course of PO CS can be added.
