Drugs to treat asthma/COPD, Maloney, 1/11/2013
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| Immediate goal in treating an asthma attack | Bronchodilation
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| Acetylcholine is released by the ____ | Parasympathetics
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| Acetylcholine binds to which receptor | M3 which causes bronchoconstriction
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| Most potent bronchoconstrictors in the body | Leukotrienes
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| Are Antihistamines effective for asthma? | No
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| First line drug for immediate treatment of acute asthma attack | Short acting beta agonist
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| Short acting beta2 agonists | Metaproterenol, Albuterol, Levalbuterol, Pirbuterol, Terbutaline
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| Long acting beta2 agonists | Salmeterol, Formoterol, Arformoterol
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| Albuterol works how quickly? | 3-5 minutes
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| Why use a SABA instead of a LABA for an asthma attack | You want your drug to work immediately so you don't die
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| Side effects of B2 agonist | Tachycardia, increased glucose levels, hypokalemia, tremors, NO urinary incontinence
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| 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
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| Why do B2 agonists cause hypokalemia | Skeletal muscles beta2 receptors causes cells to take in potassium
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| Why do B2 agonists cause Tremors? | Beta2 receptors on skeletal muscles cause tremors
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| 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
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| Antcholinergics (muscarinic blockers)for Asthma | Ipratropium bromide (inhaled and short acting)
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| 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)
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| 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
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| Will SABA or Ipratropium stop inflammation in asthma? | No way!
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| What is given to treat inflammation in asthma? | Oral systemic Corticosteroids to speed recovery and prevent recurrence
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| Oral systemic corticosteroids | Prednisone, Prednisolone, Methylprednisolone
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| Prophylactic treatment for exercise induced asthma? | Albuterol 10-15 minutes before
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| Best way to minimize steroid side effects with asthma? | Give via inhalation
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| Persistent asthmatics must be given a | Corticosteroid
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| Inhaled corticosteroids | Beclomethasone, Fluticasone, Triamcinolone, Flunisolide, Budesonide, Ciclesonide, Mometason
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| Will a corticosteroid dilate constricted airways in people with asthma or COPD | No, they are not bronchodilators. The only get rid of inflammation
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| Inhaled Corticosteroids adverse effects | Oral candidaisis (steroids are immunosupressants), unpleasant taste, dysphonia, relfex cough and bronchospasm
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| How can you reduce corticosteroid adverse effects | Use a spacer, Swish and spit, give a short acting beta2 agonist before to prevent bronchospasm
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