What is asthma?
Chronic inflammatory disorder in which the bronchi become hyper-reactive from allergens, chemicals, exercise, cold air, aspirin
_____ and ____ are used as short tem relievers DURING an asthma attack.
Beta 2 agonists
List 4 drugs classified as long term controllers to prevent asthma attacks.
- Leukotriene Modifiers
What is the MOA for short acting beta 2 agonists?
Bind to beta 2 agonists: relax of airway smooth muscle resulting in bronchodilation
List 5 ADRs associated with the use of short acting beta 2 agonists (SABAs).
- Inc BP
What is the MOA for long acting beta 2 agonists (LABAs)?
Binds to beta 2 receptors and also activate glucocorticoid receptors and enhance transcription of anti-inflammatory mediators
True or False: Long acting beta 2 agonists (LABAs) can be used for acute treatment.
Not used for rescue or acute treatment
List 2 indications for the use of long acting beta 2 agonists.
- To reduce frequency of asthmatic episodes and acute respiratory distress in COPD in patients not controlled on SABAs
- When inhaled steroids are not enough to control symptoms-when dose response curve for steroids has plateaued
_____ is an ADR that can occur with steroid based long acting beta 2 agonists.
Candidiasis: yeast infection
What is the main drug used to reduce the frequency of asthma attacks? These drugs are often given with _____.
Often given with LABAs
What are the 2 MOAs of corticosteroids?
- Dec # mast cells, eosinophils, and submucosal T lymphocytes
- Dec mRNA expression of interleukins-TNF, IL-2
What is the advantage of using leukotriene antagonists over LABAs as long term controllers for asthma?
Have the same effect as corticosteroids but with very few ADRs (maybe headache).
Why are we moving away from using aerosol inhalers to treat asthma?
They contain CFC which is damaging to the ozone
What can individuals who have trouble coordinating their breath with inhaler use, use to make this process easier?
What is the best way to treat exercise induced asthma?
Take a beta 2 agonist 15 min before exercise.
What 3 things may trigger the onset of exercise induced asthma?
- Dry cold air
- CO2 emissions from indoor ice rinks
What is the primary treatment for acute status asthmaticus?
IV steroids (take 4 to 6 hours to kick in) with beta 2 agonists, oxygen and adequate ventilation
What drugs are used to treat COPD short term? What is there MOA?
Short acting anticholinergics
MOA: Competitively inhibit the effect of Ach at muscarinic receptors, so they block contraction of airway smooth muscle, and blocks secretion of mucus
Why is the advantage of prescribing patient with COPD an anticholinergic versus a beta agonist?
The anticholinergic provides COPD patients with the added benefit of blocking mucus secretions.
List 2 ADRs associated with anticholinergics.
- Dry mouth
2. Pharyngeal irritation
What drug is a long acting muscarinic antagonist used to treat COPD? Advantage? MOA?
Tiotropium (Spriva) (LAMA drug)
Advantage: once a day dosing
MOA: Controller to prevent bronchospasm in COPD
What 4 conditions should patients taking anticholinergics be monitored for?
- Dry mouth
- Urinary retention
What 5 conditions should patients taking steroids be monitored for?
- Oral candidiasis
Patients taking beta 2 agonists should be monitored for _____.