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29 Cards in this Set
- Front
- Back
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asthma pathophys
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allergins bind to IgE antibodies on mast cells
mast cells release inflammatory mediators mediators cause inflammatory cells to infiltrate airway walls, releasing more mediators end result:airway inflammation and edema, increased mucus, smooth muscle hypertrophy, bronchospasm, |
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Classes of drugs used to treat asthma
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Bronchodialators:Beta 2 agonist, methylxanthines, anticholigernics
Anti-Inflammatory: glucocorticoids, cromolyn, leukotriene modifiers, IgE blockers |
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3 types of bronchodilators
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Beta 2 adrenergic agonist
anticholinergic methylxanthines |
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when is a Beta 2 adrenergic used
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acute asthma attack
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when is an anticholinergic used
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COPD
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how do anticholinergics work
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blocks cholenergic receptors: smooth muscle relaxation = bronchodilation
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Albuterol (Proventil)
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Beta 2 adrenergic agonist
Used in a rescue inhaler Short acting Also used in COPD bronchodilator |
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Cromolyn (Intal)
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Anti-inflammatory for asthma
Stabilizes mast cells reduced release of mediators Inhibits proliferation of inflammatory cells Nebulized or MDI First line drug for asthma |
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leukotriene modifiers
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leukotriene modifiers
prone to drug interactions and liver disfunction Decrease eosinophil infiltration, musus production, airway edema, bronchoconstriction, Orally administered as prophylaxis |
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IgE blockers
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binds circulatioing IgE
inhibits binding of IgE to mast cells |
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drug therapy for mild astha
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quick acting beta 2 agonist inhaler prn
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mild persistent asthma therapy
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low dose inhaled steroids
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severe to persistent asthma therapy
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high dose inhaled steroids, LA inhaled beta 2 agonists, oral steroids prn
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how to deal with acute exacerbation of asthma
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beta 2 agonist
IV or oral steroids 02 epi |
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management of asthma
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classify severity, drug therapy, reduce triggers, monitor
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Salmeterol (Serevent)
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Beta 2 adrenergic agonist
Inhaled long acting Concern of bleed over to Beta 1 effects Generally take with other meds |
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Montelukast (Singulair)
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antiinflammatory drug
leukotriene modifier decrease eoninophil inflitration, mucus production, airway edema, bronchoconstriction p.o. prophylaxis has less drug interaction and less damage to the liver when compared to other drugs in the same class |
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Allergic rhinitis – pathophysiology, symptoms
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inflammation of the nasal mucosa in response to allergens
sesional or perennial sneezing, runny nose, ithching, nasal congestion due to release of histimane and inflammatory mediators |
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drugs to treat allergic rhinitis
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antihistamines, intranasal glucocorcoids, intranasal cromolyn, sympathomimetics (decongestants)) oral or topical
anticholinergics subcut omalizumab |
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antihistamines
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First line preventative therapy for rhinitis
Blocks histamine receptors Relieve sneezing, rhinorrhea, ithchng Does NOT relieve congestion, not helpful for viral URI Common side effect: dry mouth, sedation Nasal spray |
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intranasal glucocorticoids
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first line therapy for prevention and treatment of allergic rhinitis
beneficial effects take 2-3 weeks pretreat with nasal decongestant SE: nasal dryness, burning, potential for systemic absorption start with a full dose and reduce when symptoms are under control |
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Antitussives –
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opioid --codiene--too many side effects
nonopioid--dextromethorphan |
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how much of a DPI gets into the lungs
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20%
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Beclomethasone dipropionate (Beclovent)
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Beclomethasone dipropionate (Beclovent)
Glucocorticoid Anti-inflammatory Inhaled Taken daily for long term control of asthma Decrease synthesis of inflammatory mediators Decrease edema in lungs Decrease infiltration and activity of inflammatory cells (eosinophil, leukocyte) |
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who uses oral glucocorticoids
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severe asthma, not for long term use
SE: bone loss, adrenal suppression, dysphonia (difficulty speaking) oropharyngeal candidiasis |
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who uses inhaled glucocorticoids
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people with asthma use it as prophlaxis daily (not prn)
SE: bone loss, adrenal suppression, dysphonia (difficulty speaking) oropharyngeal candidiasis SE are much less severe in inhaled vs.oral |
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cromolyn
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Anti-inflammatory for asthma
Stabilizes mast cells reduced release of mediators Inhibits proliferation of inflammatory cells Nebulized or MDI First line drug for asthma not for use during an attack |
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salmeterol should always be taken with
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a steroid
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four classes of asthma
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intermittant
mild persistent moderate persistent severe persistent |
