Medications For COPD and Asthma Flashcards
2 Main groups for COPD and Asthma
- Glucocorticoids
- Bronchodilators
a. Sympathomimetics
b. Anticholinergics
Glucocorticoids aka Steroids
MOA- ANTI-INFLAMMATORY
- PO- acute asthma & COPD
- Inhaled- prophylactic and maintenance
- Intranasal- allergic rhinitis
- Topical- cream (hydrocortisone)
ADR’s- risk of infection, ulcers, and hyperglycemia. Suppression of adrenal function (abruptly stopped causes acute adrenal insufficiency- can cause death).
Bronchodilators
(Sympathomimetics or Anticholinergic)
MOA- dilate the bronchial tree
Sympathomimetic (Beta-2 Selective)
BEST- best option for the patient
TEROL FAMILY
MOA- BETA- 2 AGONIST (DIRECTLY HITS RECEPTOR)
Short- acting or rescue
1. albuterol- grandfather
2. levalbuterol- (has less CV effects)
Long-acting or maintenance- “METEROL” FAMILY
1. salmeterol
2. formeterol
3. arfomoterol
M = MAINTENANCE
BLACK BOX WARNING
NO Long-Acting Beta 2 medications for asthma unless ALL OTHER MEDS FAIL (receptors are blocked if rescue inhaler is needed)
WILL RESULT IN DEATH
Also become more selective the longer the use and higher the dose- will start to connect to Beta 1’s
Xanthines or methylxanthine
(caffein)
- Aminophylline- IV ONLY
IV RATE 25mg/min - Theophylline- PO
ADR- SMOKING- increases metabolism making for higher doses
THERAPEUTIC LEVEL- 10-20mcg/mL
-Toxicity- tachycardia, palpitations, nausea, no appetite.
Anticholinergic Medications (Beta 2- direct)
MOA- INDIRECTLY causes airway relaxation by blocking acetylcholine. (acetylcholine causes contractions). Less contractions & less secretions
“Tropium”
1. Ipratropium
2. Tiotropium
Triple Therapy Medication
- Steroid, Beta-2 agonist, anticholinergic.
Drug of Choice for COPD
Long-acting beta 2 agonist- “metrol”
-can add on short acting, anticholinergic, steroids, theophylline, or triple therapy.
