Respiratory Meds Flashcards
What is Montelukast [Singulair®] used for?
It is a leukotriene inhibitor used to treat:
- Asthma, both prophylactic and chronic.
- Bronchospasm.
- Allergic rhinitis.
What is Albuterol [ProAir HFA®] used for?
It is a bet-2 agonist used to treat:
Asthma.
Bronchospasm.
COPD.
What is Fluticasone/Salmeterol [Advair Diskus®] used for?
It is a steroid combo used as a first line to treat:
Any degree of persistent asthma (mild, moderate, or severe)
What is Mometasone [Nasonex®] used for?
It is a stand-alone steroid therapy used to treat:
Allergic Rhinitis.
Nasal Polyp Therapy.
What is Acetylcysteine used for?
It is a mucolytic used to treat:
Excess Mucous.
Acetaminophen Overdose.
What are the contraindications for Acetylcysteine?
None
What are the contraindications for Mometasone?
Nasal septal ulcer, recurrent epistaxis
TB infection
Ocular HSV infection, glaucoma, cataracts, vision changes
What are the drug interactions of concern with Montelukast?
None with ocular therapies.
What are the drug interactions of concern with Albuterol?
Amphotericins, CAIs, Steroids, Macrolides (Hypokalemia)
Macrolides, Fluoroquinolones, Azoles (QT prolongation)
Sympathomimetics (Additive)
What are the drug interactions of concern with Advair Diskus?
Β-Blockers (Antagonistic)
Cyclosporine, Azole antifungals (Impaired Metabolism)
Macrolides, Amphotericins, CAIs, Steroids (Hypokalemia)
Macrolides, Sympathomimetics (QT Prolongation)
What are the drug interactions of concern with Mometasone?
None
What are the drug interactions of concern with Acetylcysteine?
None
What are the side effects of Montelukast?
ADVERSE EFFECTS
Common: headache, flu-like symptoms, pruritus, rash, restlessness
SERIOUS ADVERSE EFFECTS
Hematology: thrombocytopenia
Hypersensitivity: erythema nodosum, angioedema
What are the side effects of Albuterol?
ADVERSE EFFECTS Common: cough, dizziness, headache SEVERE ADVERSE EFFECTS Respiratory: paradoxical bronchospasm CVS: hypertension, angina, MI, arrhythmias
What are the side effects of Fluticasone?
ADVERSE EFFECTS
Common: headache, cough, pyrexia, epistaxis, nasopharyngitis
SEVERE ADVERSE EFFECTS
Hormonal: adrenal suppression, hypercorticism, pediatric growth suppression
Nasal: nasal/oral candidiasis, nasal ulcer or septal perforation
Ocular: cataracts, glaucoma, elevated IOP
What are the side effects of Salmeterol?
ADVERSE EFFECTS
Common: headache, nasal congestion, rhinitis, bronchitis, urticaria, tachycardia
SEVERE ADVERSE EFFECTS
Hypersensitivity: anaphylaxis, angioedema
Respiratory: bronchospasm (paradoxical), asthma exacerbation/death
CV: arrhythmia, HTN
What are the side effects of Mometasone?
ADVERSE EFFECTS
Common: Headache, viral infection, epistaxis, conjunctivitis
NOTABLE ADVERSE EFFECTS
Sinus: Septal perforation, ulcer, candidiasis
Ocular: Elevated IOP, glaucoma
What are the side effects of Acetylcysteine?
ADVERSE EFFECTS
Common: Flushing, pruritus, tachycardia
What is the mechanism of action for Actylcysteine?
A mucolytic
Breaks disulfide bonds, decreasing mucus viscosity.
Replenishes glutathione, facilitating non-toxic metabolism of acetaminophen.
What is the mechanism of action of mometasone?
A corticosteroid nasal spray
Inhibits multiple inflammatory cytokines;
produces multiple glucocorticoid and mineralocorticoid effects
What is the mechanism of action for SALMETEROL?
A bronchodilator
Chemical analog of Albuterol having a lipophilic side chain that enhances duration of action;
like Albuterol, this β2 Agonist produces relaxation of airway smooth muscle.
What is the mechanism of action for FLUTICASONE?
A Steroidal Anti-Inflammatory
Acts through classic steroid pathway inhibiting arachidonic acid-based eicosanoid production
What is the mechanism of action for Albuterol?
A short Acting β2 Agonist
Selectively stimulates β2 adrenergic receptors causing relaxation in airway smooth muscle
What is the mechanism of action for montelukast? (Singulair)
A Leukotriene Inhibitor
Selectively binds to airway cysteinyl leukotriene receptors blocking their stimulation by their endogenous ligands (LTC4, LTD4, LTE4) which are released by mast cells and eosinophils
