Pharm Unit 4

Question 1

Corticosteroids in Respiratory Care

Answer 1

• Corticosteroids secreted by the adrenal cortex include glucocorticoids (e.g., cortisol), mineralocorticoids (e.g., aldosterone), and sex hormones (e.g., androgen and estrogen).

• Glucocorticoids, often referred to simply as steroids, exert an anti-inflammatory effect in the body.

• The use of aerosolized corticosteroids targets inflammation in the airway, with a smaller dose reducing systemic side effects.

Question 2

• Corticosteroids have 3 major pharmacologic effects:

Answer 2

• anti-inflammation

• bronchodilation, either direct, or indirect through potentiation of Beta sympathomimetics

• Immunosuppression

Question 3

Corticosteroids Therapeutic Uses:

Answer 3

• allergic asthma

• suppression of immune response in organ transplant patients

• Arthritis

• acute inflammatory diseases

Question 4

• Clinical Indications for Use of Inhaled Corticosteroids

Answer 4

• Maintenance, control therapy of chronic asthma

• COPD

Question 5

• Side Effects:

Answer 5

• Cushing’s Disease

• Moon Face/Hump Back

• Hirsutism

• Muscle wasting

• Hypokalemia

. Aggravation of diabetes

Question 6

Most common side effects

Answer 6

• Oropharyngeal candidiasis (oral thrush)

• What to do:

• Use minimal dose

• Use reservoir

• Rinse mouth after use

Question 7

CorticosteroidsDrug examples

Answer 7

• Fluticasone (Flovent or Arnuity Ellipta)

• Beclomethasone (Qvar)

• Budesonide (Pulmicort) is a neb

• Mometasone (Asmanex)

The sones are inhalers

Question 8

Combination Corticosteroids

Answer 8

• ICS’s and LABAs are used in the treatment of COPD (emphysema &

Chronic Bronchitis)

• Fluticasone/Salmeterol (Advair)… Corticosteroid & LABA

• Budesonide/Formoterol (Symbicor)… Corticosteroid & LABA

• Mometasone/Formoterol (Dulera)…Corticosteroid & LABA

Question 9

Oral and Parental Corticosteroid

Answer 9

• Prednisone (tablet)

• Methylprednisolone (Solu-Medrol)… most commonly given by injection/intravenously but can be given in tablet form

Question 10

Nonsteroidal Antiasthma Agents

Answer 10

• Anti-leukotrienes Agents - that block the inflammatory response in asthma.

• Immunoglobulin E (IgE) - Gamma globulin that is produced by cells in the respiratory tract.

Question 11

Nonsteroidal Antiasthma Agents

• Three Subgroups of Agents

Answer 11

     • Cromolyn-like drugs (mast cell stabilizers)

• Anti-leukotrienes

• Monoclonal antibodies

Question 12

• Clinical Indications for Nonsteroidal Antiasthma Agents

Answer 12

• Prophylactic management (control) of mild persistent asthma

Question 13

• General indications of Nonsteroidal Antiasthma Agents

Answer 13

• Cromolyn is often used with infants and young children as alternatives to ICS in asthma requiring care because of safety profiles of ICS

• All of the nonsteroidal antiasthma drugs described are controllers, not relievers, and are used in asthma requiring anti-inflammatory drug therapy.

Question 14

• Clinical results of asthma (hallmark)

NAA

Answer 14

• Bronchoconstriction (wheezing, constriction)

• Mucosal swelling

• Mucus secretions

Question 15

Cromolyn (Mast Cell Stabilization) Agent

Answer 15

• Prophylactic agent in the treatment of asthma

• Cromolyn sodium (Intal)

• Prevents mast cell degranulation

Question 16

• Clinical application of cromolyn sodium

Answer 16

• It is for prophylactic use only should NOT be used during acute bronchospasm. It has NO bronchodilating action

• May take 2-4 weeks for improvement in patient’s symptoms

Question 17

Anti-Leukotriene Agents

Answer 17

• Zafirlukast (Accolate)

• Dosage

• Oral administration

• Montelukast (Singulair)

• Dosage and administration

• Oral administration

Question 18

Monoclonal Antibodies

Answer 18

• Require injection or infusion

• Are DNA-derived humanized IgG antibodies

• Benralizumab (Faserna)

• Dipilumab (Dupixent)

• Dosage and administration

• Parenteral administration

• Hazards and side effects

• Most severe is anaphylaxis

• Commonly observed include injection site reactions, fever, headache, sore throat

Question 19

Tranexamic Acid

Answer 19

given aerosolized or down tube for hemoptysis as a clotting promoter