NonSteroidal Asthma Agents Chapter 12

Question 1

What are the three types of non-steroidal anti-asthma agents?

Answer 1

1. mast cell stabilizers (cromolyn sodium)
2. anti-leukotrienes that block inflammatory mediators
3. monoclonal antibodies (IgE immunotherapy)

Question 2

What is the definition of step 2 asthma?

Answer 2

symptoms experienced greater than 2 days/week and greater than 2 nights/month
FEV1 or peak flow of 80% or greater with PEF variability between 20 to 30%

Question 3

What are the clinical indications for the use of non-steroidal antiasthmatics?

Answer 3

the prophylactic management of mild, persistent asthma (step 2)

Question 4

Cromolyn and antileukotrienes are typically recommended for use with what population?

Answer 4

recommended as alternatives to low dose inhaled corticosteroids in asthma requiring step 2 care, particularly in infants and children (due to the safety profile of corticosteroids)

Question 5

Antileukotrienes can be useful in combination with what other class of inhaled drug?

Answer 5

synergistic effect with inhaled corticosteroids to reduce the dose of the steroid

Question 6

Is inflammation a factor in both types of asthma?

Answer 6

YES

Question 7

What are the 3 components of asthma?

Answer 7

1 acute asthma attack (resolving spontaneously or with treatment
2 hyperresponsiveness of the airways to various stimulii
3 persistent inflammation that becomes worse over time and can lead to airway remodeling

Question 8

What are the three key players in the bodies inflammatory response?

Answer 8

mast cells, leukotrienes and IgE

Question 9

How does airway inflammation manifest?

Answer 9

bronchoconstriction, airway swelling, increased mucus secretion

Question 10

Extrinsic asthma is a product of an immune response from ____________ acting on mast cells and IgE

Answer 10

T-lymphocytes

Question 11

Extrinsic asthma is a product of an immune response from T-lymphocytes acting on __________

Answer 11

mast cells and IgE

Question 12

What is the mode of action of cromolyn like agents?

Answer 12

they inhibit mast cell degranulation by basically coating the mast cell and preventing the release of histamine and histamine mediators that cause bronchospasm and inflammatory cell activity in the airway

Question 13

What is the trade name, route and dosage for cromolyn sodium?

Answer 13

Intal; MDI 2 puffs QID

SVN- 20 mg in 2 mL

Question 14

Which type of asthma does cromolyn sodium work on, extrinsic or intrinsic?

Answer 14

BOTH

Question 15

Accolate, Singulair and Zyflo are examples of what class of drug?

Answer 15

anti-leukotrienes

Question 16

What is the dosage for Singulair

Answer 16

oral 10 mg tablet at night

Question 17

T/F Nonsteroidal antiasthma agents have a bronchodilating effect.

Answer 17

FALSE. In fact they may cause bronchoconstriction

Question 18

T/F Nonsteroidal antiasthma agents begin working immediately

Answer 18

False. They take 2 to 4 weeks before therapeutic results occur

Question 19

T/F Nonsteroidal antiasthma agents offer a limited benefit for acute airway obstruction

Answer 19

FALSE- these are controller medicines NOT relievers

Question 20

What are some of the side effects seen with Cromolyn and Nedocromil?

Answer 20

cough, nasal congestion, throat irritation, dry mouth, hoarseness. Additionally, nedocromil has a bad taste and can cause headache, vomiting and nausea
*side effects dissipate over time (longer you take the meds, the less likely you are to have any of the side effects)

Question 21

How do you assess the efficacy of the treatment?

Answer 21

Peak flow meter, action plan based on symptoms