Exam 2 Flashcards
(157 cards)
What are the three predictors of lung volume?
Gender
Height (taller = larger vol)
Age
What is the pattern of asthma and what drug class does it best respond to?
eosinophilic - allergic, inflammatory pattern
STEROIDS
do daily symptoms of asthma or QOL correlate with lung volume findings?
No
Asthma SX and QOL do not correlate with lung volume
COPD depicts which pattern and responds well to what drug class?
neutrophilic (chronic mucus production allows bacterial growth)
ANTIBIOTICS
What is the greatest risk factor for COPD?
Smoking
What is Asthma COPD Overlap Syndrome (ASCOS)
involves inflammation and bronchoconstriction
Do Asthma or COPD have alveolar destruction?
COPD
Which drugs are generally classified as relievers? What does it mean to be a reliever?
Albuterol
Salmeterol
Tiotropium (anti-cholinergic)
Theophylline (rarely used)
- relievers bronchodilate to RELIEVE symptoms
Which drugs are administered PO for Asthma TX?
Montelukast (controller)
Theophylline (rarely used)
- because PO, systemic side effects common
How are Spacers Helpful?
- more drug into the lungs (from 1/3 to 1/2)
- less drug into the gut
(fewer systemic side effects)
What is the MOA for montelukast?
leukotriene receptor antagonist (LTRA); block LTD4, LTE4, stop binding
(oral admin)
- CYP3A4 metab
otherwise, minimal adv. effects
What is the MOA for theophylline?
similar to caffeine; CNS stimulant
- bronchodilates
- not an alternative to ICS; more like LABA
Which controller medication is primarily used in asthma tx?
Montelukast (Singulair)
lipoxygenase pathway (block pathway: prevent leukotriene production)
which drug blocks IgE production and plays a HUGE role in asthma treatment?
Corticosteroid - Beclomethasone (ICS)
- broad anti-inflammatory drug of choice
Which Short Acting Beta Agonist (SABA) is used as a short acting rescue inhaler for asthma?
Albuterol (Salbutamol)
- onset in 90s, increases lung volume 20%
Is Albuterol meant for daily use?
No
Daily use = poorly controlled
Which drug is albuterol related to and what S/E are expected with this drug?
Like Epinephrine
- Tachycardia
- Hypertension
- Jitteriness/Mild Anxiety
Should you recommend an OTC inhaled epinephrine such as asthmanefrin for asthma?
NO! Works like an inhaled Epi-Pen; 15s-5 min duration, NO BENEFIT
which Long Acting Beta Agonist (LABA) is used, often in combination with steroids for Asthma TX? How long does it work?
Salmeterol - increases lung volume
> 10% in 10 min,
> 30% in 1 hour.
Declines to 15% in 12 hours
Does salmeterol control disease progression?
No; rarely used in practice, more risk of adverse effects (over-stimulation)
Which anti-cholinergic has a persistent effect and does not easily achieve tolerance?
Tiotropium
How does Tiotropium compare to Salmeterol?
Salmeterol (LABA) loses persistence long term, less tolerance;
equal clinical effects
How do inhaled corticosteroids (ICS) target inflammation, are they relievers or controllers? what should patients be reminded of? why?
block IgE, controllers
- remind patient to rinse mouth after use; local thrush infxn; effect on LONG BONEs
Are steroids used to control of Asthma or COPD?
steroids are recommended for
BOTH ASTHMA and COPD
CONTROLLER DRUGS