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pharmacology 1

drugs for asthma

anti-inflammatory agents 2 types: glucocorticods such as prednisone or cromolyn which is primary used in pediatrics.
bronchodilators 2 types: beta2agonists such as albuterol or theophylline which is not a common drug
glucocorticoids or corticosteroids are for reducing inflammation. can be administered by inhalation primary for patients with moderate to severe asthma and should be used daily or for severe asthmatic patients they can be taken orally or IV
glucocorticoid side effects orophayngeal candidiasis, dysphonia (hoarseness, difficulty speaking), adrenal suppression in long term use (very tired), bone loss, slow growth in children from long term use
how to reduce side effects of glucocorticoids decrease the dose, rinse mouth after use, use a space device.
inhaled corticosterioid example Flovent generic name: Fluticasone propionate which is a locally acting anti-inflammatory and immune modifier. it is used to decrease frequency of asthma attacks, prevention of pulmonary damage associated with chronic asthma.
Adverse effects of flovent (inhaled corticosteroid) hoarseness, oropharyngeal fungal infections, esophogeal candidiasis, dry mouth
Corticosteriod drug, methylprednisone brand name is Solu-medrol. action is to suppress inflammation. Given by IV in the hospital for very bad asthma attack.
cromolyn is: an anti-inflammatory drug, for kids, because it is a safe and slow drug, takes 2-3 weeks. Use prophylaxtically to suppress inflammation, not for quick relief. *Follow a fixed dosing schedule, and give 15 minutes before exercising*
Bronchodilator does what? provides symptomatic relief but do not alter the underlying disease. Patient should also take glucocorticoid for long term therapy. Use caution in pts with DM, hyperthyroid, heart disease, hypertension and angina
Function of Beta 1 heart increases, altered rhythm and angina, renin released
Fuction of Beta 2 example: albuterol. vasodilation, broncho dilation (asthma).. dopamine is for patients in shock which it dilates renal blood vessels
Bronchodilator : beta 2 adrengernic agonists include albuterol, salmeterol, terbutaline. most effective for relief of acute bronchospams and prevention of exercise induced bronchospasm. used for quick relief and long term
adverse effects of bronchdilators inhaled: systemic effects such as tachycardia, angina, and tremors ** albuterol in high dose will change to a beta 1 and will increase the heart rate ** Oral: excessive dosing leads to angina pectoris, and tachydysrhythmias, tremor
Info about albuterol : proventil : short acting bronchodilator adrenergic, management of reversible airway obstruction. Binds to beta 2 adrenergic receptors in airway smooth muscle.
Adverse effects of albuterol: **cardio- chest pain, palpitations, angina, hypertension, tachycardia**, nervousness, restlessness, tremor, headache, insomnia
Bronchodilator :: methylxanthine *hospital drug, very toxic, leads to dysrhytmia, tachycardia* example is theophylline- narrow therapeutic index
anti-leukotriene drugs new class of asthma drugs. works on immmune system at cellular level. ex: montelukast (singulair). can not be used for quick relief of asthma attack. lasts 24 hours
class 1 : intermittent asthma : not severe : first time attack..use: short acting inhaled b2 agonist prn ( albuterol )
class 2 : mild persistent asthma.. use: short acting inhaled b2 agonist prn (albuterol) and low dose inhaled corticosteroids (fluticasone :flovent: )
class 3 : moderate persistent asthma : bad asthma attack..use inhaled corticosteroid, not oral. a long acting bronchodilator ( salmeterol known as serevent or formoterol which is foradil )..add a anti-leukotriene drug such as montelukast aka singular or zafirlukast aka accolate
class 4: severe persistent asthma high dose inhaled corticosterod and po prednisone or use IV in hospital such as solu-medrol
glucocorticoid/ LABA combinations either fluticason (steroid)/salmeterol(bronchodilator)aka advair or budesonide/formoterol aka symbicort. for long therm therapy, not recommened for initial therapy.
Created by: hdishuk1