Pulmonary drugs Flashcards
Albuterol
beta 2 agonist short acting ^ cAMP causes bronchodilation, mast cell stabilization, and skeletal muscle stimulation ADR: tachycardia, tremors, transient dec. in K levels, lactic acidosis USES: acute asthma exacerbation, exercise induced asthma, acute COPD
Levalbuterol
beta 2 agonist short acting ^ cAMP causes bronchodilation, mast cell stabilization, and skeletal muscle stimulation ADR: tremors, tachycardia, transient dec. in K levels, lactic acidosis USES: acute asthma exacerbation, exercise induced asthma, acute COPD
Terabutaline
beta 2 agonist short acting ^ cAMP causes bronchodilation, mast cell stabilization, and skeletal muscle stimulation ADR: tachycardia, tremors, transient dec. in K levels, lactic acidosis USES: acute asthma exacerbation, exercise induced asthma, acute COPD
Formoterol
beta 2 agonist long acting ^cAMP causes bronchodilation, mast cell stabilization, and skeletal muscle stimulation ADR: tachycardia, tremor, lactic acidosis, transient dec. in K levels Must be combined with ICS to prevent increased risk of asthma related death USES: prevention of asthma attack, COPD maintenance
Salmeterol
beta 2 agonist long acting ^cAMP causes bronchodilation, mast cell stabilization, and skeletal muscle stimulation ADR: tachycardia, tremors, transient dec. in K levels, lactic acidosis must be combined with ICS to prevent increased risk of asthma related deaths USES: prevention of asthma attacks; maintenance of COPD
Indacaterol
beta 2 agonist long acting ^cAMP causes bronchodilation, mast cell stabilization, and skeletal muscle stimulation ADR: tachycardia, tremors, transient dec. in K levels, lactic acidosis Must be given with ICS to prevent increased risk of asthma related deaths USES: prevention of asthma attacks; maintenance of COPD
Vilanterol
beta 2 agonist long acting ^ cAMP results in bronchodilation, mast cell stabilization, and skeletal muscle stimulation ADR: tachycardia, tremors, transient dec. in K levels, lactic acidosis Must be given with ICS to prevent increased risk of asthma related deaths USES: prevention of asthma attacks; maintenance of COPD
Ipratropium Bromide
anticholinergic short acting inhibits M1 and M3 which results in dec. cGMP –> bronchodilation ADR: blurred vision, dry mouth, nausea, urinary retention, tachycardia, CNS effects (low bioavailibility so minimal side effects) USES: acute asthma, acute COPD, maintenance of COPD bronchospasms
Tiotropium
anticholinergic long acting inhibits M1 and M3 results in decreased cGMP–> bronchodilation ADR: blurred vision, dry mouth, nausea, urinary retention, tachycardia, CNS effects USES: maintenance of COPD
Acidinium bromide
anticholinergic long acting blocks M1 and M3 resulting in decreased cGMP —> bronchodilation ADR: blurred vision, dry mouth, nausea, urinary retention, tachycardia, CNS effects USES: maintenance of COPD
Umeclidinium bromide
anticholinergic long acting blocks M1 and M3 resulting in decreased cGMP –> bronchodilation ADR: blurred vision, dry mouth, nausea, urinary retention, tachycardia, CNS effects USES: maintenance of COPD
Theophylline
methylxanthine inhibits PDE and increase cAMP–> bronchodilation inflammatory cell regulator ADR: GI upset, tachyarrthymias, seizures, jitteriness USES: acute asthma; emphysema, chronic bronchitis
Beclomethasone
inhaled corticosteroid reduces inflammatory cells activation, recruitment, and infiltration decrease vascular permeability ADR: bone resorption, metabolism, skin thinning, candidiasis, GR
Budenoside
inhaled corticosteroid reduces inflammatory cells activation, recruitment, and infiltration decrease vascular permeability ADR: bone resorption, metabolism, candidiasis, GR
Fluticasone
inhaled corticosteroid reduces inflammatory cells activation, recruitment, and infiltration decrease vascular permeability ADR: bone resorption, metabolism, candidiasis, GR
Mometasone
inhaled corticosteroid reduces inflammatory cells activation, recruitment, and infiltration decrease vascular permeability ADR: bone resorption, metabolism, candidiasis, GR
Triamcinolone
inhaled corticosteroid reduces inflammatory cells activation, recruitment, and infiltration decrease vascular permeability ADR: bone resorption, metabolism, candidiasis, GR
Methylprednisolone
systemic corticosteroid reduces inflammatory cells activation, recruitment, and infiltration decrease vascular permeability ADR: hyperglycemia, HTN, fractures, sodium and water retention, impaired wound healing, infections, glaucoma, pancreatitis
Prednisone
systemic corticosteroid reduces inflammatory cells activation, recruitment, and infiltration decrease vascular permeability ADR: hyperglycemia, HTN, fractures, sodium and water retention, impaired wound healing, infections, glaucoma, pancreatitis
Hydrocortisone
systemic corticosteroid most potent mineralcorticoid reduces inflammatory cells activation, recruitment, and infiltration decrease vascular permeability
Dexamethasone
systemic corticosteroid most potent anti-inflammatory longest acting reduces inflammatory cells activation, recruitment, and infiltration decrease vascular permeability ADR: hyperglycemia, HTN, fractures, sodium and water retention, impaired wound healing, infections, glaucoma, pancreatitis
Cromolyn
anti-inflammatory
mast cell stabilizer; inhibits activation and release of mediators from eosinophils and epithelial cells
ADR: cough and wheezing
USES: prevention of asthma; prior to exercise or exposure to allergens
Nedocromil
anti-inflammatory
mast cell stabilization; inhibits activation and release of mediators from eosinophils and epithelial cells
ADR: coughing, wheezing, and bad taste
USES: prevention of asthma; prior to exercise or exposure to allergens
Zafirlukast
Leukotriene receptor antagonist
prevents mucus secretion, bronchoconstriction, and eosinophil recruitment
ADR: headache, nausea, abdominal pain
USES: prevention of mild-persistent asthma; allergic rhinitis
Montelukast
Leukotriene receptor antagonist
prevents mucus secretion, bronchoconstriction, and eosinophil recruitment
ADR: headache, nausea, abdominal pain
USES: prevention of mild-persistent asthma; allergic rhinitis
Zileuton
leukotriene modifier–> 5-lipoxygenase inhibitor
prevents conversion of arachidonic acid to leukotriene
ADR: liver toxicity, hyperbilirubinemia
Not used much
Use: mild-persistent asthma, allergic rhinitis
Omalizumab
Anti-IgE
ADR: anaphylaxis
USES: treatment of severe allergic asthma
Mepolizumab
Anti- IL5
ADR: hypersensitivity reaction/anaphylaxis, injection site reaction, headache, myalgia
USE: severe allergic asthma (add on therapy)
Anti-histamines
1st generation
competitive antagonist to H1 receptors
prevent histamine binding and thereby prevent bronchoconstriction
lipophilic so more side effects than 2nd generation
ADR: sedation
USES: allergic reactions, allergic rhinitis, motion sickness
Anti-histamine
2nd generation
competitive anatonist to H1 receptors
prevent histamine binding and thereby prevent bronchoconstriction
USES: allergic reactions, allergic rhinitis
Antitussives- opioids
codeine, hydrocodone, hydromorphone
act centrally to increase cough threshold
ADR: nausea, vomiting, sedation, and constipation
USES: suppression of cough
Benzonatate
anti-tussive
blocks cough reflex (acts at the stretch receptors of vagal afferents)
ADR: nausea, mucosal numbness
USES: cough
Guanifenesin
expectorant
loosens and thins lower respiratory secretions
ADR: nausea, vomiting, dizziness, and diarrhea (from sorbitol)
USES: ineffective productive coughs
Nintedanib
tyrosine kinase inhibitor
ADR: GI, increased liver enzymes, MI, increased bleeding risk
USES: pulmonary fibrosis
Pirfenidone (esbriet)
ADR: photosensitivty, liver toxicity, skin rash
USE: pulmonary fibrosis
