Test 4 - Pulm Flashcards
Drugs to treat ashtma
Beta 2 agonists - sympathomimetic agents Theophylline (methylxanthines) Antimuscarinic agents Corticosteroids Leukotriene pathway inhibitors
B2 agonist MOA
Bind to b2 receptors on smooth muscle — activates AC to yield CAMP which relaxes bronchial and tracheal smooth muscle
Short acting b2 agonists
Albuterol and levalbuterol
Long acting b2 agonists
Advair - salmeterol/fluticasone
Symbicort - Formoterol/budenoside
SABA duration of action
4 hours
Max bronchodilation with SABA achieved after ___________ of inhalation
15 minutes
This Saba is a purer form and causes less tachycardia
Levalbuterol
Salmeterol/Formoterol duration of action
12 hours - 2x a day dosing
Salmeterol/Formoterol always used in combo with a _____________
Corticosteroid
Sympathomimetic (b2) AE
Transient tachy, palpitations, tremor, excitability, headache, hypokalemia
Theophylline is given _________
Orally
Theophylline requires _______________
Therpeutic drug monitoring
Due to side effects and newer agents, Theophylline is now used as an add-on for
Maintenance therapy in refractory disease
Short acting antimuscarinic
Ipatropium (atrovent)
Long acting antimuscarinic
Tiotropium (spiriva)
Ipratropium is given via inhalation route for ___________
Acute episodes of asthma
Ipratropium has _________ systemic absorption. It does not enter the _______
Minimal; CNS
Ipratropium has enhanced bronchodilation when combined with _________
Albuterol
Ipratropium bromide + albuterol=
Combivent
Tiotropium is used for as maintenance therapy for _________
COPD
Corticosteroids inhibit the production of _____________
Cytokines
Are corticosteroids bronchodilators?
NO
Corticosteroids reduce _____________
Hyper-reactivity
Corticosteroids are given routinely via inhalation as ____________ in moderate to severe asthma
Maintenance therapy
Corticosteroids are given via oral route for ___________ AND ___________
Severe, acute episodes and refractory disease
Common corticosteroid side effects
Hoarseness and oral thrush (rinse mouth!)
Inhaled corticosteroid agents
Budenoside
Fluticasone
Leukotrine pathway inhibitor agents
Singulair and Zyflo
LPI most commonly used
Singulair
Zyflo is associated with __________
Liver toxicity
LPIs are given __________
Orally
LPIs are used for __________
Maintenance control
Reassess pt ________ after each med adjustment
2-6 weeks
Baseline treatment for ashtma
SABA for rescue (everyone should have!)
SABA > 2 times per week first step
Low dose inhaled steroid or singulair (LPI)
SABA > 2 x a week second step
Medium dosed inhaled steroid OR
Add LABA/steroid
SABA > 2x a week third step
Medium dosed inhaled steroid + LABA
SABA > 2x a week fourth step
Consult asthma specialist for addition of oral steroids, high dose inhaled steroid, antibody
____________ more commonly seen in COPD vs. Asthma
Long-acting antimuscarinics
_______ is not used in COPD
IgE
___________ are usually dosed significantly higher in COPD
Corticosteroids
___________ may be used if infection is present with COPD
Antibiotics
