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18 Cards in this Set
- Front
- Back
assignmnent 6 |
chapter 11 page 181 to 194 Rau Rau workbook chapter 9 finish Chapter 11 109 to 112 |
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Non steroidal anti inflammatory |
Chromylin sodium (Intal) :Prevents degranulation of the mast cell :therefore muting allergic stimuli Nedocromil sodium (tilade) :inhibits mast cells, eosinophils, airway epithelial cells from releasing inflammatory cytokines :increases eosinophil production (present in allergic reactions) |
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Anti leukotrine |
Slide of life When the antigen antibody reaction takes place, it decreases cyclic 35 amp. Cromolyn sodium and nedyl cromosodium prevent degranulation from occuring
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Non steroidal anti inflammatory |
Montelukast (singulair) :leukotriene receptor antagonist :Thus preventing bronchoconstriction, mucus secretions, vascular permeability... inflammation |
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Non steroidal anti inflammatory |
Cromolyn like drugs (mast cell stabilizers) Antileukotrienes (anti LTs) Monoclonal antibodies (prevent release of leukotrienes for asthma)
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Non steroidal anti infmallamtory indications |
Prophylactic management (control) of mild persistent asthma :Cromolyn and anti Luekotriene as alternatives to ICS (inhaled cortico steroid) in asthma requiring step 2 care
Generel indications for Cromolyn :cromolyn is often used with infants and young children as alternatives to ICS in asthma requiring step 2 care because of safety profiles of ICS :Anti leukotrienes can be useful in combination with ICS to reduce the steroid dose |
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Immunological (allergic) response |
Allergic response of asthma involves mast cells and IgE Mast cells release :Leukotrienes :prostaglandins :Proteases :Histamines :Platelet activating factor (PAF) :cytokines |
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Cascade of mediators |
Inflammatory response manifests as :vascular leakage(occurs in the interstitium and tissue leading to edema) :bronchoconstriction :mucus secretions :mucosal swelling All of these lead to obstruction of airflow in the bronchioles Accumulation and activation of eosinophils lead to damage of the airway
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Cromolyn Mast cell stabilizing agent |
Prophylactic agent in the treatment of asthma Cromylyn sodium (disodium cromoglycate) :Dosage and administration ::SVN 20 mg/ampule or 20 mg/2ml (1%) :Mechanism of action ::Prevents mast cell degranulation
Cromolyn sodium (disodium cromoglycate) :side effects ::Cough ::Nasal congestion ::Wheezing ::Epixtaxis ::nose burning
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Anti Leukotrine (they are anti inflammatories, but not steroids) |
Cromolyn prevents a release of IgE and protaglandins via mast cell stabalization.
Leukotriene receptors are blocked so the |
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Antileukotriene agents |
Leukotrienes and inflammation Leukotrienes are potent bronchoconstrictors and stimulate other cells to cause :Airway edema :Mucous secretion :Ciliary beat inhibition ::Recruitment of other inflammatory cells
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Antileukotriene agents |
5-LO inhibitor :Zileuton (Zyflo, Zyflo CR) Leukotriene receptor antagonists :Zafirlukast (Accolate) :Montelukast (Singulair) Monoclonal antibodies :Omalizumab (Xolair)
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ANtileukotriene agents |
Omazlizymab (Xolair) Dosage and administration :Oral administration :600 mg tables qid Mechanism of action :inhibits 5:LO enzyme Hazards and side effect :Headache, abdominal pain, oss of stregth, dyspepsia :Monitor liver functions :Interacts with theophylyine and warfarin Zafirlukast (accolate) :Dosage ::Oral administration ::10 mg bid children 5 to 11 years old ::20 mg bid 12 years old and older :mechanism of action ::Leukotrine receptor antagonists :Hazardsa and side effects ::Headache, infection, nausea, diarrhea, generalized and abdominal pain |
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Antileukotriene agents |
Montelukast (Singulair) :Dosage and administration ::Oral administration ::4mg and 10 mg ::5 mg chewable :Mechanism of action ::Leukotriene receptor antagonists ::Binds with high affinity and selectivity to CysLT, receptor subtype |
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Antileukotriene agents |
Montelukast (singulair) :Hazards and side effects ::Diarrhea, nausea ::Laryngitis, pharyngitis ::Otitis, sinusitis, viral infection |
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Antileukotriene agents advantages |
Oral administration, possible once daily dosing Safe, with few side effects to date Effective in aspirin sensitivity and often in exercise induced asthma Systemic distribution reaches entire lung through the circulation Additive effect with inhaled steroids May reduce steroid dose or prevent an increase in steroid dose Formulation approved for pediatric dosing (montelukast) |
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Antileukotriene agents disadvantages |
Antiinflammatory action limited to one mediator pathway Unknown long term toxicity Variable response :Effective in about 50% to 70% of patients Systemic drug exposure Generally not useful as monotherapy |
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Antiinflammatory overview |
Inhaled steroids, cromolyn like and antileukotreines all have a brochoprotective effect All are given prophyllactically (preventative, before the horse gets out) All are the maintenance drugs of choice for asthma |