Flashcards in Pharm 47 - Asthma Deck (53)
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31
Methylxanthine clinical applications
Asthma, COPD
32
Adverse effects include Ventricular arrhythmia, seizure; also tachyarrhythmias, N/V, insomnia, tremor, restlessness
Methylxanthine
33
Inhibition of PDE III and IV in smooth muscle -> bronchodilation; inhibition of PDE IV in T cells and eosinophils -> anti-inflammatory/ immunomodulatory; MONITOR PLASMA LEVELS; avoid co-administration with fluvoxamine, enoxacin, mexiletine, propranolol, troleandomycin -> theophylline toxicity; avoid co-administration with zafirlukast -> lower plasma concentration of zafirlukast
Drug-drug interactions w/ CYP3A inhibitors (cimetidine, -azole antifungals)
Methylxanthine
34
MOA Inhibits Ca2+ transport into smooth muscle cells -> smooth muscle relaxation
Magnesium Sulfate
35
Used for Atrial paroxysmal tachycardia, barium poisoning, cerebral edema, eclampsia, hypomagnesmia, seizure
Magnesium Sulfate
36
Adverse effects include Heart block, hypotension, prolonged bleeding time, hyporeflexia, CNS depression, respiratory tract paralysis
Magnesium Sulfate
37
Magnesium Sulfate contraindications
Heart block, myocardial damage
38
Therapeutic considerations Include Tocolytic agent causes uterine relaxation -> delay preterm labor; may benefit pts w/ acute asthma exacerbation
Magnesium Sulfate
39
MOA Inhibit COX-2 action and prostaglandin synthesis by inducing lipocortins; inhibition of IL-4 and IL-5 strongly reduces inflammatory response in asthma
Inhaled Corticosteroids
40
Irritating list of Inhaled Corticosteroids (7)
Beclomethasone, triamcinolone, fluticasone, budesonide, flunisolide, mometasone, ciclesonide (Bec, Bud, and Mom went to Triam (Try on?) Flutes and to eat Flun (flan?) and iCicles....)
41
Corticosteroid clinical applications
Inflammatory conditions, autoimmune diseases
42
Adverse effects Include Immunosuppression, cataracts, hyperglycemia, hypercortisolism, depression, euphoria, osteoporosis, growth retardation in children, muscle atrophy; also impaired wound healing, HTN, fluid retention, oropharyngeal candidiasis, dysphonia
Inhaled Corticosteroid
43
Corticosteroid contraindications
Systemic fungal infections
44
Therapeutic considerations include: Does not correct underlying disease, only limits effects of inflammation; requires tapering dosage after chronic use to avoid adrenal insufficiency; inhaled corticosteroids have fewer systemic adverse effects (can be reduced further by using large-volume spacer and rinsing mouth after use); inhaled steroids (except beclomathasone and triamcinolone) are subject to 1st-pass metabolism, so they don't reach systemic circulation
Inhaled Corticosteroid
45
MOA Inhibit Cl- transport, which affects Ca2+ gating and prevents granule release
Also includes Nedocromil
Cromolyn
46
Clinical applications: Asthma, allergic rhinitis, keratitis, keratoconjunctivitis, mast-cell disorder, vermal conjunctivitis
Cromolyn
47
Adverse effects: Abnormal taste, burning eyes, cough, throat irritation
Cromolyn
48
Therapeutic considerations: Prophylaxis of allergic asthma and exercised-induced asthma; more effective in kids/young adults vs. elderly; excellent safety profile, but not as effective as other asthma medications
Cromolyn
49
MOA: Humanized mouse antibody; prevents IgE from binding Fc on mast cells and APCs; decreases circulating IgE
Omalizumab
50
Omalizumab clinical applications
Asthma
51
Adverse effects: Anaphylaxis; also, injection site reaction, rash, HA
Omalizumab
52
Therapeutic considerations: Affects both early- and late-phase asthmatic responses, administered subcutaneously every 2-4 wks (must monitor after injection for several hours due to possible immune response)
Omalizumab
53
