Pulmonary Drugs Flashcards
Beclomethasone*
Asthma/COPD
Inhaled glucocorticoid; inhibits synthesis of virtually all cytokines;
1st-line therapy for chronic asthma (except mild asthma)
–> inactivate NF-kB (transcription factor that induces production of TNF-alpha, among other inflammatory agents)
Prednisone*
Asthma/COPD
Oral glucocorticoid
Inhibits synthesis of virtually all cytokines;
1st-line therapy for chronic asthma (except mild asthma)
–> inactivate NF-kB (transcription factor that induces production of TNF-alpha, among other inflammatory agents)
Nicotine*
Tobacco Cessation
Patch, lozenge, gum, inhaler, spray
Varenicline (Chantix)*
Tobacco Cessation
Partial nicotine receptor agonist, blocks effect of real nicotine, 3-fold increase in quitting rate but headache, nausea, insomnia, psychiatric side effects
Bupropion (Zyban)
Tobacco Cessation
Antidepressant, mxn of action not well understood
Diltiazem
Pulmonary Arterial Hypertension
Calcium channel blockers (test vasoreactivity first)
Verapamil
Pulmonary Arterial Hypertension
Calcium channel blockers (test vasoreactivity first)
Epoprostenol
Pulmonary Arterial Hypertension
Prostacyclin analogue
Sildenafil
Pulmonary Arterial Hypertension
PDE5 (Phosphodiesterase 5) inhibitor
Oral
Drug
Bosentan
Pulmonary Arterial Hypertension
Endothelin receptor competitive antagonists (endothelin is protein that constricts blood vessels and raises blood pressure)
–> Result: decreased pulmonary vascular resistance
generally kept in balance
PO?
Omalizumab*
Asthma
Anti-IgE therapy; binds to circulating IgE regardless of specificity (IN CIRCULATION); does not activate complement; forms small, biologically inert omalizumab:IgE complexes
Result: interrupts allergic cascade
Budesonide
Asthma
Glucocorticoid
Omalizumab*
Asthma
Anti-IgE therapy; binds to circulating IgE regardless of specificity; does not activate complement; forms small, biologically inert omalizumab:IgE complexes
Result: interrupts allergic cascade
Albuterol*
Short-Acting Beta2 Agonist (SABA)
Asthma/COPD
“A” for “Acute” asthma attack; relaxes bronchial smooth muscle (beta2)
Use: symptom relief (acute exacerbation)
intermediate duration
aerosols
also affect airway edema and airway inflammation
Salmeterol*
Long-Acting Beta2 Agonists (LABA)
Asthma (longer term)/COPD
Use: controller, prophylaxis
long-acting agent for prophylaxis = prolonged management
adverse effects: tremor and arrhythmia
aerosol
also affect airway edema and airway inflammation
Ipratropium
Short-acting Anti-cholinergic
Asthma/COPD
competitive block of muscarinic receptors –> preventing bronchoconstriction (modest effect)
Use: symptom relief of asthma
used with COPD if there is reversible bronchoconstriction
Tiotropium
Long-Acting Anticholinergic
Asthma/COPD
Use: controller
Budesonide
Glucocorticoids
Asthma
Use: controller
Fluticasone
Glucocorticoids
Asthma
Use: controller
Terbutaline
Short-acting Beta2 Agonist (SABA)
Asthma/COPD
Use: symptom relief
aerosols
also affect airway edema and airway inflammation
intermediate acting!
Montelukast
Asthma
Leukotriene D4 Receptor Antagonist (LTD4) (block leukotriene receptors);
–> especially good for aspirin-induced asthma
Zafirlukast
Asthma
Leukotriene D4 Receptor Antagonist (LTD4) (block leukotriene receptors);
–> especially good for aspirin-induced asthma
Chromolyn Sodium
Asthma
Mast cell stabilizer prevents release of mediators from mast cells; effective ONLY for *prophylaxis against asthma* NOT EFFECTIVE DURING ACUTE ASTHMA ATTACK --> block airway inflammation Toxicities: rare
Zileuton
Asthma
5-lipoxygenase pathway inhibitor;
blocks conversion of arachadonic acid to leukotrienes
–> may be good in children to avoid giving them glucocorticoids; also to patients with ASPIRIN SENSITIVITY or whose asthma is exacerbated by other NSAIDS
