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NURS 572 Ch 75 asthm

Pharm Ch 75 asthma

What 2 classes of drugs are used to tx asthma anti-inflammatory-----bronchodilators
What drugs in the anti-inflamm class are used glucocorticoids---NSAIDs
what drugs are in the bronchodilator class Beta-2 agonists---anticholinergics---leukotriene modifiers---methylxanthines
what is the advantage to inhalation tx delivers drug where it's needed ---especially with spacer---21% to lung vs. 9% without spacer
3 types of inhalation tx MDIs = metered dose inhalers-----DPI = dry powder inhaler -----nebulizer
what are the MOST EFFECTIVE anti-asthma drugs inhaled glucocorticosteroids most effective
local ADRs of inhaled steroids oropharyngeal candidiasis----dysphonia (voice impairment)----prevent by gargline after admin, using a spacer
systemic ADRs of long-term use of inhaled steroids osteoporosis-----retarded growth rate, may catch up----cataracts/glaucoma------rare HPA axis suppression
name 3 inhaled steroids ending in -ide budesonide-----ciclesonide-----flunisolide
name 4 inhaled steroids ending in -one beclomethasone-----fluticasone-----mometasone----triamcinolone
name 2 oral/systemic steroids generally used for asthma prednisolone----predenisone
name 2 oral/systemic steroids if don't need mineralcorticoid activity (prolong action preferred) methylprednisolone-----dexamethasone
Action of Beta-2 adrenergic agonists most effect for ACUTE bronchospasm------prevention of exercise induced bronchospasm-----often included in routine tx----also prophylactic
how can Beta-2 agonists be admin inhaled or oral
ADRs of oral Beta-2 agonists tremor common, tol developse----systemic Beta-1 SEs possible (tachy, angina)-----HYPOKALEMIA
ADRs of inhaled Beta-2 agonists much lower incidence of tremor, systemic Beta-1, hypokalemia
name 4 quick/short acting inhaled Beta-2 agonists albuterol----levabuterol----bitolterol----pirbuterol
albuterol quick/short inhaled B-2 agonist
levalbuterol quick/short inhaled B-2 agonist
bitolterol quick/short inhaled B-2 agonist
pirbuterol quick/short inhaled B-2 agonist
name 2 long acting inhaled Beta-2 agonists salmeterol---formoterol (and alfrometerol)
what are 2 oral beta-2 agonists albuterol, terbutaline
what is are 2 non-steroidal anti-inflammatory inhaled drugs cromolyn-----nedocromil
what drug is SAFEST of all anti-asthma meds that would be cromolyn
what is MOA of cromolyn, nedocromil NOT A BRONCHODILATOR-----phrophylaxis---suppresses inflammation
ADRs of cromolyn, nedocromil virtually no systemic bwo 8% absorption---cough---bronchospasm
name 2 anti-cholinergics that can be inhaled with or without addition of albuterol ipratropium----tiotropium
cromolyn class nonsteroidal anti-inflamm
nedocromil class nonsteroidal anti-inflamm
MOA anti-cholinergics blocks the muscarinic receptors that would cause bronchocon--> bronchoDIL
are anticholinergics more/less effective than Beta-2 agonists less effective, but additive for pts who are difficult to control
ADRs of anicholinergics dry mouth, throat irritation---system effects rare
ipratropium class anticholinergic
tiotropium - longer acting - its class anticholinergic
methylxanthines MOA this class not established
name 1 drug in methylxanthine class theophylline - rarely used
why is theophylline rarely used has a very narrow therapeutic window. ADRs a,n,v,d----CNS nerv/insom,conv-----CV tachy,dys,angina
theophylline class methylxanthine
leukotriene modifier MOA suppress leukotrienes so they can't bronchocon--> net effect bronchDIL
name 1 leukotriene modifiers montelukast-qd
which leukotriene has no liver toxicity SE montelukast
Created by: lorrelaws