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Flashcards in Final Exam Pulm Deck (37)
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1

Categories of Rx used to treat asthma

Bronchodilating agents, anti-inflammatory agents

2

Bronchodilating agents

Sympathomimetic (B2 agonists), methylxanthines, antimuscarinic

3

Asthma anti-inflammatory agents

Corticosteroids, leukotrine pathway inhibitors

4

MOA B2 agonist

Inhaled - agonizes B2 on smooth muscle in lung - AC - cAMP - bronchodilation

5

Short acting B2 agonist

Rescue therapy - Albuterol, levalbuterol

6

LABA

Long acting B2 agonist - maintenance therapy; Advair, Symbicort

7

Characteristics of levalbuterol

Onset 15 min; DOA 4h; more selective - less tachycardia

8

LABA characteristics

Salmeterol/Formoterol WITH steroid - never used as monotherapy (BBW - increased risk for asthma related events)

9

Methylxanthine

Theophylline (Theo-Dur)

10

Characteristic of Theophylline

Requires therapeutic drug monitoring, PO, add-on for maintenance therapy in refractory cases

11

Antimuscarinic agents for asthma

Ipratropium bromide, tiotropium

12

Ipratropium bromide characteristics

Short acting - reserved for acute episodes or intolerant to albuterol, anticholinergic (dry mouth), does NOT enter CNS

13

Combivent

Ipratropium/albuterol - enhanced effect of ipratropium

14

COPD maintenance therapy

Combivent, Tiotropium (long acting antimuscarinic)

15

PO Corticosteroids are used when?

Short, acute episodes and refractory disease

16

Inhaled corticosteroids are used when?

Maintenance therapy in moderate to severe asthma

17

Type of drug - corticosteroid

NOT bronchodilator, anti-inflammatory (inhibit production of cytokines)

18

Side effects of corticosteroids

Thrush (oral candidiasis) and hoarseness; rinse mouth after inhaled neb

19

Inhaled corticosteroids

Budenoside, Fluticasone

20

Advair, Symbicort

Reserved for severe disease, LABA + corticosteroid

21

Anti-inflammatory that is not corticosteroid

Leukotrine pathway inhibitor

22

Montelukast

Maintenance therapy - improve control/reduce frequency of exacerbations; PO.

23

AE Zyflo

Liver toxicity (leukotrine pathway inhibitor)

24

COPD treatment - maintenance therapy

Spiriva (tiotropium) - antimuscarinic

25

COPD corticosteroids

Significantly higher dose than for asthma

26

COPD additional treament

Antibiotics if exacerbation caused by infection

27

First step to asthma Tx

Assess compliance, administration, environment - ALWAYS

28

What prompts re-eval in asthma pt?

SABA > 2 days/week

29

After tx change for asthma, when do you reassess?

2-6 weeks

30

1st line medication - Asthma

SABA for rescue