Pulmonary Anti-inflammatory's

Question 1

Metered-Dose Inhalers

Answer 1

Small, handheld, measured dose with each puff
Dose:1-2 puffs over 1 minute
Spacers are highly recommended to increase the amount of drug to site of infection
Require coordination

Question 2

Nebulizer

Answer 2

Converts a drug solution into a mist (finer droplets than inhalers)
Facemask or handheld mouthpiece
No coordination required
Common in office or home. Portable
Children and end-stage diseases

Question 3

Respimats

Answer 3

Inhaler that delivers a fine mist
Doesn’t use propellants
Delivers actuation over 1-1.5 seconds
Extremely small particle size to ensure delivery of drug to site of action (lungs)

Question 4

Dry Powder Inhaler

Answer 4

DPI’s deliver a dry, micronized powder, directly to the lungs
Breath activated
Deliver a lil bit more than an MDI with no spacer to the lungs

Question 5

Anti-Inflammatory Drugs

Answer 5

Glucocorticoids
Leukotriene Modifiers
Omalizumab
Roflumilast

Question 6

Glucocorticoids

Answer 6

Asthma, COPD
First line agent in Asthma
Suppresses inflammation and reduces bronchial hyperreactivity
ADR: Inhaled- minor and rare, oropharyngeal candidiasis (oral thrush) and hoarseness. RINSE mouth AFTER USE. Immune reduction allows overgrowth of fungal organisms if they stay in the mouth.

Question 7

Oral Glucocorticoids

Answer 7

ADRs from chronic use, systemic effects

Rare unless chronic use

Question 8

Fluticasone

Answer 8

ICS
Asthma
CONTRA: Hypersensitivity to milk proteins or lactose

Question 9

Beclomethasone

Answer 9

Oral Glucocorticoid
Maintenance and prophylactic Asthma.
CONTRA: status asthmaticus or acute asthma episodes requiring intensive measures

Question 10

Mometasone

Answer 10

ICS
Asthma maintenance
CONTRA: Hypersensitivity to milk proteins, primary treatment of status asthmaticus, or other acute episodes of asthma requiring intensive measures

Question 11

Montelukast

Answer 11

Leukotriene Receptor Antagonist
Asthma (2nd line agent after steroids), allergic rhinitis, exercise induced bronchoconstriction
Leukotriene Modifier
BOX: SERIOUS neuropsychiatric events

Question 12

Zafirlukast

Answer 12

For Asthma
Leukotriene receptor antagonist
CONTRA: Hepatic impairment
ADR: Headache

Question 13

Zileuton

Answer 13

Asthma
Inhibits 5-Lipoxygenase
CONTRA: Active liver disease or liver enzymes > 3x ULN
ADR: Headache

Question 14

Roflumilast

Answer 14

COPD
Enzyme Inhibitor
CONTRA: Moderate to sever liver impairment

Question 15

Omalizumab

Answer 15

Asthma, chronic spontaneous urticaria
IgG monoclonal Abs that inhibit IgE from binding to Mast Cells
BOX: Anaphylaxis, requires close monitoring
ADR: Injection site reactions

Question 16

Budesonide

Answer 16

Asthma control
CONTRA: Milk
Can be nebulized for the kiddos