Drugs used in Asthma and Allergy Flashcards
What is the difference between intermittent and persistent asthma?
Intermittent Asthma
Symptoms occur 2 or fewer times per week
Oral steroids needed no more than once a year
Persistent Asthma
Needs bronchodilator treatment almost every day
Symptoms prevent patient from participating in normal activities
What are the primary “relievers” in asthma treatment?
B2 agonists used as bronchodilators
What are the short acting B2 agonists?
Albuterol
Terbutaline
Metaproterenol
Bitolterol
What are the long acting B2 agonists?
All end in -erol
Salmeterol
Formoterol
Vilanterol
B2 agonists
MOA
Activate adenylyl cyclase in bronchial smooth muscle
Increases cAMP intracellularly, causes bronchodilation
B2 agonists
Administration
Most often used in metered inhaler.
Could be used in nebulizer (expensive)
Oral- slower onset, more side effects
Parenteral
B2 agonists
Side Effects
How can these be avoided?
Muscle tremors
Tachycardia
Anxiety
Restlessness
Take 1 puff instead of 2 to avoid. Symptoms tend to decrease over time using that drug
Theophylline
MOA
Phosphodiesterase inhibitor used as a long acting bronchodilator
Theophylline
Clinical Use
Long acting bronchodilator used in children under 2yo (because they cannot take inhalational drugs)
Ipatropium and Tiotropium
MOA
Muscarinic antagonists
By blocking muscarinic receptors in the airways, these drugs prevent bronchoconstriction
When would corticosteroids be used in asthma treatment? How are they administered?
Persistent asthma
May be inhalational, oral, or IV
What drugs are used more as asthma “controllers?”
Corticosteroids
Corticosteroids
Onset of Action and Duration of Action
Onset - 3 hrs
Duration 10-12 hrs (inhaled), 6-12 hrs (oral)
Corticosteroids
MOA
Inhibit arachidonic acid synthesis by inhibiting phospholipase A2
Thus, inhibits synthesis and release of leukotrienes and prostaglandins
Corticosteroids Adverse Effects (Short and Long Term)
Short term:
High energy
Hunger
Weight gain
Long term:
Osteoporosis
Cataracts
Myopathy
