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Respiratory > Respiratory Exam 1 - ASTHMA MEDICATIONS > Flashcards

Respiratory Exam 1 - ASTHMA MEDICATIONS Flashcards

(61 cards)

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0
Q

Beclomethasone Dipropionate

A

Inhaled Corticosteroid

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1
Q

Fluticasone Propionate

A

Inhaled Corticosteroid

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2
Q

Budesonide

A

Inhaled Corticosteroid

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3
Q

Flunisolide

A

Inhaled Corticosteroid

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4
Q

Mometasone Furoate

A

Inhaled Corticosteroid

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5
Q

Triamcinolone Acetonide

A

Inhaled Corticosteroid

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6
Q

Ciclesonide

A

Inhaled Corticosteroid

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7
Q

Inhaled Corticosteroids - INDICATION

A

Long-term prevention of symptoms

Suppression, control, reversal of inflammation

Reduced need for oral corticosteroids

Most potent/effective inflammatory med. available

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8
Q

Inhaled Corticosteroids - MOA

A

Anti-inflammatory:
Block LATE reaction to allergen and reduce hyper-responsiveness
Inhibit cytokine production, adhesion, protein activation, and inflammatory migration & activation

Reverse B2 receptor down regulation

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9
Q

Inhaled Corticosteroids - AE

A

Local:
Cough, dysphonia, candidiasis

Low-medium doses:
suppression of growth in children

High doses:
Systemic effects

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10
Q

Inhaled Corticosteroids - CONSIDERATIONS

A

Wash mouth out

Adults:
Consider calcium & vitamin D supplements

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11
Q

Methylprednisolone

A

Systemic Corticosteroid

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12
Q

Prednisone

A

Systemic Corticosteroid

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13
Q

Prednisolone

A

Systemic Corticosteroid

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14
Q

Systemic Corticosteroids - INDICATIONS

A

Short term:
3-10 days to gain prompt control of inadequately controlled asthma

Long term:
prevention of symptoms of SEVERE PERSISTENT asthma ONLY

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15
Q

Systemic Corticosteroids - AE

A 
Hyperglycemia
Fluid retention
Weight gain
Hypertension
Growth suppression
Cushing's syndrome
Impaired immune function
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16
Q

Systemic Corticosteroids - CONSIDERATIONS

A

Use lowest effective dose
Long term: Alternate day AM dosing or 3pm daily dosing
Take with food
Do not administer varicella vaccine (wait one month after use)

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17
Q

Cromolyn Sodium

A

Mast Cell Stabilizer

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18
Q

Nedocromil

A

Mast Cell Stabilizer

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19
Q

Mast Cell Stabilizers - INDICATION

A

Long term prevention of symptoms in MILD PERSISTENT asthma

Preventative treatment prior to exercise or exposure to known allergen

**Used as an alternative but not preferred

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20
Q

Mast Cell Stabilizers - MOA

A

Anti-inflammatory:
Blocks EARLY & LATE reaction to allergen.
Interferes with chloride channel function. Stabilizes mast cell membrane & inhibits activation & release of mediators from eosinophils & epithelial cells.

Inhibits acute response to exercise, cold dry air, and SO2

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21
Q

Mast Cell Stabilizer - AEs

A

Cough
Irritation
Unpleasant taste (nedocromil)

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22
Q

Mast Cell Stabilizer - CONSIDERATIONS

A

may need 4-6 wks to determine max benefit

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23
Q

Omalizumab

A

Immunomodulator

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24
Immunomodulator - INDICATION
Long term control & prevention of symptoms in adults who have MODERATE or SEVERE PERSISTENT asthma inadequately controlled by ICS **ADJUNCT THERAPY
25
Immunomodulator - MOA
Recombinant DNA-derived humanized monoclonal antibody that binds to CIRCULATING IgE - prevents it from binding to receptors on basophils & mast cells Decreases mast cell mediator release from allergen exposure Decreases number of receptors in basophils & submucosal cells
26
Immunomodulator - AEs
Pain @ injection site Anaphylaxis
27
Immunomodulator - CONSIDERATIONS
Monitor for anaphylaxis Must refrigerate
28
Montelukast
Leukotriene Receptor Antagonists (LRTAs)
29
Zafirlukast
Leukotriene Receptor Antagonists (LRTAs)
30
Leukotriene Receptor Antagonists (LRTAs) - INDICATIONS
Montelukast: Long term control of MILD PERSISTENT asthma in pts >1yo Zafirlukast: Long term control of MILD PERSISTENT asthma in pts >7yo *ALTERNATIVE (not preferred) **ADJUNCT with ICSs (Not preferred in pts >12yo compared to LABAs)
31
Leukotriene Receptor Antagonists (LRTAs) - MOA
Selective competitive inhibitor of CysLT1 receptor
32
Leukotriene Receptor Antagonists (LRTAs) - AEs
Zafirlukast: Reversible hepatitis Irreversible hepatic failure
33
Leukotriene Receptor Antagonists (LRTAs) - CONSIDERATIONS
Montelukast: Ceiling Effect Zafirlukast: Take 1hr before or 2hr after meals
34
Zileuton
5-Lipoxygenase Inhibitor
35
5-Lipoxygenase Inhibitor - INDICATION
Long term control & prevention of symptoms in MILD PERSISTENT asthma for pts >12yo May be used with ICS as combo therapy in MODERATE PERSISTENT asthma in pts >12yo *ALTERNATIVE (not preferred - less desirable than LTRAs)
36
5-Lipoxygenase Inhibitor - MOA
Inhibits production of leukotriene from arachidonic acid (LTB4 & cysteinyl leukotrienes)
37
5-Lipoxygenase Inhibitor - AEs
Elevated liver enzymes
38
5-Lipoxygenase Inhibitor - CONSIDERATIONS
Monitor LFT
39
Formoterol
Long-Acting B2-Agonist (LABA)
40
Salmeterol
Long-Acting B2-Agonist (LABA)
41
Albuterol (sustained release PO)
Long-Acting B2-Agonist (LABA)
42
Long-Acting B2-Agonist (LABA) - INDICATIONS
Long term prevention of symptoms ADDED to ICS NOT to be used as monotherapy NOT to be used to treat acute symptoms or exacerbations LABA is preferred in combination with ICS in >12yo
43
Long-Acting B2-Agonist (LABA) - MOA
Bronchodilation: | Smooth muscle relaxation following adenylate cyclase activation & increase in cAMP
44
Long-Acting B2-Agonist (LABA) - AEs
``` Tachycardia Skeletal muscle tremor Hypokalemia Prolonged QT interval (OD) Potential severe life-threatening exacerbations ```
45
Long-Acting B2-Agonist (LABA) - CONSIDERATIONS
Daily use should not exceed 100mcg of Salmeterol OR 24mcg Formoterol
46
Theophylline
Methylxanthines
47
Methylxanthines - INDICATION
Long term control & prevention of MILD PERSISTENT asthma Adjunct with ICS in MODERATE PERSISTENT asthma Not preferred
48
Methylxanthine - MOA
Bronchodilation: Smooth muscle relaxation from phosphodiesterase inhibition & adenosine antagonism May effect eosinophil infiltration into bronchial mucosa Increases diaphragm contractility & mucociliary clearance
49
Methylxanthine - AEs
LOTS Dose related toxicities Narrow TI WHY NOT SEEN OFTEN
50
Albuterol
Short-Acting B2-Agonist (SABA)
51
Levalbuterol
Short-Acting B2-Agonist (SABA)
52
Pirbuterol
Short-Acting B2-Agonist (SABA)
53
Short-Acting B2-Agonist (SABA) - INDICATIONS
Relief of acute symptoms Preventative treatment for EIB prior to exercise *Therapy of choice
54
Short-Acting B2-Agonist (SABA) - MOA
Bronchodilation: | Smooth muscle relaxation following adenylate cyclase activation & increase in cAMP
55
Short-Acting B2-Agonist (SABA) - AEs
``` Tachycardia Muscle tremor Hypokalemia Increased lactic acid Headache Hyperglycemia ```
56
Ipratropium Bromide
Anticholinergic
57
Anticholinergic - INDICATIONS
Relief of acute bronchospasm Provides ADDITIVE benefit to SABA in MODERATE-SEVERE asthma exacerbations Alternative to pts intolerant to SABA
58
Anticholinergic - MOA
Bronchodilation: Competitive inhibitor of muscarinic cholinergic receptors Reduces intrinsic vagal tone in airways - may block reflex bronchoconstriction to irritants May decrease mucous gland secretion
59
Anticholinergic - AEs
Dry mouth Increased wheezing in some
60
Anticholinergic - CONSIDERATIONS
ONLY reverses cholinergically mediated bronchospasm

Respiratory (4 decks)

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