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34 Cards in this Set
- Front
- Back
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Classes of Anti-Asthma Drugs
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Beta-2 Agonists (#1)
Muscarinic Receptor Antagonists (#2) Methylxanthines (#3) Leukotriene Modifiers Glucocorticosteroids (the actual Rx) Sodium Cromolyn/Dedocromil Sodium Omalizumab |
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What do Beta-2 agonists do?
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relax bronchial smooth muscle
inhibit mediator release from mast cells Inhibit vagal tone and increase mucus clearance |
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Most common SE w/ Beta-2 Agonists?
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Tremor
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Other possible SE's?
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Maybe tolerance
Maybe hypokalemia when used w/ xanthines or glucocorticoids |
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Classes of Beta-2 Agonists?
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Resorcinols
Saligenins Others |
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Who are the Resorcinols?
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Metaproterenol
Terbutaline |
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Who are the Saligenins?
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Albuterol
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Who are the Others?
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Bitolterol (pro-drug)
Pirbuterol Levalbuterol |
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Who are the long acting Beta-2 agonists?
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Salmeterol
Formoterol |
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Where does Ipratropium bromide work?
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Blocks M3 cholinergic receptors
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Activities of Ipratropium bromide?
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inhibits mucus secretion augmentation
may increase mucus clearance No effect on inflammation few SE's |
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Who is the xanthine to know?
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Theophylline
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Why aren't xanthines used much?
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Least expensive...but
Least effective |
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Anti-asthmatic actions of Xanthines?
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Relieve acute attachs
Rx chronic asthma Inhibit synthesis and secretion of inflammatory mediators |
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Other Actions of xanthines?
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CNS: tremor, nervousness, screw w/ sleep
Positive inotropy, chronotropy Vasodilation except in cerebrum where they constrict Weak diuretic |
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Therapeutic index for xanthines?
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NARROW
10-20mg/L |
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SE's of xanthines?
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CV
CNS Anorexia, N&V Fatal arrhythmias (> 30mg) |
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Actions of Glucocorticoids?
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Inhibit generaiton of leukocyte chemotaxins
Inhibit generaiton of spasmogenics and vasodilators Inhibit eosinophil influx into lungs Reduce cytokine synthesis basically ANTI-INFLAMMATORY |
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What don't glucocorticoids do?
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Bronchodilate...so combo them
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Examples of Glucocorticoids for asthma?
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Beclomethasone
Budesonide Triamcinolone Flunisolide Fluticasone |
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SE's of glucocorticoids?
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oropharyngeal candidiasis
dysphonia adrenal suppression w/ large doses |
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Examples of Leukotriene Modifiers?
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Zafirlukast
Montelukast |
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Actions of Leukotriene Modifiers
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Prevent bronchospasm
Bronchodilate |
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Who is the lipo-oxygenase inhibitor?
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Zileuton
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What's up with Zileuton?
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disappeared in US (is back)
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SE's of Zileuton?
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Mild
elevate liver enzymes in 4% of pts decreases warfarin clearance |
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SE's of Zafrilukast
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may interact w/ warfarin and increase PTT
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Effects of Cromolyn Na and Nedocromil Na?
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Not bronchodilators
Prophylactics to reduce immediate and late phases of asthma Good for exercise-induced and irritant-induced asthma Good w/ kids |
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Mechanism of Na guys?
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Mast cell stabilizer
Inhibit parasympathetic and cough reflexes Inhibit release of T-cell cytokines |
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SE's of Na guys?
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bronchospasm
cough/wheezing Laryngeal edema HA Rash Joint swelling Pain Nausea |
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what kind of drug is Omalizumab?
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Recombinant humanized anti-IgE Ab
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Mech of omalizumab?
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binds IgE, so it can't bind to its receptor
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Administration of omalizumab?
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Subcu every 2-4 weeks
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Indicated for?
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adults w/ allergies and moderate to severe asthma
(not a bronchodilator) |
