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Pharmacology > Week 6 Asthma > Flashcards

Week 6 Asthma Flashcards

1
Q

List the common triggers

A

Allergies
Irritants (tabaco, pollution)
Exercise
Medication (NSAIDs, B blocker)
Infection (cold, sinusitis)
Exposure (cold, dry air)
Acid reflux

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2
Q

Describe the process of airway remodeling

A

Long time change to asthmatic pt airway
→cause structural change

Basement membrane thickens
Goblet cells thicken

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3
Q

Symptoms of a patient with asthma

A

Wheezing
Cough
Chest tightness
Shortness of breath
Dyspnea/Shortness of breath

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4
Q

Role of spirometry and what measure?

A

Diagnostic process (require!!)
Measure force and volume

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5
Q

Role of peak flow meter and what measure?

A

Measures force
Used daily at home to possible predict

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6
Q

Describe the four classes of asthma

A
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7
Q

What is the Metered Dose Inhaler?

A

Drug in solution or suspension in a pressurized canister
Must shake if suspension

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8
Q

Metered Dose Inhaler
a) Advantages
b) Disadvantages

A

a) Small and convenient
b) Technique-dependent efficacy

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9
Q

What is the Spacer Device?

A

Used only with MDIs
Allows evaporation of propellant prior to inhalation
enhanced lung delivery

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10
Q

Spacer Device
Advantages

A

Decreased oropharyngeal deposition
Enhanced lung delivery
Eliminates need for good lung-hand coordination

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11
Q

What is the Dry Powder Inhaler (DPI)?

A

Breath actuated micronized powder

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12
Q

Dry Powder Inhaler
a) Advantages
b) Disadvantages

A

a) Requires minimal hand-lung coordination

b) Require higher inspiratory flows than MDIs
Powder may irritate throat and cause cough

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13
Q

What is the Nebulizer?

A

Use pressure or vibration to aerosolize liquid medication

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14
Q

Nebulizer
a) Advantages
b) Disadvantages

A

a) Requires no special technique
Can be used in patients unable to take
　deep or forceful breaths

b) Requires electricity (plug-in or battery)
Longer duration of treatment
　(10-15 minutes)

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15
Q

How to use Metered Dose Inhaler?

A

Take off the cap and shake it!
Breath out
Breathe in SLOWLY!! then actuate inhaler
Hold the breath as long as comfortable
breath out slowly

Wait 1-2 min to do more

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16
Q

Inhaled Corticosteroids
Medications name 6

A

Mometasone (Asmanex®)
Beclomethasone (QVAR®)
Budesonide (Pulmicort®)
Triamcinolone
Flunisolide (Aerobid®)
Fluticasone (Flovent®)
Triamcinolone (Azmacort®)

Mom,Bec, Bud tri (try)

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17
Q

Inhaled Corticosteroids
Characteristics

A

Anti-inflammatory
Reduce responsiveness to asthma triggers

First-line treatment for control
All ages

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18
Q

Inhaled Corticosteroids
Adverse effects

A

Cough
Oral thrush (topical fungal infections)
Hoarseness
Possible systemic effects

19
Q

Inhaled Corticosteroids
Reducing Adverse effects

A

Administer with aerochamber spacer device
Rinse mouth thoroughly following inhalation
Always use the lowest effective dose

20
Q

Long-Acting β2 Agonists/LABA
Medication name

A

Salmeterol
Formoterol
Vilanterol (only in combination products)

21
Q

Long-Acting β2 Agonists/LABA
Characteristics

A

ONLY used in addition to inhaled ICS in patients with asthma
Black Box Warning
Can be used alone in COPD

22
Q

Long-Acting β2 Agonists/LABA
What is the black box waring?

A

Pt is more likely to die for asthma attack if used alone to prevention

23
Q

Leukotriene Receptor Antagonists
Medication name

A

Montelukast
Zafirlukast

24
Q

Leukotriene Receptor Antagonists
Characteristics

A

Block leukotriene receptors and prevent bronchoconstriction
Not a bronchodilator – NOT for rescue
Mainly adjunctive therapy

25
Q

Leukotriene Receptor Antagonists
Advantages

A

Oral administration
Well tolerated in children and adults
Useful in patients with poor inhaler technique

Use with ICS or LABA

26
Q

Mast Cell Stabilizers
Characteristics

A

Prevents mast cell degranulation during asthma attacks
NOT a bronchodilator

27
Q

Mast Cell Stabilizers
Advantages

A

Very well tolerated
unpleasant taste

28
Q

Mast Cell Stabilizers
indication

A

Pt with allergen mediated and exercise induced bronchoconstriction

29
Q

Methylxanthines
Medication

A

Theophylline (PO)
Aminophylline (IV)

30
Q

Methylxanthines
Characteristics

A

Smooth muscle relaxation
3rd line

31
Q

Leukotriene Receptor Antagonists
Disadvantages

A

Lacks anti-inflammatory properties
Many ADRs/Serious ADRs

Need to monitor serum drug concentrations
Therapeutic range = 10-20 mcg/ml

32
Q

Methylxanthines
ADRs

A

Common ADRs
Insomnia
GI upset (including vomiting)
Tachycardia
Headaches

Serious ADRs
Seizures
Cardiac arrhythmias

33
Q

Short-Acting β2 Agonists/SABA
Medication name

A

Albuterol
Levalbuterol

34
Q

Short-Acting β2 Agonists/SABA
Indications

A

Quick relief of acute symptoms
Preventative treatment prior to exposure to trigger

Being replaced by formoterol + inhaled corticosteroid LABA+ICS

35
Q

Short-Acting β2 Agonists/SABA
Mechanism

A

Stimulates β2 receptors in the lung　
Smooth muscle relaxation → bronchodilation

36
Q

Short-Acting β2 Agonists/SABA
ADR

A

Tremor
Tachycardia

d/t stimulating B1 receptors in heart

37
Q

Short-Acting Muscarinic Antagonists(SAMA)
Medication name(SAMA)

A

Ipratropium
Oxitropium

38
Q

Short-Acting Muscarinic Antagonists(SAMA)
indication

A

Relief of acute bronchospasm
Reverses acetylcholine-induced bronchospasm

39
Q

Short-Acting Muscarinic Antagonists(SAMA)
ADRs

A

Dry mouth
headache
dizziness
Anticholinergic effects

40
Q

Short-Acting Muscarinic Antagonists(SAMA)
Place in therapy

A

Used as an additive drug with SABA
Never used alone for rescue
No effect on exercise-induced asthma
Do not use open mouth inhaler technique

41
Q

Systemic Corticosteroids
Medication name

A

Methylprednisolone – IV
Prednisolone – Syrup
Prednisone – Oral tablet

42
Q

Systemic Corticosteroids
indication

A

Pt with severe exacerbation or a longer duration of exacerbation

Reverses inflammation and speeds up recovery by preventing
profession of exacerbation 悪化

43
Q

Systemic Corticosteroids
ADR

A

Adrenal suppression
Osteoporosis
Hypertension
Hyperglycemia
Weight gain, fluid retention
Cataracts and glaucoma
Slow wound healing

Pharmacology (34 decks)

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