drugs to treat asthma and COPD

Question 1

what are the main goals in asthma management

Answer 1

Reduction in impairment

reduction of risk

Question 2

What are the 2 drug classes for Asthma

Answer 2

Anti inflammatory drugs

Bronchodilators

Question 3

Albuterol MOA, Indications, Adverse effects, Xontraindictions

Answer 3

B2 agonist that causes vasodilation
-Short acting beta agonist

Indications:
-asthma, acute bronchitis, COPD, cough

Adverse effects:
-HA, dizziness, insomnia, dry mouth, cough

Contraindictions:
-Paradoxical bronchospasm, Deterioration of asthma, CV effects, Hypersensitivity

Question 4

Terbutaline MOA, Indications, Cautions, Adverse effects

Answer 4

Only B2 agonist that is available subQ injection

Short acting B agonist that prefers B2

indications:
-bronchospasm with asthma, acute bronchitis, emysema for 12 and older

Cautions:

• Tocolysis
• not recommended in patients with sulfur allergy

Adverse effects: HA, nausea, tachycardia, and palpitations

Question 5

Metaproterenol MOA, indications, and Cautions

Answer 5

B2 agonist that is short acting

indications:
-bronchial asthma and reversible bronchospasm via COPD and bronchitis

Cautions:

• can cause a cardiovascular effect
• paradoxical bronchospasm

Question 6

Pirbuterol MOA, indications, and cautions

Answer 6

Short acting B2 agonist

Indications: prevention in bronchospasm

cautions:
-significant cardiovascular effect in some patients

Question 7

Levalbuterol MOA, indications, and cautions

Answer 7

Short acting B2 agonist

Indications: treatment of bronchospasm in patients 4 or older

Cautions: Life threatening paradoxical bronchospams may occur

Question 8

Beclomethasone MOA, cautions, indications

Answer 8

Inhaled Corticosteroid

indications: maintence treatment of asthma 5 or older

Cautions:

• adrenal insufficiency related deaths
• recovery for Hypothalamic pituitary adrenal function

Question 9

Budesonide MOA, cautions, indications

Answer 9

Inhaled Corticosteroid

Indications: treatement of asthma

Cautions: not used for status asthmaticus or other insive episodes of asthma
-hypersensitivity to milk

Question 10

Ciclesonide MOA, Indications, and Cautions

Answer 10

Inhaled Corticosteroid

Indications: maintence treatment of asthma as prophylactic therapy

Cautions:

• not indicated for the relief of acute bronchospasm
• not recommended in candida albicans infection

Question 11

Flunisolide MOA, Indications, COntradictions

Answer 11

Inhaled corticosteroid

Indications: asthma maintenance treatment
-replacement of oral corticosteroids

Contradictions:
-status asthmaticus or acute intensive episodes

Question 12

Fluticasone MOA, Indications and Cautions

Answer 12

Inhaled Corticosteroid

Maintenance of asthma at 4 years and older

Cautions:

• not indicated for relief of acute bronchospams
• Candida albicans infections

Question 13

Mometasone MOA, Indications, and Cautions

Answer 13

Inhaled corticosteroid

Maintenance of asthma as prophylactic therapy

Cautions:

• not used in status asthmaticus
• hypersensitivity to milk proteins

Question 14

Triamcinolone MOA, Indications and cautions

Answer 14

Inhaled Corticosteroid

Indications: Maintenance of asthma
-and who need systemic corticosteroid administration

Cautions:

• not indicatied for relief of acute bronchospasm or status asthmaticus
• deaths due to adrenal insufficiency

Question 15

Prednisone MOA, indications and Corticosteroids

Answer 15

Oral and Parenteral Corticosteroid

Indications: used as anti inflammatory or immunosuppressive agent
-endocrine conditions

Cautions:

• lead to hypothalamic pituitary adrenal axis suppression
• Monitor for cushing and hyperglycemia

Question 16

When to use Oral and parenteral corticosteroids?

Answer 16

Combination with short acting beta agonist to treat severe asthma flare ups

Question 17

Fomoterol MOA, indications and Cautions

Answer 17

MOA: Long acting beta agonist

Indications: treatment of long term asthma control and maintenance of bronchoconstriction with COPD

Cautions:
-increase risk of asthma related deaths and asthma related hospitals if not given with long term inhaled corticosteroid

Question 18

Salmeterol MOA and indications

Answer 18

Long acting Beta 2 agonist

Treatment of asthma 4 and older and prevention of excercise induced bronchospasm in patients

maintenance of bronchospasm in COPD

Question 19

Indacaterol and Vilanterol MOA and indications

Answer 19

Long acting B2 agonist

used in breathing problems caused by COPD, chronic bronchitis and emphysema

Question 20

Olodaterol MOA and indications

Answer 20

Long acting B2 agonist

Used in long term once daily maintenance bronchodilator treatment of airflow obstruction in patients

Question 21

What must all LABA be given with?

Answer 21

Concomitant of a long term asthma control medication such as inhaled corticosteroids

prevent the risk of asthma related deaths and hospitilizations

Question 22

Atropine MOA, Indications and Cautions

Answer 22

Anti muscarinic agent that blocks the parasympathetic nerve from causing bronchoconstriction

Indications:
-temporary blockade of severe or life threatening muscarininc effects

Cautions:
-dose restricted to 2-3 mg due to atropine induced tachycardia

Question 23

Ipratropium MOA, indications

Answer 23

Anticholinergic drug

bronchodilator for treatment of bronchospasm

-relatively free of systemic atropine like effects

Question 24

Tiotropium MOA, indications

Answer 24

Anticholinergic drug

Indicated for the long term once daily maintenance treatment of bronchospasm associated with COPD

Question 25

Aclidinium MOA, and indications

Answer 25

Anticholinergic drug Indicated for the long term maintenance treatment of bronchospasm associated with COPD including chronic bronchitis and emphysema

Question 26

What are Methylxanthines MOA

Answer 26

Smooth muscle relaxation and suppression of the response of the airways to stimuli (non bronchodilator) -block PDE? derived from xanthine

Question 27

Theophylline indications and cautions

Answer 27

Used in the treatment of asthma and other lung problems such as emphysema and chronic bronchitis Methylxanthines Cautions: -extreme caution in patients with peptic ulcer disease, seizure disorders and cardiac arrhythmias

Question 28

Montelukast MOA, indications and cautions

Answer 28

Leukotiene antagonist: binds CysLT1 receptor -inhibits LTD4 Indications: -treat allergies and prevent asthma attacks Cautions: -Not indicated for use of reversal of bronchospasm of acute asthma attacks

Question 29

Zafirlukast MOA, indications and cautions

Answer 29

Leukotriene antagonist, -LTD4 and LTE4 Indications: -prophylaxis and chronic treatment of asthma Cautions: -Hepatotoxicity

Question 30

Zileuton MOA, Indications, and cautions

Answer 30

Leukotriene antagonist by inhibiting 5-lipoxygenase and inhibits (LTB4, LTC4, LTD4, and LTE4) formation Indications: -prophylaxis and chronic treatment of asthma Cautions: -acute liver disease not recommended

Question 31

Omalizumab MOA, Indications, and cautions

Answer 31

Anti IgE antibody Indications: - indicated for moderate to severe persistent asthma in patients 6 years and older with a positive skin test or in vitro reactivity to a perennial aeroallergen - also for chronic idiopathic urticaria Cautions: -anaphylaxis