Pulmonary Anti-Inflammatories Flashcards
3 pulmonary anti-inflammatories
LTRAs
inhaled corticosteroids
mast cell stabilizers
2 Leukotriene receptor antagonist (LTRA) drugs
montelukast (Singulair)
zafirlukast (Accolade)
What do leukotrienes cause
inflammation, bronchoconstriction, and mucus production
MOA of leukotriene receptor antagonist (LTRA)
LTRAs prevent leukotrienes from attaching to receptors located on immune cells and within the lungs -> prevents inflammation
How is LTRAs given
PO
What are LTRAs used for
oral prophylaxis and chronic treatment of asthma in adults and children
Can also be given for allergies
What are LTRAs not used for
actue asthma attacks
Adverse effects of LTRAs
headache nausea dizziness insomnia diarrhea
T/F Montelukast has few drug-drug interactions
TRUE
T/F Zafirlukast has several drug-drug interactions
TRUE
3 inhaled corticosteroids
beclomethasone diproprionate (Beclovent)
budesonide (Pulmicort Turbuhaler)
fluticasone (Flovent)
how are inhaled corticosteroids given
via nebulizer or MDI
MOA of inhaled corticosteroids
reduce inflammation and enhance activity of beta agonists
Also help with bronchodilation
how long will it take inhaled corticosteroids to be in full effect
several weeks
why is inhaled corticosteroids given
Given for prevention of persistent asthma attacks and long-term maintenance of severe COPD
T/F Inhaled corticosteroids are a rescue drug
FALSE
what needs to be taught for asthma with inhaled corticosteroids
teach to take on a regular schedule, not PRN & give the bronchodilator first to allow more thorough absorption of the steroids
Adverse effects of inhaled corticosteroids
pharyngeal irritation, coughing, dry mouth, and oral fungal infections
What should a patient do after inhaled corticosteroid use
rinse mouth
What are the 2 combos of Inhaled glucocorticoid & bronchodilators
budesonide &formoterol (Symbicort)
fluticasone & salmeterol (Advair)
what are inhaled glucocortiocoid and bronchodilator combos used for
Used for moderate to severe asthma
key teaching point for glucocortiocoid and bronchodilator combos
NEVER USED FOR ACUTE ATTACKS
Mast cell stabilizer drug
cromolyn (Intal)
MOA of cromolyn
stabilize membranes of mast cells & prevent release of broncho-constrictive inflammatory substances
what is cromolyn used for
prevention of acute asthma attacks
when should cromolyn be administered
15-20 minutes prior to known triggers
monoclonal antibody anti-asthmatic drug
omalizumab (Xolair)
MOA of omalizumab
monoclonal antibody which selectively binds to immunoglobulin IgE -> limits the release of mediators of allergic response
how is omalizumab be given
injection
what must be monitored during omalizumab
Must be monitored closely for hypersensitivity reactions (anaphylaxis big risk)
Indication of omalizumab
indicated for add-on therapy for asthma
omalizumab is the newest generation of what
anti-asthmatic
selective PDE-4 inhibitor drug
roflumilast
MOA of roflumilast
selectively inhibits PDE4 enzyme in the lung cells
Potent anti-inflammatory effects within the lungs
what is roflumilast indicated for
prevention of COPD exacerbations
what is roflumilast not used for
acute/immediate action
How is roflumilast
orally
S/E for roflumilast
N/V/D,
headache,
muscle spasms, decreased appetite, uncontrollable tremors
6 Long-term control medication PREVENTERS of asthma
Anticholinergics Xanthine derivative Inhaled corticosteroids Leukotriene modifiers Mast cell stabilizers LABA
2 quick relief medications of asthma
SABA
albuterol/Proventil
