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318 CH 75

Drugs for Asthma

QuestionAnswer
What is Asthma? Chronic inflammatory disorder. Immune mediated inflammation.
what are the s/s of Asthma? breathlessness, tightness in chest, wheezing, dyspnea and cough
what are the 2 goals of the treatment of Asthma? Bronchodilate [Beta 2] and Decrease inflammation [Steriods]
what are the 3 anti-inflammatory drugs used for asthma? (1) Glucocorticoids, (2) Leukotreien modifiers [Singulair, (3) Chromolyn [Chromolyn(Intal)]
what are the most effective anti-inflammatory drugs for asthma? glucocorticoids
what is the mechanism of action for glucocorticoids? Suppress inflammation, decrease action of inflammatory cells (Eosinophils), decrease edema in airway
what is them primary administration method of glucocorticoids for asthma? inhalation (can be administered orally)
what are the side effects of glucocorticoids (steroids in general)? bone loss, dry mouth/thrush, adrenal fatigue
what can a pt do to prevent bone loss while on glucocorticoids? calcium/Vitamin D supplements
who is at increased risk for bone loss? asian, white women who smoke and don't perform weight baring exercises
what can a pt do to reduce dry mouth/thrush in a pt on inhaled glucocorticoids? rinse with water after inhalation
what will be necessary in times of stress in a pt who's adrenal glands are fatigued? more steroids
glucocorticoids: are they used for acute asthma attacks or are they used long term for prophylaxis? long term
who takes oral glucocorticoids? it is reserved for pts with severe asthma. the risk for toxicity is increased with duration of use, so should be as brief as possible.
what are the most common adverse effects (that are different from inhaled) in oral glucocorticoids? orthopharyngeal candidas and dysphonia (hoarseness and speaking difficulty)
What is the mechanism of action for Singulair? promote bronchodilation and decrease inflammation/edema
Is singulair more or less effective compared to glucocorticoids? less
what is singulair used for? exercise induced asthma (pt 15+ years), in conjunction for allergic rhinitis
what is the dosing schedule for Singulair? PRN or long term? NOT PRN! takes at least 24 hours to see max effect. 1x/day
what is the major side effect of Singulair? increase in suicide
what is the SAFEST of all anti-asthma drugs? Chromolyn [Intal]
what is Chromolyn [Intal]? prophylactic med or PRN? prophylactic anti-inflammatory med used for asthma
how is chromolyn [Intal] administered for asthma? inhalation
what is chromolyn [Intal] used for? exercise induced asthma (age 15+) and chronic asthma
What bronchodilators used for (in asthma)? symptomatic relief. acute attack.
What bronchodilators are used for asthma pts? Beta 2 adrenergic agonists, Methylxanthines (Theophyllin), Glucocorticoid/LABA combo (Advair)
are beta 2 adrenergic agonsts used acute or prophylactically? both. short acting - PRN. Long acting - prophylactically[ONLY IN CONJUNCTION with glucocorticoids]
what are the adverse effects of Beta2 agonists? (Asthma) Tachycardia, TREMOR, angina
adverse effects of long acting Beta 2 agonists (asthma)? may increase the risk of severe asthma and asthma-related deaths
what is the mechanism of action for Theophyllin? relaxes smooth muscle and promotes bronchodilation
administration route for Theophyllin ORAL or in emergencies IV. NOT INHALED!
therapeutic index for Theophyllin: 5-15
s/s mild theophyllin toxicity: (therapeutic level of this) n/v/d, restlessness. 20-25
s/ssevere theophyllin toxicity. what is the therapeutic level of this? dysrhythmias and convulsions >30
what is the antidote of Theophyllin? none!! use activated charcoal, cathartic for OD. if administered IV, these things will not help.
what is teh glucocorticoid/LABA combo drug? Advair
what is the mechanism of action for Advair? anti-inflammatory / bronchodilator
how is Advair administered? dry powder inhaler (NOT A RESCUE inhaler)
administration schedule for Advair 2x/day
side effects of Advair those of Glucocorticoid and LABA
Created by: 1398660434
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