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Pharmacology > Asthma drugs > Flashcards

Asthma drugs Flashcards

(54 cards)

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1
Q

General principles of Asthma management

A

The overall objectives of antiasthma therapy are to:
To return lung function to as near normal as possible
To prevent acute exacerbations of the disease
To achieve a normal quality of life
Permits normal activities (exercise)

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2
Q

Primary classes of drug therapy

A

Bronchodilators

Anti-inflammatory agents

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3
Q

Referred as RELIEVERS

- they provide rapid symptomatic relief

A

Bronchodilators

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4
Q

Referred as CONTROLLERS

-provide long-term stabilization of symptoms

A

Anti-inflammatory agents

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5
Q

Used both in maintenance therapy and as needed to reverse acute attacks

A

Bronchodilators

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6
Q

Must be used in conjunction with bronchodilators except for mild asthma

A

Anti-inflammatory agents

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7
Q

All treatment regimens should include PATIENT EDUCATION that is focused on the following:

A
  • The appropriate use of medications to control symptoms
  • Recognition of the signs of a deteriorating disease status
  • Prevention strategies
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8
Q

A/E of Epinephrine

A

Feeling of nervousness and anxiety
Hand and upper extremity tremors
Palpitation
Extreme hypertension, CVA, pulmonary edema, angina and arryhythmias

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9
Q

A/E of Isoproterenol

A

Tachycardia, dizziness and nervousness

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10
Q

A/E of B2 adrenoreceptors

A

Muscle tremor

Tachycardia and palpitations

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11
Q

Pharmacological effects of Theophylline

A

Smooth muscle relaxation
CNS excitation
Cardiac stimulation

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12
Q

Theophylline inhibits

A

cyclic nucleotide phosphodiesterases

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13
Q

Actions of Theophylline in Asthma

A 
Antagonism of adenosine
Inhibition of mediator release
Increased sympathetic activity
Alteration in immune cell function
Reduction in respiratory muscle fatigue
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14
Q

Effect of theophylline is px with Heart failure, liver disease and severe respiratory obstruction

A

Slow down its metabolism

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15
Q

A/e of theophylline

A

Nausea and vomiting (most frequent for those receiving for the first time) (20mcg/ml)
Probability of seizures (>40 mcg/mL)
Arrhythmia, hypotension, and cardiac arrest (bolus IV injection)

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16
Q

Effect of theophylline in children

A

In children: restlessness, agitation, diuresis, fever.

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17
Q

T/F: Theophylline Half life is prolonged in patients with CHF

A

TRue

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18
Q

T/F: You can give theophylline with Cimetidine and Zileuton

A

False: Extreme caution in patients who are medicated with Cimetidine & Zileuton

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19
Q

Adrenomimetic agents are use both as ____ & ____ to maintain patency over the long term

A

These agents are used both as needed to reverse acute episodes of bronchospasm and prophylactically to maintain airway patency over the long term.

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20
Q

Pharmacologic effects of adrenomimetic agents

A

Pharmacologic effects: bronchodilation, tachycardia, anxiety and tremor.

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21
Q

What are examples of the bronchodilator drugs

A 
Epinephrine
Isoproterenol
Selective Beta 2-adrenoceptor agonist
Theophylline
Anticholinergics
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22
Q

Action of epinephrine

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A

activates both alpha and beta receptors

23
Q

Epinephrine is administered

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A

Subcutaneously

Administered subcutaneously to manage severe acute episodes of bronchospasm and status asthmaticus

24
Q

Epinephrine timing of effect

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A

5-15 minutes

Measurable improvement in pulmonary function is maintained for up to four hours

25
Epinephrine cardiovascular effcts
increased heart rate, increased cardiac output, increased stroke volume, elevation of systolic pressure, decrease in diastolic pressure and decrease in systemic vascular resistance.
26
Isoproterenol action
Beta adrenoceptor agonist | Not selective for b1 and B2
27
Isoproterenol administration
inhalation Administered exclusively by inhalation from metered dose inhaler or from nebulizers
28
Isoproterenol is mainly used for
bronchospasm
29
Isoproterenol timing effect
Effect is instantaneous but short-lived
30
Examples of Selective Beta 2-adrenoceptor agonist
Terbutaline Albuterol Salmeterol
31
Selective B2-adrenoceptor agonist administration
Terbutaline and Albuterol are administered either orally or by inhalation Salmeterol is given by inhalation only
32
Selective B2-adrenoceptor agonist timing
Terbutaline and Albuterol Used for acute attacks due to rapid onset Salmeterol suitable for prophylactic use more than in acute attacks (due to slow onset of action)
33
When to use Terbutaline and Albuterol
acute attacks | prematur labor
34
When to use Salmeterol
Prophylaxis
35
Action of anticholinergics
stimulate cholinergic nerve fibers > (+) muscarinic cholinoreceptors > (+) bronchoconstriction, mucus secretion, broncho vasodilation
36
Quaternary amine derivative of atropine that is used via inhalation in the treatment of COPD and Asthma
Ipratropium Bromide
37
Advantages of Ipratropium bromide
- Has a slower onset of action thus suitable for prophylactic use - More effective in COPD than Asthma - Effective in patients who have psychogenic asthma and in patients taking beta blockers - It does not inhibit mucociliary clearance so it does not promote accumulation of secretions in lower airways
38
A/E of anticholinergics
dry mouth, headache, nervousness, dizziness, nausea and cough
39
Examples of anti-inflammatory agents
Corticosteroids
40
Main mechanism of corticosteroids as asthma drug
inhibit inflammatory processes
41
Disadvantage of corticosteroids
The clinical effects take several hours to several days to develop making it not advisable for quick relief of acute bronchospasm Most of the agents are used for maintenance treatment of asthma as prophylactic therapy
42
A/E of Steroids
``` Systemic Steroids: Adrenal suppresion Cushingoid changes Growth retardation Cataracts Osteoporosis CNS effects/behavioral changes Increased susceptibility to infections ``` Inhaled Corticosteroids Generally well tolerated Either poorly absorbed or rapidly metabolized and inactivated Most frequent side effects: oral candidiasis, dysphonia, sore throat and irritation Adverse effects outweigh the benefits from inhaled steroids
43
Alternative therapies for asthma
Leukotriene Modulator
44
Example of leukotriene modulators
Zafirlukast, Montelukast,and Zileuton
45
Most common side effects of Zafirlukast, Montelukast,and Zileuton
Dyspepsia
46
Main use fo Zafirlukast, Montelukast,and Zileuton
For prophylaxis and chronic treatment of asthma should not be used for acute episodes
47
Administration of Zafirlukast, Montelukast,and Zileuton
oral
48
Contraidications of taking Zileuton
Zileuton inhibits the metabolism of Theophylline Zileuton has drug reaction with warfarin, terfenadine and propranolol Zileuton is contraindicated in patients with acute liver disease
49
Zafirlukast increases plasma concentration of ___ and decreases plasma concentrations of ___
Warfarin ; Theophylline and Erythromycin
50
Prophylaxis for mild or moderate asthma (4-6 weeks)
Cromolyn sodium and Nedocromil sodium
51
Admission of Cromolyn sodium and Nedocromil sodium
Inhalation
52
Advantage of Cromolyn sodium and Nedocromil sodium
Safe in children
53
Action of Cromolyn sodium and Nedocromil sodium
stabilizes mast cells > prevent mediator release > inhibit effects on irritant receptors and inflammatory cells
54
Non-pharmacologic Treatment of Asthma
``` Cessation of smoking Avoidance of environmental exposure Engage in physical activity (swimming) Avoidance of occupation exposures Avoidance of medications that can trigger Asthma attacks Healthy diet ```

Pharmacology (11 decks)

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