Beta2 Adrenergic Agonists- Classification
bronchodilator
Beta2 Adrenergic Agonists- Mech of Action
- stimulate adenylyl cyclase causing increase of cAMP resulting in bronchodilatation
- inhibits relase of mediators from mast cells that cause bronchospasm
Beta2 Adrenergic Agonists- Route of Administration
- inhalation
- oral
- subcutaneous (terbutaline only)
Beta2 Adrenergic Agonists- Therapeutic Use
- symptomatic relief of bronchospasm in acute asthma attacks
Beta2 Adrenergic Agonists- Unique Use
- subcutaneous terbutaline for atatus asthmaticus
- bitolterol for nocturnal asthma
Beta2 Adrenergic Agonists- Side Effects
- skeletal muscle tremor
- anxiety
- tachycardia
Theophylline- Classification
bronchodilator
Theophylline- Mech of Action
- inhibits cAMP phophodiesterases causing increase of cAMP resulting in bronchodilation
- competititive antagonist at adenosine receptors resulting in bronchodilation
Theophylline- Routes of Administration
- oral
- slow IV over 40 min.
Theophylline- Therapeutic Use
maintenance therapy for chronic asthma
Theophylline- Unique Use
sustained-release oral theapy for nocternal asthma
Theophylline- Major Side Effects
NARROW THERAPEUTIC INDEX
- fasciculations
- generalized convulsions
- tachycardia
- circulatory collapse
Ipratropium Bromide- Classification
bronchodilator
Ipratropium Bromide- Mech of Action
- antagonist at muscarinic receptors leading to decreased inositol triphosphate, causing decreased release of Ca ions from endoplasmic reticulum resulting in bronchodilatation
Ipratropium Bromide- Routes of Administration
inhalation
Ipratropium Bromide- Therapeutic Use
alone or in combination with beta2-adrenergic agonist in acute asthma attacks
Ipratropium Bromide- Unique Use
when a coexisting chronic bronchitis or cough is the predominant symptom in asthmatic patients
Ipratropium Bromide- Side Effects
local drying of mouth
Adrenal Corticosteroids- Classification
Anti-inflammatory agent
Adrenal Corticosteroids- Mech of Action
- increases synthesis of lipomodulin, which inhibits phospholipase A2 which suppresses release of arachidonic acid, which inhibits release of leukotrienes and prostaglandins, resulting in bronchodilatation
Adrenal Corticosteroids- Routes of Administration
- inhalation
- oral
- IV
Adrenal Corticosteroids- Therapeutic Use
maintenance therapy for chronic asthma
Adrenal Corticosteroids- Unique Use
treats the underlying inflammation of asthma, reducing frequency and severity of attacks
Adrenal Corticosteroids- Side Effects
- systemic from oral therapy
- local such as oropharyngeal candidiasis, dysphonia, dry mouth and cough from inhalation therapy
Cromolyn Sodium- Classification
anti-inflammatory agent
Cromolyn Sodium- Mech of Action
decreases Ca influx by IgE Ab and thereby inhibits release of mediators from mast cells that cause bronchospasm
Cromolyn Sodium- Routes of Administration
inhalation
Cromolyn Sodium- Therapeutic Use
prophylactic therapy for preventing bronchospasm
Cromolyn Sodium- Unique Use
- prior to exercise challenge
- prior to cold air challenge
Cromolyn Sodium- Side Effects
occasional coughing
Zafirlukast- Classification
leukotriene inhibitor
Zafirlukast- Mech of Action
complete with LTD4 at its receptor site on airway cells to block bronchoconstriction and inflammation
Zafirlukast- Route of Administration
oral (on an empty stomach)
Zafirlukast- Therapeutic Use
prophylactic therapy for preventing bronchospasm
Zafirlukast- Unique Use
- aspirin-induced asthma
- prior to cold-air challenge
Zafirlukast- Side Effects
- headache
- nausea
Zileuton- Classification
leukotriene inhibitor
Zileuton- Mech of Action
inhibits 5’-lipoxygenase to decrease production of leukotrienes
Zileuton- Route of Administration
oral
Zileuton- Therapeutic Use
prophylactic therapy for preventing bronchospasm
Zileuton- Unique Use
- exercise/aspirin-induced asthma
- nocturnal symptoms/nocturnal asthma
Zileuton- Side Effects
contraindicated in patients with hepatic disease
Omalizumab- Classification
monoclonal antibody
Omalizumab- Mech of Action
forms complex with IgE which lowers serum free IgE preventing release of histamine and leukotrienes from mast cells
Omalizumab- Route of Administration
subcutaneous
Omalizumab- Therapeutic Use
prophylactic therapy for chronic asthma
Omalizumab- Unique Use
none given
Omalizumab- Side Effects
possible long-term risk of malignancy