Week 10 - Asthma, Antiinflammatory and Bronchodilators

Question 1

What is asthma? (2)

Answer 1

• Chronic disease in which reversible acute airway obstruction occurs intermittently, reducing airflow
• airway obstruction occurs by both inflammation and airway tissue sensitivity with bronchoconstriction

Question 2

In asthma, what does inflammation cause? (2)

Answer 2

• inflammation triggers an attack due to various reasons (allergens, irritants, GERD)
• leads to wheezing, dyspnea, coughing, which can exacerbate to respiratory failure

Question 3

Which patients is asthma often noted in? (2)

Answer 3

• in children
• seen in ER if severe (status asthmaticus)

Question 4

Asthma is treated similar to ___ patients

Answer 4

COPD

Question 5

What are the two main classes of drugs used for asthma and COPD?

Answer 5

• Antiinflammatory agents and bronchodilators

Question 6

Which drug is a principle antiinflammatory, and when is it administered? (3)

Answer 6

glucocorticoids
- Fluticasone
- administered on a fixed schedule by inhalation for stable COPD/asthma

Question 7

Which drug is a principle bronchodilator and when is it administered? (3)

Answer 7

• Beta 2 agonists
• salbuterol and salmeterol
• may be administered on fixed schedule (long-term control) or PRN (acute attack) by inhalation
  ie. anxiety attack

Question 8

What is the MOA of fluticasone? (4)

Answer 8

• decreases airway inflammation
• decreased synthesis and release of proinflammatory hormones
• decreased activity of inflammatory cells
• decrease edema of the airway mucosa

Question 9

What are the indications for fluticasone?

Answer 9

• control inflammation of asthma and COPD

note than ppl with COPD have chronic bronchitis and therefore inflammation

Question 10

What are the adverse effects of fluticasone? (2)

Answer 10

oral thrush
- so rinse mouth with water after administration

Question 11

Why is fluticasone a controller drug? (2)

Answer 11

• maintenance use
• cannot stop an acute episode and should not be used alone

Question 12

If there are exacerbations with flovent use, what should occur?

Answer 12

• may change to oral or IV steroids if severe enough

Question 13

Salbuterol and salmeterol are bronchodilators. What are their MOA? (2)

Answer 13

• provide symptomatic relief by causing bronchiolar smooth muscle relaxation, but no effect on inflammation
• sympathomimetic drugs that activate beta2-adrenergic receptors, promoting bronchodilation and relieving bronchospasm

Question 14

What are the indications for salbuterol and salmeterol?

Answer 14

• provide short term and rapid symptomatic relief for patients with asthma and COPD (rescue breathing drug, works W/I seconds)

Question 15

When is salbuterol/Ventolin taken? (3)

Answer 15

• PRN for ongoing SOB
• rescue/reliever drug
• short acting

Question 16

When is salmeterol taken? (2)

Answer 16

• long-term control, long acting
• fixed schedule (COPD)

Question 17

What is the onset of action for salbuterol and salmeterol?

Answer 17

• short acting is almost immediate, duration 5 hours

Question 18

What are the adverse effects of salbuterol and salmeterol? (2)

Answer 18

• short acting (tachycardia, angina, tremor)
• Long acting (never use as first line therapy for prolonged control or alone)