Unit 4-Asthma Flashcards Preview

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Flashcards in Unit 4-Asthma Deck (48):
1

Albuterol; Terbutaline; Metoproterenol; Pirbutal

Drug class

Bronchodilator - short-acting β2 agonist)

2

Albuterol; Terbutaline; Metoproterenol; Pirbutal

Mechanism

Relax bronchial smooth muscle, inhibit mediator release (mast cells, basophils), increase mucociliary clearance, suppression of microvascular permeability

3

Albuterol; Terbutaline; Metoproterenol; Pirbutal

Uses

Prevent or reduce exercise-induced bronhospasms; mild asthma & acute exacerbations

4

Albuterol; Terbutaline; Metoproterenol; Pirbutal

Side effects

Musculoskeletal tremor, Tachycardia, hyperglycemia, hypokalemia, hypomagnesemia

Tolerance with chronic use, Prolonged QTc, lactic acidosis, paradoxical bronchospasm

5 minutes to take action, 4-6 hours duration; nebulizer delivers more, but greater side effects. Note: Levalbuterol is R-isomer of albuterol.

5

Salmeterol (Serevent); Formoterol; Indacaterol

Drug class

Bronchodilator - long-acting β2 agonist

6

Salmeterol (Serevent); Formoterol; Indacaterol

Uses

used for long-term control of asthma symptoms (always in comination with inhaled steroids)

7

Salmeterol (Serevent); Formoterol; Indacaterol

Side effects

8

Salmeterol (Serevent); Formoterol; Indacaterol

Mechanism

Relax bronchial smooth muscle, inhibit mediator release (mast cells, basophils), increase mucociliary clearance, suppression of microvascular permeability

9

Salmeterol (Serevent); Formoterol; Indacaterol

Side effects

Musculoskeletal tremor, Tachycardia, hyperglycemia, hypokalemia, hypomagnesemia

Tolerance with chronic use, Prolonged QTc, lactic acidosis, paradoxical bronchospasm

10-15 minutes to take action, 6-12 hours (max) of duration; nebulizer delivers more, but greater side effects; oral is least effective (requires more dose --> side effects); can be used night symptoms, but not ideal

10

Theophylline (Theolair); Theobromine; Caffeine

Drug class

Bronchodilator (Methylxanthine)

11

Theophylline (Theolair); Theobromine; Caffeine

Mechanism

Phosphodiesterase inhibition and enhanced signalling via increased cAMP and cGMP; relax bronchial smooth muscle

12

Theophylline (Theolair); Theobromine; Caffeine

Uses

Reduce inflammation and bronchospasm in moderate to severe asthma, night symptoms

13

Theophylline (Theolair); Theobromine; Caffeine

Side effects

CNS stimulation or seizures, tachycardia/arrythmias, anorexia, nausea

Low therapeutic index! Metabolized by liver; cimetidine and quinoline increase blood levels

14

Roflumilast

Drug class

Methylxanthine

 

15

Roflumilast

Mechanism

Selective PDE4 inhibitor; more of an anti-inflammatory agent than bronchodilator

16

Roflumilast

Uses

COPD

17

Roflumilast

Side effects

CNS stimulation or seizures, tachycardia/arrythmias, anorexia, nausea

18

Ipratropium (Atrovent); Tiotropium; Atropine

Drug class

Quarternary amine antimuscarinic

19

Ipratropium (Atrovent); Tiotropium; Atropine

Mechanism

Blocks vagal pathways and decreases vagal tone to bronchial smooth muscle; also blocks the reflex bronchoconstriction caused by inhaled irritants

Note: tiotropium has anti-inflammatory properties and decreases mucus secretion.

20

Ipratropium (Atrovent); Tiotropium; Atropine

Uses

First-line agent for chronic COPD; status asthmaticus (w/ nebulized β2-agonists); no role in chronic stable asthma

21

Ipratropium (Atrovent); Tiotropium; Atropine

Side effects

Typical antimuscarinic effects; acute angle glaucoma; paradoxical bronchospasm

 

22

Aclidinium Bromide

Drug class

Quarternary amine antimuscarinic

23

Aclidinium Bromide

Mechanism

Blocks vagal pathways and decreases vagal tone to bronchial smooth muscle; also blocks the reflex bronchoconstriction caused by inhaled irritants

24

Aclidinium Bromide

Uses

Functionally similar to tiotropium

25

Aclidinium Bromide

Side effects

Less systemic & CNS side effects than other antimuscarinics due to extremely short circulation half-life.

 

26

Budesonide; Fluticasone propionate; beclomethasone

Drug class

Corticosteroid - anti-inflammatory agent

27

Budesonide; Fluticasone propionate; beclomethasone

Mechanism

Anti-inflammatory effects: inhibition of growth factor secretion, inhibition of arachidonic acid metabolites and platelet activation factor, inhibition of leukocyte accumulation, decreased vascular permeability, inhibition of neuropeptide-mediated responses, inhibition of mucous glycoprotein secretion

28

Budesonide; Fluticasone propionate; beclomethasone

Uses

Cornerstone treatment of persistent asthma; beneficial combination with beta-2 agonist; limited role in COPD

29

Budesonide; Fluticasone propionate; beclomethasone

Side effects

Inhaled has thrush, hoarseness, dry cough, mild adrenal suppression (higher doses); oral has mood-swings, increased appetite, and suppression of adrenocorticotropic hormone secretion (Cushing's Syndrome)

30

Ciclesonide

Drug class

Corticosteroid - anti-inflammatory agent

31

Ciclesonide

Mechanism

Same as other corticosteroids, but is a prodrug and only activated by airway esterase.

32

Ciclesonide

Uses

Cornerstone treatment of persistent asthma; beneficial combination with beta-2 agonist; limited role in COPD

33

Ciclesonide

Side effects

Less side effects than other corticosteroids (on site activation required)

34

Sodium cromoglycate; Nedocromil sodium

Drug class

Anti-inflammatory agent

35

Sodium cromoglycate; Nedocromil sodium

Mechanism

Prevent mast cell degranulation and mediator release from mast cells

36

Sodium cromoglycate; Nedocromil sodium

Uses

Prophylaxis for inhibiting both early and late phase reactions; best results in mild and allergic asthma

37

Sodium cromoglycate; Nedocromil sodium

Side effects

Minimal local side effect (cough & throat irritation)

38

Montelukast (Singulair); Pranlukast (Azlaire); Zafirlukast (Accolate)

Drug class

Leukotriene inhibitor

39

Montelukast (Singulair); Pranlukast (Azlaire); Zafirlukast (Accolate)

Mechanism

Leukotriene receptor antagonist

40

Montelukast (Singulair); Pranlukast (Azlaire); Zafirlukast (Accolate)

Uses

Add-on therapy in mild persistent asthma; aspirin-induced asthma; prophylaxis for exercise-induced bronchospasm

41

Montelukast (Singulair); Pranlukast (Azlaire); Zafirlukast (Accolate)

Side effects

Well tolerated

Must monitor liver function test.

42

Zileuton

Drug class

Leukotriene inhibitor

43

Zileuton

Mechanism

Inhibits 5-lipoxygenase and blocks leukotriene synthesis

44

Zileuton

Uses

Add-on therapy in mild persistent asthma; aspirin-induced asthma; prophylaxis for exercise-induced bronchospasm

45

Zileuton

Side effects

Liver toxicity

46

Omalizumab

Drug class

Anti-IgE mAB

47

Omalizumab

Mechanism

Blocks IgE function.

48

Omalizumab

Uses

Poorly controlled severe asthma

Administered by subQ injection every 3 weeks