respiratory therapy Flashcards
- Leukotriene Inhibitors
- Beta-2 Agonists
- Steroidal Anti-Inflammatories
respiratory therapy drug classes
Asthma, chronic obstructive pulmonary disease (COPD), and allergic rhinitis
commonly encountered respiratory diseases
_________ is a chronic disease characterized by hyper-responsive airways
asthma
______ includes emphysema and chronic bronchitis and is currently the fourth most common cause of preventable deaths in the US
COPD
ATOPIC and hypersensitive pt
steroid responders
characterized by itchy, watery eyes, runny nose, and a nonproductive cough, is an extremely common condition
allergic rhinitis
- Montelukast [Singulair®]
- Albuterol [ProAir HFA®]
- Fluticasone/Salmeterol [Advair Diskus®]
- Mometasone [Nasonex®]
respiratory therapies
extremely susceptible to pneumonia due to phlegm
pt with bronchitis
pt presents with conjunctivitis in addition to what disease due to nasal and eye pathway connection?
allergic rhinitis
most prescribed/popular leukotriene inhibitor
montelukast (singulair)
• INDICATION
– Asthma*, bronchospasm, allergic
rhinitis
• DOSING [10mg] – 1 tab qd
montelukast
drug is used chronically and for prophylaxis
montelukast
CLINICAL PHARMACOLOGY – Leukotriene Inhibitor
• Mechanism of Action
– 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
montelukast
blocks leukotriene receptor specifically
montelukast
unlike albuterol, this drug is not an aerosol
montelukast
ADVERSE EFFECTS
• Common: headache, flu-like symptoms, pruritus, rash, restlessness
SERIOUS ADVERSE EFFECTS
• Hematology: thrombocytopenia
• Hypersensitivity: erythema nodosum, angioedema
montelukast adverse effects
ADVERSE EFFECTS
• Common: headache, flu-like symptoms, pruritus, rash, restlessness
SERIOUS ADVERSE EFFECTS
• Hematology: thrombocytopenia
• Hypersensitivity: erythema nodosum, angioedema
montelukast adverse effects
instead of pt using beta 2 agonist and steroids, if put on this drug it can reduce adverse side effects of the other drugs that could have serious complications
montelukast
serves as chemotaxic (recruitment of immune cells) mediators
leukotriene
by blocking leukotriene what happens to immune system
immune system is unable to respond –> therefore flu symptoms are created
CONSEQUENCE of thrombocytopenia
hemmorhage
thrombocytopenia
platelet reduction in circulation
erythema nodosum
development of redness, manifested in arms and shin
DRUG INTERACTIONS
• None involving ocular therapeutics
montelukast drug interaction
short acting beta two agonist
number one drug to provide quick relief of symptoms in asthma
can produce cataracts, elevated iop, impaired wound healing, infection
steroids
• INDICATION
– Asthma, bronchospasm, COPD
• DOSING [90μg/puff] – 2 puffs q4-6h
albuterol
distinction b/w montelukast and albuterol
albuterol is inhaled through mouth therefore only benefits lungs; while montelukast benefits nose and lungs
distinction b/w montelukast and albuterol
albuterol is inhaled through mouth therefore only benefits lungs; while montelukast benefits nose
distinction b/w montelukast and albuterol
albuterol is inhaled through mouth therefore only benefits lungs; while montelukast benefits nose
• CLINICAL PHARMACOLOGY – Short Acting β2 Agonist
• Mechanism of Action
– Selectively stimulates β2 adrenergic receptors causing relaxa3on in airway smooth muscle
albuterol moa
ADVERSE EFFECTS
• Common: cough, dizziness, headache SEVERE ADVERSE EFFECTS
• Respiratory: paradoxical bronchospasm
• CVS: hypertension, angina, MI, arrhythmias
albuterol adverse effects
cough due to local irritation; different cough than salmeterol???
albuterol
causes a paradoxical bronchospasm
albuterol
would u use phenylephrine to dilate on a pt taking albuterol?
no, cuz it might increase bp further; always check their bp
how do we remember hyper/hypotension?
think beta 2 agonist elevates bp
if taking too much albuterol, it can effect bp how?
increase it
DRUG INTERACTIONS
• Amphotericins, CAIs, Steroids, Macrolides (Hypokalemia)
• Macrolides, Fluoroquinolones, Azoles (QT prolongation)
• Sympathomimetics (Additive)
albuterol drug interactions
would u use phenylephrine to dilate on a pt taking albuterol?
no cuz it might increase bp further; always check their bp
how do beta blockers work for treating glaucoma?
Beta-blocker eyedrops work well to reduce how much fluid is made in the eye. They lower the pressure inside the eyes by about 25%. (reduce aqhu and lower pressure)
how do beta blockers work for treating glaucoma?
Beta-blocker eyedrops work well to reduce how much fluid is made in the eye. They lower the pressure inside the eyes by about 25%. (reduce aqhu and lower pressure)
asthma treatment for long term control
long acting beta 2 agonist and/or corticosteroid
asthma treatment for quick relief of symptoms
short acting beta 2 agonist
unlike the cough, an adverse effect seen in ace inhibitors, this drug causes a cough due to local inflammation
albuterol
