Resp. Drugs Flashcards
(30 cards)
Albuterol
Bronchodilator
Class:Adrenergic
Agonists, SABA
MOA:↑cAMP!relaxation of bronchial smooth muscle!bronchodilation
Inhalation minimizes systemic side effects (poorly absorbed via the lungs
Uses: -DOC for acute relief of bronchospasm
Acute COPD/asthma attacks
AE:Tremors Tachycardia Arrhythmia Hyperglycemia Tolerance w/ excessive use Paradoxical bronchospasm
Pirbuterol
Bronchodilator
Class:Adrenergic
Agonists, SABA
MOA:↑cAMP!relaxation of bronchial smooth muscle!bronchodilation
Inhalation minimizes systemic side effects (poorly absorbed via the lungs
Uses: -DOC for acute relief of bronchospasm
Acute COPD/asthma attacks
AE:Tremors Tachycardia Arrhythmia Hyperglycemia Tolerance w/ excessive use Paradoxical bronchospasm
Terbutaline
Bronchodilator
Class:Adrenergic
Agonists, SABA
MOA:↑cAMP!relaxation of bronchial smooth muscle!bronchodilation
Inhalation minimizes systemic side effects (poorly absorbed via the lungs
Uses: -DOC for acute relief of bronchospasm
Acute COPD/asthma attacks
AE:Tremors Tachycardia Arrhythmia Hyperglycemia Tolerance w/ excessive use Paradoxical bronchospasm
Salmeterol
Bronchodilator
Class:Adrenergic
Agonists, LABA
MOA:↑cAMP!relaxation of bronchial smooth muscle!bronchodilation
Inhalation minimizes systemic side effects (poorly absorbed via the lungs
Uses: Long term control and prevention of sxs in
moderate-severe asthma/COPD when used in
combo w/ inhalational corticosteroids
Prevent exercise-induced bronchoconstriction
for 12-24hrs
AE:Tremors Tachycardia Arrhythmia Hyperglycemia Tolerance w/ excessive use Paradoxical bronchospasm
Genetic polymorphism in β2 receptors! risk of worsening asthma, exacerbations, death
Formoterol
Bronchodilator
Class:Adrenergic
Agonists, LABA
MOA:↑cAMP!relaxation of bronchial smooth muscle!bronchodilation
Inhalation minimizes systemic side effects (poorly absorbed via the lungs
Uses: Long term control and prevention of sxs in
moderate-severe asthma/COPD when used in
combo w/ inhalational corticosteroids
Prevent exercise-induced bronchoconstriction
for 12-24hrs
AE:Tremors Tachycardia Arrhythmia Hyperglycemia Tolerance w/ excessive use Paradoxical bronchospasm
Genetic polymorphism in β2 receptors! risk of worsening asthma, exacerbations, death
Ipratropium
Bronchodilator
CLASS: Muscarinic Antagonists , Short acting
MOA:Competitively Blocks PSN! ↓bronchoconstriction &
↓mucous secretion
USES:-Asthma
-Prevents vagal mediated bronchoconstriction and drug induced bronchospasm
AE:-Dry mouth
-Caution in pts with glaucoma,
BPH and bladder neck
obstruction
Tiotropium
Bronchodilator
CLASS: Muscarinic Antagonists , Long acting
MOA:Competitively Blocks PSN! ↓bronchoconstriction &
↓mucous secretion
USES:COPD
AE:-Dry mouth
-Caution in pts with glaucoma,
BPH and bladder neck
obstruction
Theophylline
Bronchodilator
CLASS:Methylxanthine derivatives
MOA:Inhibit phosphodiesterase! ↑cAMP! bronchodilation
USES:Asthma; limited role d/t small therapeutic window
Prophylactic against nocturnal attacks!
AE:Tremor, Insomnia, GI distress
Hypokalemia
Hyperglycemia
Seizures & arrhythmias
Aminophylline
Bronchodilator
CLASS:Methylxanthine derivatives
MOA:Inhibit phosphodiesterase! ↑cAMP! bronchodilation
USES:Asthma; limited role d/t small therapeutic window
Prophylactic against nocturnal attacks!
AE:Tremor, Insomnia, GI distress
Hypokalemia
Hyperglycemia
Seizures & arrhythmias
Beclomethasone
Anti-inflammatory Agent
CLASS: Corticosteroids, Inhaled
MOA: Inhibit PLA2!↓ arachidonic acid!↓ synthesis of leukotrienes, cytokines, and prostaglandins
Bind to glucocorticoid response elements (GREs) in the nucleus!↓inflammation
Prevents remodeling of respiratory tract
USES:DOC for prophylaxis of asthma
AE:Cough
Oral thrush
Dysphonia
Pharyngeal candidiasis
Fluticasone
Anti-inflammatory Agent
CLASS: Corticosteroids, Inhaled
MOA: Inhibit PLA2!↓ arachidonic acid!↓ synthesis of leukotrienes, cytokines, and prostaglandins
Bind to glucocorticoid response elements (GREs) in the nucleus!↓inflammation
Prevents remodeling of respiratory tract
USES:DOC for prophylaxis of asthma
AE:Cough
Oral thrush
Dysphonia
Pharyngeal candidiasis
Budesonide
Anti-inflammatory Agent
CLASS: Corticosteroids, Inhaled
MOA: Inhibit PLA2!↓ arachidonic acid!↓ synthesis of leukotrienes, cytokines, and prostaglandins
Bind to glucocorticoid response elements (GREs) in the nucleus!↓inflammation
Prevents remodeling of respiratory tract
USES:DOC for prophylaxis of asthma
AE:Cough
Oral thrush
Dysphonia
Pharyngeal candidiasis
Flunisolide
Anti-inflammatory Agent
CLASS: Corticosteroids, Inhaled
MOA: Inhibit PLA2!↓ arachidonic acid!↓ synthesis of leukotrienes, cytokines, and prostaglandins
Bind to glucocorticoid response elements (GREs) in the nucleus!↓inflammation
Prevents remodeling of respiratory tract
USES:DOC for prophylaxis of asthma
AE:Cough
Oral thrush
Dysphagia
Pharyngeal candidiasis
Dexamethasone
Anti-inflammatory Agent
CLASS: Corticosteroids, IV
MOA: Inhibit PLA2!↓ arachidonic acid!↓ synthesis of leukotrienes, cytokines, and prostaglandins
Bind to glucocorticoid response elements (GREs) in the nucleus!↓inflammation
Status asthmaticus (Severe refractory asthma)
-TXT chronic rhinitis (beclomethasone and
flunisolide)!effects not seen for 2 wks
-Dexamethasone before birth for prophylaxis of
RDS
Prevents remodeling of respiratory tract
USES:DOC for prophylaxis of asthma
AE:Abnormal glucose metabolism↑appetite, weight gain, HTN, adrenal suppression
Prednisolone
Anti-inflammatory Agent
CLASS: Corticosteroids, IV
MOA: Inhibit PLA2!↓ arachidonic acid!↓ synthesis of leukotrienes, cytokines, and prostaglandins
Bind to glucocorticoid response elements (GREs) in the nucleus!↓inflammation
Status asthmaticus (Severe refractory asthma)
-TXT chronic rhinitis (beclomethasone and
flunisolide)!effects not seen for 2 wks
-Dexamethasone before birth for prophylaxis of
RDS
Prevents remodeling of respiratory tract
USES:DOC for prophylaxis of asthma
AE:Abnormal glucose metabolism↑appetite, weight gain, HTN, adrenal suppression
Zileuton
Anti-inflammatory Agent
CLASS: Leukotriene Inhibitors
MOA:Inhibits 5- lipoxygenase
USE:-Prevent exercise-induced asthma up to 24hrs in 50% of patients
-Prevent antigen and aspirin induced asthma
AE:Elevated liver enzymes
Zafirlukast
Anti-inflammatory Agent
CLASS: Leukotriene Inhibitors
MOA:LTD4 receptor antagonist
USE:-Prevent exercise-induced asthma up to 24hrs in 50% of patients
-Prevent antigen and aspirin induced asthma
AE:Vasculitis and systemic
eosinophilia resembling
Churg-Strauss (rare)
Montelukast
Anti-inflammatory Agent
CLASS: Leukotriene Inhibitors
MOA:LTD4 receptor antagonist
USE:-Prevent exercise-induced asthma up to 24hrs in 50% of patients
-Prevent antigen and aspirin induced asthma
AE:Vasculitis and systemic
eosinophilia resembling
Churg-Strauss (rare)
Omalizumab
Anti-inflammatory Agent
CLASS: Antibody
MOA:Binds to IgE on sensitized mast cells! prevent activation and
release of LTs + other mediators
USES:Prophylactic mgmt. of severe refractory asthma
when inhaled corticosteroids are inadequate (pts
older than 12)
AE:Anaphylaxis
Cromolyn
Anti-inflammatory Agent
CLASS:Release inhibitors
MOA: Unknown!↓release of
mediators from mast cells
Not for acute attacks
USES:Ophthalmic, nasopharyngeal and
gastrointestinal allergy
Rarely used for prophylaxis of asthma
AE:Infrequent laryngeal edema Cough Wheezing Nedocromil!unpleasant taste
Nedocromil
Anti-inflammatory Agent
Anti-inflammatory Agent
CLASS:Release inhibitors
MOA: Unknown!↓release of
mediators from mast cells
Not for acute attacks
USES:Ophthalmic, nasopharyngeal and
gastrointestinal allergy
Rarely used for prophylaxis of asthma
AE:Infrequent laryngeal edema Cough Wheezing Nedocromil!unpleasant taste
Codeine
Cough and Rhinitis
CLASS:Opioids
MOA: Act via G proteins! depress CNS cough center
USES:Acute debilitating cough (Wakes up from sleep)
↓cough reflex
Dextromethorphan
Cough and Rhinitis
CLASS:Opioids
MOA: Act via G proteins! depress CNS cough center
USES:Acute debilitating cough (Wakes up from sleep)
↓cough reflex
N-acetylcysteine
NAC
Cough and Rhinitis
CLASS:Mucolytic agent
MOA:Breaks disulfide bonds in mucus
USES:Mgmt. of acetaminophen OD CF
