Nonsteroidal Antiasthma

Question 1

What is it used for

Answer 1

–control management of mild persistent asthma
–used to prevent symptoms from starting
–has no bronchodilating effect

Question 2

Mechanism of Inflammation in Asthma: Extrinsic

Answer 2

–Allergic
–dust, smoke, pets

Question 3

Mechanisms of inflammation in Asthma: Intrinsic

Answer 3

–Nonallergic
–cold air, stress, excerise

Question 4

3 components of Asthma

Answer 4

–Acute asthma attack:resolves spontaneously or with treatment
–Hyperresponsiveness of airways to various stimuli
–Persistent inflammation that becomes worse

Question 5

Cromolyn Agent: Cromolyn Sodium

Answer 5

–Trade Name: Disodium cromoglycate
–Mode of Action: prevents mast cell degranulation by blocking the release of chemical mediators if inflammation
–Prevents asthma triggers
–Methos od Admin: SVN 20mg/ampule or 20mg/2ml (1%)
–Side Effects: cough, nasal congestion, wheezing, nasal itching, epistaxis, nose burning

Question 6

Antileukotriene Agents

Answer 6

–Leukotrienes are potent bronchoconstrictor and stimulate other cells to cause:
-airway edema
-mucus secretion
-ciliary beat inhibition
-recruitment of other inflammatory cells
–Alternative to steroids or cromolyn
–Used for Long-Term control

Question 7

Antileukotriene Agents: Zileuton

Answer 7

–Trade Name: Zyflo, Zyflo CR
–Rarely Used
–Dosage and Admin: Oral, 600mg tablets,QID
Used in adults and children ages 12+
1hr before and 2 hrs after meals
–Hazards and Side effects: Headache, abdominal pain, loss of strength, dyspepsia
monitor liver function
interacts with theophylline and warfarin

Question 8

Antileukotriene Agents: Zafirlukast

Answer 8

–Trade Name: Accolate
–Dosage and Admin: Oral admin
10mg, BID children 5/11yrs
20mg, BID 12yrs and older
–Hazards and Side Effects: headache, infection, nausea, diarrhea, generalized abdominal pain, decrease liver function

Question 9

Antileukotriene Agents: Montelukast

Answer 9

–Trade Name: Singulair
–Dosage and Admin: Oral, 4mg or 10mg, 5mg chewable
Approved for ages 6months and up
–Hazards and side effects: diarrhea, laryngitis, pharyngitis, nausea, sinusitis, viral infection

Question 10

Advantages

Answer 10

–oral admin
–possible once daily dosing
–safe with few side effects
–effective in aspirin sensitivity and often exercise-induced asthma
–systemic distribution reaches entire lung
–additive effect with inhaled steroids

Question 11

Disadvantage

Answer 11

antiinflammatory action limited to one mediator pathway
–unknown long-term toxicity
–effective only to 50-70% of pt
–no predictor of pt who will respond
–systemic drug exposure

Question 12

Monoclonal Antibodies: Omalizumab

Answer 12

–Trade Name: Xolair
–Mode of Action: blocks the attachment of IgE to mast cells reducing inflammatory mediators
–Dosage and Admin: Parenteral, 150mg/ 1.2 mL, every 2 to 4 weeks
–Hazards and side effects: anaphylaxis, injection site reactions, fever, headache, and sore throat

Question 13

What kind of Asthma is associated with an allergic reaction

Answer 13

–extrinsic