Asthma/COPD Flashcards Preview

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Flashcards in Asthma/COPD Deck (14):
1

Epinephrine / Adrenaline

Indication: Status asthmaticus, anaphylaxis, emergent treatment of asthma

MOA: Non-selective adrenergic agonist. B-2 adrenergic receptor stimulation > increased cAMP > immediate relaxation of bronchial smooth mm,

SE: B-1 agonist > cardiac stimulation > tachycardia, palpitations, arrhythmias, anxiety, increased cardiac oxygen demand. A-1 agonist > dry mouth. Hyperglygemia

Oral administration is ineffective

2

Albuterol / Ventolin, Proventil

Indication: Acute, uncomplicated asthma symptoms, COPD, chronic bronchitis
No antiinflammatory activity"

MOA: B-2 adrenergic receptor stimulation > increased cAMP > relaxation of bronchial smooth muscle cells, bronchodilation.

SE: B-1 agonist > cardiac stimulation > tachycardia, palpitations, arrhythmias, anxiety. Inhalation route has fewer side effects/
Usually tolerated well. "

3

Salmeterol / Serevent

Indication: Chronic asthma or bronchospasm. Not for actue symptoms.

DO NOT USE SOLEY. MUST USE IN CONJUNCTION WITH OTHER THERAPIES"

MOA: B-2 adrenergic receptor stimulation > increased cAMP > relaxation of bronchial smooth muscle cells, bronchodilation.

SE: Headache, cough

4

Ipratropium - Atrovent

Anticholinergic

indication: May be used with adrenergic agonists, or in lieu of them. Fewer cardiac side effects than adrenergic agonists. Similar in structure to atropine. Anti-parasympathetic activity.

MOA: Competitive agonists at muscarinic acetylcholine receptor sites > unopposed sympathetic tone in the airways > smoth muscle relaxation and bronchodilation.

Parasympolytic"

5

Theophylline / Theo-dur

xanthine--caffeine analog

indication: Asthma therapy used to repalce a beta agonist.

MOA: Exact mechanism unkown. Inhibition of phosphodiesterase (the enzyme that breaks down cAMP). Anti-parasympathetic activity > bronchial smooth muscle dilation.

SE: Narrow therapeutic window. (Has been largely replaced by B agonists and corticosteroids) Fewer cardiac side effects than adrenergic agonists.

6

Beclomethasone / Beclovent

Corticosteroid

Indication: Asthma that cannot be controlled by bronchodilators (sympathomimetics) alone

MOA: Reduction in macs, eos, and T-cells > decreased inflammation and edema. Decreased capillary permeability > inhibited release of LKs.
No direct effect on airway smooth muscle. "

SE: Oral thrush (reduced risk if rinse mouth after inhalation). Small risk for adrenal suppression. Inhaled steroids have fewer side effects than PO.

7

Prednisone / Deltasone

Corticosteroid

indication: COPD, worsening asthma

MOA: Decrease inflammation and edema in respiratory tract.

SE: Salt and water retention, fat gain and redistribution (buffalo hump, striae), hyperglycemia/diabetes, osteoporosis, adrenal suppression. Abrupt withdrawal may cause Addisonian crisis.

8

Zafirlukast / Accolate

Leukotriene Inhibitor

indications: Chronic asthma - not for acute event!

MOA: Competitive antagonism of LK D4 and E4 receptors in bronchial wall smooth muscle > inhibits bronchoconstriction and inflammation

Not indicated for reversal of bronchospasm in acute asthma attacks."

SE: Headache, GI distress, diarrhea, increased incidence of respiratory infecitons (in older patients)

9

Codeine

Narcotic Analgesic. Cough Suppressant.

indication: Cough suppression

MOA: Decrease sensitivity of CNS cough centers int the medulla > suppress cough. Broken down by the body into morphine.

SE: Drowsiness, constipation (as w/ all pain relieving narcotics), GI upset when taken on an empty stomach, potential for dependence

10

Dextromethorphan (DM)

Indication: Synthetic derivative of morphine
. Cough suppressant.


ME: Decrease sensitivity of CNS cough centers > suppress cough.

SE: Drowsiness, constipation (as w/ all pain relieving narcotics), GI upset when taken on an empty stomach, potential for dependence

11

Diphenhydramine / Bendadryl

Allergic rhinitis Antihistamine (sedating)

indication: Allergic rhinitis, conjunctivitis, urticaria, pruritis. Induce sleep.

MOA: H1 (histamine 1) receptor site bloackade. The production of histamine is not blocked, just the receptor.

SE: Sedation. Drying and thickening of secretions > may worsen asthma or sinusitis. Urinary retention.
Nausea, vertogo, motion sickness. "

12

Loratadine / Claritin

Non sedating antihistamine

indication: Seasonal allergic rhinitis, hay fever

MOA: H1 (histamine 1) receptor agonist. The production of histamine is not blocked, just the receptor.

SE: Drying of secretions, dry mouth.

13

Beclomethasone (Beconase), Budesonide (Rhinocort)

allergic rhinitis nasal corticosteroid

Nasal Rhinitis

MOA: Reduction of inflammatory mediators in the nasal mucosa.

SE: Irritation of nasal muscosa, nose bleeds, sore throats, nasal candidiasis, can worsen a bacterial infection Systemic side effects uncommon.

14

Phenylephrine (Neo-synephrine, Afrin), Oxymetazoline (longer acting)

Alpha Adrenergic Agonist Nasal Spray

MOA: Buildup of CO2, which acts as a vasodilator.

SE: The most addictive OTC drug. Rebound effects: rhinitis medicosum (nasal mucosal swelling and congestion)