Pulmonary Anti-Inflammatories

Question 1

3 pulmonary anti-inflammatories

Answer 1

LTRAs

inhaled corticosteroids

mast cell stabilizers

Question 2

2 Leukotriene receptor antagonist (LTRA) drugs

Answer 2

montelukast (Singulair)

zafirlukast (Accolade)

Question 3

What do leukotrienes cause

Answer 3

inflammation, bronchoconstriction, and mucus production

Question 4

MOA of leukotriene receptor antagonist (LTRA)

Answer 4

LTRAs prevent leukotrienes from attaching to receptors located on immune cells and within the lungs -> prevents inflammation

Question 5

How is LTRAs given

Answer 5

PO

Question 6

What are LTRAs used for

Answer 6

oral prophylaxis and chronic treatment of asthma in adults and children

Can also be given for allergies

Question 7

What are LTRAs not used for

Answer 7

actue asthma attacks

Question 8

Adverse effects of LTRAs

Answer 8

headache
nausea
dizziness
insomnia
diarrhea

Question 9

T/F Montelukast has few drug-drug interactions

Answer 9

TRUE

Question 10

T/F Zafirlukast has several drug-drug interactions

Answer 10

TRUE

Question 11

3 inhaled corticosteroids

Answer 11

beclomethasone diproprionate (Beclovent)

budesonide (Pulmicort Turbuhaler)

fluticasone (Flovent)

Question 12

how are inhaled corticosteroids given

Answer 12

via nebulizer or MDI

Question 13

MOA of inhaled corticosteroids

Answer 13

reduce inflammation and enhance activity of beta agonists

Also help with bronchodilation

Question 14

how long will it take inhaled corticosteroids to be in full effect

Answer 14

several weeks

Question 15

why is inhaled corticosteroids given

Answer 15

Given for prevention of persistent asthma attacks and long-term maintenance of severe COPD

Question 16

T/F Inhaled corticosteroids are a rescue drug

Answer 16

FALSE

Question 17

what needs to be taught for asthma with inhaled corticosteroids

Answer 17

teach to take on a regular schedule, not PRN & give the bronchodilator first to allow more thorough absorption of the steroids

Question 18

Adverse effects of inhaled corticosteroids

Answer 18

pharyngeal irritation, coughing, dry mouth, and oral fungal infections

Question 19

What should a patient do after inhaled corticosteroid use

Answer 19

rinse mouth

Question 20

What are the 2 combos of Inhaled glucocorticoid & bronchodilators

Answer 20

budesonide &formoterol (Symbicort)

fluticasone & salmeterol (Advair)

Question 21

what are inhaled glucocortiocoid and bronchodilator combos used for

Answer 21

Used for moderate to severe asthma

Question 22

key teaching point for glucocortiocoid and bronchodilator combos

Answer 22

NEVER USED FOR ACUTE ATTACKS

Question 23

Mast cell stabilizer drug

Answer 23

cromolyn (Intal)

Question 24

MOA of cromolyn

Answer 24

stabilize membranes of mast cells & prevent release of broncho-constrictive inflammatory substances

Question 25

what is cromolyn used for

Answer 25

prevention of acute asthma attacks

Question 26

when should cromolyn be administered

Answer 26

15-20 minutes prior to known triggers

Question 27

monoclonal antibody anti-asthmatic drug

Answer 27

omalizumab (Xolair)

Question 28

MOA of omalizumab

Answer 28

monoclonal antibody which selectively binds to immunoglobulin IgE -> limits the release of mediators of allergic response

Question 29

how is omalizumab be given

Answer 29

injection

Question 30

what must be monitored during omalizumab

Answer 30

Must be monitored closely for hypersensitivity reactions (anaphylaxis big risk)

Question 31

Indication of omalizumab

Answer 31

indicated for add-on therapy for asthma

Question 32

omalizumab is the newest generation of what

Answer 32

anti-asthmatic

Question 33

selective PDE-4 inhibitor drug

Answer 33

roflumilast

Question 34

MOA of roflumilast

Answer 34

selectively inhibits PDE4 enzyme in the lung cells Potent anti-inflammatory effects within the lungs

Question 35

what is roflumilast indicated for

Answer 35

prevention of COPD exacerbations

Question 36

what is roflumilast not used for

Answer 36

acute/immediate action

Question 37

How is roflumilast

Answer 37

orally

Question 38

S/E for roflumilast

Answer 38

N/V/D, headache, muscle spasms, decreased appetite, uncontrollable tremors

Question 39

6 Long-term control medication PREVENTERS of asthma

Answer 39

``` Anticholinergics Xanthine derivative Inhaled corticosteroids Leukotriene modifiers Mast cell stabilizers LABA ```

Question 40

2 quick relief medications of asthma

Answer 40

SABA | albuterol/Proventil