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CPR 2 Exam 2 > Iszard Asthma and COPD Drugs > Flashcards

Iszard Asthma and COPD Drugs Flashcards

1
Q

How do inhalers work?

A
  • Beta agonists excite receptors
  • ICS for inflammation
  • Muscarinic antagonists Inhibit receptors
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2
Q

How does a drug treatment plan for asthma go as it worsens?

A
  • SABA →ICS →LABA →LAMA
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3
Q

How does a drug treatment plan go for a COPD patient as their condition worsens?

A
  • SABA → LAMA → LABA→ ICS
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4
Q

What do bronchodilators B2 agonists, act on?

A

Airway smooth muscles to reverse bronchoconstriction of asthma

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5
Q

Albuterol (SABA) indications?

A
  • asthma
  • acute bronchitits
  • COPD
  • broncholitits
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6
Q

Albuterol AE?

A
  • HA
  • Dizzy
  • Insombia
  • Dry mouth
  • Cough
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7
Q

Albuterol contraindications?

A
  • Paradoxical bronchospasm
  • Deterioration of asthma
  • CV effects
  • Immediate hypersensitivity
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8
Q

Terbutaline MOA?

A
  • beta adrenergic agonist with preferential effects on Beta 2 recceptors and can be given subcutaneous injection
    • Sulfur allergy not recommended
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9
Q

Indications of terbutaline?

A
  • Prophylaxis of brochospasm associatedd with asthma
  • broncholitits
  • emphysema
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10
Q

Cautions for terbutaline

A

Not recommended for tocolysis

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11
Q

AE for Terbutaline?

A
  • HA
  • Nausea
  • Tachycardia
  • Palpitations
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12
Q

Indications for Metaproterenol (SABA)?

A
  • Asthma
  • Reversible bronchospasm which may occur in bronchitits and COPD
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13
Q

Cautions for Metaproterenol

A
  • can produce significant cardiovascular effects
  • paradoxical bronchospasms (life threatening)
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14
Q

Pirbuterol (SABA)?

A
  • Used in prevention and reversal of bronchospasm
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15
Q

Cautions for Pirbuterol (SABA)?

A
  • clinical significant cardio effects
    • BP and pulse rate
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16
Q

Levalbuterol (SABA) indications? Warnings

A
  • treatment or prevention of bronchospasm in 4+
  • life threatening paradoxical bronchospasm
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17
Q

Beclomethasone (ICS) indications?

A
  • maintenance treatment for asthma and prophylactic therapy 5+ yo
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18
Q

Beclomethasone cautions?

A
  • deaths due to adrenal insufficiency have occurred in asthmatic patients during/after the transition from systemic corticosteroids to inhaled
  • After withdrawl from systemic corticosteroids a few months are required for recovery of hypothalamic pituitary adrenal function
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19
Q

Effects of ICS?

A
  • given twice daily
  • rapidly improves symtpoms
  • effective in preventing asthma sx
  • Reduce airway hyperresponsiveness
  • prevent irreversible changes in airway
  • withdrawal of ICS results in slow deterioration of asthma control
  • First line therapy for patients with persistent asthma
20
Q

Budesonide (ICS) Indications and warnings?

A
  • Maintenance treatment of asthma as prophylactic therapy
  • should not be used during an asthma attack
  • severe hypersensitivity to milk proteins is contraindicated
21
Q

Ciclesonide (ICS) indications and warnings?

A
  • Prophylactic asthma agent, not used in acute situations
  • Don’t use in presence of candida albicans infections
  • associated with less frequent candidiasis as it is a prodrug
22
Q

Flunisolide (ICS) indications and contraindications?

A
  • Prophylactic therapy
  • also used for asthma patients requiring oral corticosteroid therapy
  • not used for status asthmaticus or other acute episodes
23
Q

Fluticosone (ICS) indications and contraindicatons?

A
  • Prophylactic therapy of asthma
  • Not used for acute bronchospasm
  • candida albicans infection risk increases
24
Q

Mometasone (ICS) use and cautions?

A
  • Prophylactic therapy
  • not used for acute situations
  • not used if hypersensitivity to milk proteins
25
Q

Triamcinolone (ICS) indications and warnings?

A
  • prophylactic therapy asthma
  • also used for those who require sytemic corticosteroid administration which could reduce or eliminate the need for these
  • not used for acute situations
  • deaths due to adrenal insufficiency have occurred during/after transition from systemic to inhaled steroids
26
Q

When are oral and parenteral corticosteroids used?

A

In combination with short acting beta agonists to treat moderate to severe asthma

27
Q

Prednisone use? (OCS)

A
  • anti-inflammatory or immunosuppressive agent for many diseases and endocrine conditions
28
Q

Cautions for prednisone?

A
  • May lead to hypothalamic pituitary adrenal axis suppression
  • Monitor for cushing and hyperglycemia and taper doses for withdrawal
29
Q

Uses for LABA’s?

A
  • treatment of asthma as an add on to long term asthma control meds
  • Maintenance tx of bronchoconstrictio with COPD
30
Q

Contraindications/warnings for LABA’s?

A
  • increases risk of asthma related deaths and hospitalizations
  • don’t use without ICS or other long term control meds
31
Q

Salmeterol (LABA) uses?

A
  • Prevention of exercise induced bronchospasm
  • maintenance of bronchospasm in COPD
32
Q

Indacaterol and Vilanterol (LABA) indications?

A

Treat breathing problems due to COPD, including chronic bronchitis and emphysema

33
Q

Olodaterol (LABA) uses?

A

long term once daily maintancne bronchodilator treatment of airflow obstruction in patients with COPDS, chronic bronchitis and emphysema

34
Q

Ipratropium (anticholinergic) uses?

A

bronchodilator for maintenance of bronchospasm

Potent atropine analog poorly absorbed so it is free of systemic atropine like effects

35
Q

Tiotropium (anticholinergic) uses?

A
  • Long term once daily maintenance of bronchospasm associated with COPD
  • also reduces COPD exacerbations
36
Q

Aclidinium (anticholinergic) uses?

A
  • long term maintenance of bronchospasm associated with COPD
37
Q

What are Methylxanthines?

A
  • class of dugs that are derived from purin base xanthine
  • used in treatment of airway obstruction caused by asthma, bronchitis or emphysema
  • includes
    • theophylline
    • theobromine
    • caffeine
38
Q

What are the two actions that theophylline has in the airways of patients with reversible obstruction?

A
  • Smooth muscle relaxation
  • suppression of response of airways to stimuli
39
Q

Theophylline warnings?

A

extreme caution in patients with PUD seizure disorders and cardiac arrhythmias

40
Q

What class do Zafirlukast and Montelukast fall under?

A

Selectively reversible antagonissts of Cysteinyl Leukotriene receptors

41
Q

Zafirlukast and Montelukast effects?

A
  • Have anti inflammatory actions
  • Glucocorticoid sparing effect (potentiates them)
42
Q

Montelukast indications?

A
  • treat allergies and prevent asthma attacks
  • not indicated for reversal of bronchospasm in acute asthma attacks
43
Q

Zafirlukast uses and cautions?

A
  • prophylaxis and treatment of asthma
  • Hepatotoxicity
    • monitor ALT AST
44
Q

Zileuton uses?

A
  • used as prophylaxis and chronic asthma treatment
  • not recommended for acute asthma attacks
  • not used in patients with active liver disease or persistent hepatic function enzyme elevations 3x ULN
45
Q

What are the four methods Monocolonal Ab drugss work?

A
  1. binds free IgE
  2. Decreases expression of high affinity receptors
  3. decreases mediator release
  4. Decreases allergic inflammation prevents exacerbation of asthma and reduces symptoms
46
Q

Omalizumab uses?

A
  • anti IgE used for moderate to severe persistent asthma in patients with postive skin test or in vitro reactivity to perennial aeroallergens
  • also used for chronic idiopathic urticaria in patients who are still symptomatic with H1 inhibitors
47
Q

Omalizumab cautions?

A
  • need to be given in hospital setting due to risk of anaphylaxis

CPR 2 Exam 2 (17 decks)

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