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Asthma/COPD drugs

Drugs to treat asthma/COPD, Maloney, 1/11/2013

Immediate goal in treating an asthma attack Bronchodilation
Acetylcholine is released by the ____ Parasympathetics
Acetylcholine binds to which receptor M3 which causes bronchoconstriction
Most potent bronchoconstrictors in the body Leukotrienes
Are Antihistamines effective for asthma? No
First line drug for immediate treatment of acute asthma attack Short acting beta agonist
Short acting beta2 agonists Metaproterenol, Albuterol, Levalbuterol, Pirbuterol, Terbutaline
Long acting beta2 agonists Salmeterol, Formoterol, Arformoterol
Albuterol works how quickly? 3-5 minutes
Why use a SABA instead of a LABA for an asthma attack You want your drug to work immediately so you don't die
Side effects of B2 agonist Tachycardia, increased glucose levels, hypokalemia, tremors, NO urinary incontinence
Why do B2 agonists cause tachycardia? Reflex due to vasodilation and the beta2 has some affinity for the beta1 receptors on the heart causing increased heart rate
Why do B2 agonists cause hypokalemia Skeletal muscles beta2 receptors causes cells to take in potassium
Why do B2 agonists cause Tremors? Beta2 receptors on skeletal muscles cause tremors
Why doesn'y a B2 agonist cause urinary incontinence? The beta2 receptors in the bladder are found on the detrusor muscle. A beta2 agonist will cause the detrusor to relax which will hold in urine
Antcholinergics (muscarinic blockers)for Asthma Ipratropium bromide (inhaled and short acting)
What drug is given for actue exacerbation asthma if patient is not controlled well with SABA alone or cannot tolerate SABAists? Iptratropium brominde (add onto SABA or as 2nd line treatment)
Why does ipratropium have less side effects than atropine? Ipratroprium is charges which prevents it from crossing membranes and is far less systemically absorbed than atropine
Will SABA or Ipratropium stop inflammation in asthma? No way!
What is given to treat inflammation in asthma? Oral systemic Corticosteroids to speed recovery and prevent recurrence
Oral systemic corticosteroids Prednisone, Prednisolone, Methylprednisolone
Prophylactic treatment for exercise induced asthma? Albuterol 10-15 minutes before
Best way to minimize steroid side effects with asthma? Give via inhalation
Persistent asthmatics must be given a Corticosteroid
Inhaled corticosteroids Beclomethasone, Fluticasone, Triamcinolone, Flunisolide, Budesonide, Ciclesonide, Mometason
Will a corticosteroid dilate constricted airways in people with asthma or COPD No, they are not bronchodilators. The only get rid of inflammation
Inhaled Corticosteroids adverse effects Oral candidaisis (steroids are immunosupressants), unpleasant taste, dysphonia, relfex cough and bronchospasm
How can you reduce corticosteroid adverse effects Use a spacer, Swish and spit, give a short acting beta2 agonist before to prevent bronchospasm
Created by: mcasto