Pulm 2- Steroids Flashcards
What is the mechanism of ICS?
Can you double the dose?
Inhibits inflammatory cells (mast cells, eosinophils, basophils), cytokines (histamines, leukotrienes)
No- flat response curve
What class is Beclametasone HVA (QVAR)?
ICS
What class is Budesonide DPI
(Pulmicort)?
SE?
ICS
SE: Need more in smokers
Oral Candidiasis
Cough
What class is Ciclesonide
(Alvesco)?
SE?
ICS
Dysphonia
Adrenal suppression
What class is Fluticasone FHA (Flovent)?
ICS
What class is Flunisolide (Aerobid)?
ICS
What class is Mometasone DPI?
ICS
What class is Fluticasone/ Salmeterol (Advair)?
ICS
LABA
What class is Budesonide/Formeterol HFA?
ICS LABA
What class is Mometasone/Formeterol?
ICS
LABA
What class is Monteleukast
(Singulair)?
Peds?
Leukotriene inhibitor
Peds OK
What class is Zafirlukast
(accolate)?
Mechanism?
SE?
Competetively antagonize leukotriene D4
HepatoTox- Monitor LFTs
What is the mechanism of Zileuton
(Zyflo)?
SE?
Inhibity 5-liopxygenase (leukotriene)
Hepatotoxic- Monitor LFTs
2C9- Many DDI
What is the mechanism of anti-cholinergic bronchodilators?
Inhibit effects of ACh on muscarinic receptors -> bronchodilation
What is the mechanism of Ipratropium
(Atrovent)?
SE?
Time to effect?
Anti-cholinergic Blurred Vision Dry Mouth Urinary Retention DDI- Other Anti-ACh meds 30 min onset, 4 hrs duration
What is the mechanism of Tiotropium
(Spiriva)?
SE?
Time to effect?
Anti-cholinergic Blurred Vision Dry Mouth Urinary Retention DDI- Other Anti-ACh meds Onset: 30 min, 24hrs duration
What is the mechanism of Methylxanthines?
Inhibit phosphodiesterase -> increase cAMP + antagonize adenosine receptors = bronchodilates
What are the DDI, SE of theophylline?
What drug class?
Methylxanthine
DDI- SZ meds, rifampin, St Johns Wort, Cipro, Clarothro…. Narrow therapeutic index
HA/N/V
SZ, Arrythmia
What is the MOA of immunomodulators?
How given?
Inhibits binging of IgE to receptors on mast cells and basophils -> prevent release of inflammatory markers
SubQ q2-4 weeks
What class is Omalixumab (Xolair)? SE?
Immunomodulator (IgE)
Risk of anaphylaxis, follow for 2 hours for 3 months, then 30 min
What is the mechanism of monoclonal anti-bodies?
Monoclonal antibody that targets IL-5
IL-5 -> Stimulates maturaltion/release of eosinophils -> inflammation
What class is Mepozimulab (Nucala)? SA? Indication?
Monoclonal antibody Anaphylaxis, angioedema, bronchospasm, hypotension, uticaria, ras Maintenance med for asthma SQ qmonth ** If Hz of herpes zoster, tax 1st
What class is Reslizumab (Cinqair)? SA? Indication?
Monoclonal antibody
SA: Anaphylaxis, malignancy, CPK elevation -> muscle complications, OP pain
Ind: Maintenance severe asthma >18 c eosinophilic phenotype
