Iszard Asthma and COPD drugs Flashcards
What are the 2 drug categories for asthma?
- Anti inflammatory
2. Bronchodialators
What class relaxes smooth muscle airways?
beta 2 relax airway smooth-muscle cells of all airways
What type of drug is albuterol?
Short acting beta agonist (SABA)
What is the only b2 agonist drug available by subcutaneous injection ?
Terbutaline Sulfate
What type of drug is terbutaline?
Terbutaline-(SABA) is a beta-adrenergic agonist with preferential effects on the beta-2 receptors resulting in smooth muscle relaxation.
What beta 2 agonies is used as a bronchodilator for bronchialasthmaand for reversible bronchospasm which may occur in association withbronchitisand COPD
Metaproterenol
What beta 2 agonist is indicated in the prevention and reversal of bronchospasm in patients 12 years of age and older with reversible bronchospasm including asthma.
It may be used with or without concurrent theophylline and/or corticosteroid therapy.
Pirbuterol
What beta agonist drug can produce a clinically significant cardiovascular effect in some patients,
Pirbuterol
What beta agonist drug can produce cardiovascular effects and can produce paradoxical bronchospasm which is life threatening?
Metaproterenol
What beta 2 agonist is used in treatment or prevention of bronchospasm in patients 4 years of age and older with reversible obstructive airway disease
Levalbuterol
What is a caution in taking levalbuterol?
Life-threatening paradoxical bronchospasm may occur
What is beclomethasone?
Inhaled corticosteroid
What inhaled corticosteroid is prescribed as a maintenance treatment for asthma and as prophylactic therapy in patients 5 years of age and older.
Beclomethasone
What is is a concerting of switching from systemically active corticosteroids to Beclomethasone?
deaths due to adrenal insufficiency have occurred in asthmatic patients during and after transfer from systemic corticosteroids to less systemically available inhaled corticosteroids.
What can take time to recover when switching from systemic corticosteroids to beclomethasone?
After withdrawal from systemic corticosteroids, a number of months are required for recovery of hypothalamic-pituitary adrenal (HPA) function
What class is the most effective controllers for asthma and most effective anti-inflammatory agents used in asthma therapy?
Inhaled corticosteroids!
How do inhaled corticosteroids work?
major effect of corticosteroids is to switch off the transcription of multiple activated genes that encode inflammatory proteins
What is first line therapy in persistant asthma?
Inhaled Corticosteroids (ICS)
If Inhaled Corticosteroids (ICS)
do not control asthma sx at low dose, what is give?
add a LABA
What inhaled corticosteroids are used as Maintenance treatment of asthma as prophylactic therapy six years and older?
- Budesonide
2. Flunisolide
What inhaled corticosteroid is used in pts 12 and older for prophylactic tx?
Ciclesonide
What inhaled corticosteroid can be used in patients 4 yo and older for prophylactic therapy_
- Fluticasone
2. Mometasone
My asthma patient requires an oral corticosteroid therapy, what inhaled corticosteroid can I give them to reduce the need for that?
Flunisolide can be used in place of oral corticosteroid
Your patient takes Flucasone and has a rxn in their mouth! What is it?
Candida albicans infection of the mouth and pharynx may occur.
Your asthma patients has a hypersensitivy to milk. What inhaled corticosteroid should they NOT take?
Mometason – you get MILK from MOM
You have a patient who requires systemic corticosteroid administration.. you are thinking of a drug but it is contraindicated in status asthmatics and you are concerned that they will die from adrenal insufficiency when they start this inhaled corticosteroid…
Triamcinolone
- : Contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required
- deaths due to adrenal insufficiency have occurred in asthmatic patients during and after transfer from systemic corticosteroids
What drug is used in combination with short acting beta agonists to treat moderate to severe asthma flare-ups and is more likely to cause side effects than inhaled corticosteroids.
oral corticosteroids
What oral corticosteroid is
Used as an anti-inflammatory or immunosuppressive agent and for the treatment of certain endocrine conditions. IT can also lead to to hypothalamic-pituitary-adrenal (HPA) axis suppression
Prednisone
What long acting beta agonist is used for treatment of asthma in patients ≥5 years as an add-on to a long-term asthma control medication such as an inhaled corticosteroid. and for maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD).
Fomoterol-Long Acting Beta Agonist (LABA)
What long acting beta agonist is used for prevention of exercise-induced bronchospasm (EIB) in patients aged 4 years and older. Also, maintenance treatment of bronchospasm
Salmeterol-LABA
What are indacaterol and vilanterol used for?
LABA used to treat breathing problems caused by COPD
What is olodaterol?
LABA Used in the long-term, once-daily maintenance bronchodilator treatment of airflow obstruction
What anti muscarinic is indicated for temporary blockade of severe or life threatening muscarinic effects.?
Atropine
What should the total dose of atropine be?
2-3 mg to avoid the detrimental effects of atropine-induced tachycardia on myocardial oxygen demand.
What is Ipratropium used for? whats so great about it?
- maintenance treatment of bronchospasm relatively
- free of systemic atropine-like effects.
What is tiotropim?
anti cholinergic indicated for the long-term, once-daily, maintenance treatment of bronchospasm associated with COPF
What is Aclidinium?
Anticholinergic the long-term maintenance treatment of bronchospasm associated with COPD
What drug class is derived from the purine base xanthine?
Methylxanthines
What type of drug are theophylline, theobromine, and caffeine?
Methylxanthines
How does theophylline treat asthma, emphysema or chronic bronchitis?
- Smooth muscle relaxation (bronchodilation)
2. Suppression of the response of the airways to stimuli (non-bronchodilator prophylactic effects).
What do leukotriene antagonists do?
- used both for treatment and prevention of acute asthmatic attacks.
- acts by binding to cysteinyl leukotriene (CysLT) receptors and blocking their activation and the subsequent inflammatory cascade
What drug is a leukotriene antagonist that inhibits physiologic actions of LTD4 at the CysLT1 receptor without any agonist activity.
Montelukast inhibits physiologic actions of LTD4 at the CysLT1 receptor without any agonist activity.
What does montelukast do?
Montelukast is a leukotriene antagonist that inhibits physiologic actions of LTD4 at the CysLT1 receptor without any agonist activity.
What is montelukast leukotriene antagonist used for? What is it NOT used for?
-treat allergies and prevent asthma attacks.
NOT INDICATED FOR REVERSAL OF BRONCHOSPASM DURING AN ACUTE ASTHMA ATTACK
What competitive receptor antagonist of leukotriene D4 and E4 is used in prophylaxis and chronic treatment of asthma in adults and children 5 years of age and older?
Zafirlukast
What is a warning of Zafirlukast ?
Hepatotoxicity
Zileuton is a leukotriene given in what form?
Controlled release, immediate release was withdrawn from the market
What is use of leukotriene inhibitor zileuton?
prophylaxis and chronic treatment of asthma in adults and children 12 years of age and older and not used to treat an acute asthma attack.
What is an adverse effect of zileuton?
Not recommended in cases where active liver disease or persistent hepatic function enzyme elevations are ≥3 times the upper limit of normal.
What is Omalizumab?
anti IgE Monoclonal Ab
What is indicated for for moderate to severe persistent asthma in patients 6 years of age and older with a positive skin test or in vitro reactivity to a perennial aeroallergen and chronic idiopathic urticaria?
Monoclonal Antibody
Omalizumab
What is a major concern ofMonoclonal Antibody
Omalizumab
Anaphylaxis -can be life-threatening and observe patients for an appropriate period of time after administration.
