Pharm 47 - Asthma Flashcards Preview

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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

Has slow onset of action so it should not be used for acute asthma flares.

Salmeterol