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11 Cards in this Set

  • Front
  • Back
Drug delivery methods
MDI- Meter Dosed Inhaler- require skill
Nebulizer- passive breathing
Asthma- pathophys
Mast cell activation (IgE-cytokines)
Bronchoconstriction (Parasympathetic- ACh and muscarinic)
Ca vs cAMP on smooth muscle tone
nocternal asthma
primarily due to parasympathetic activity which is higher at night
3 components to asthma therapy
Avoidance- avoid trigger
"Beclomethasone and prednisolone"
modulate gene expression- reduce inflammation and hypersensiticity via immunosupression- esp Mast cells and eosinophils
Side Effects- dose dependant, tolerance can lead to need for increased dose, local immunosuppression-candidiasis
delayed onset of action
oral and aerosol
Degranulation Inhibitors
"Cromolyn sodium"-ie Intal
bloack mast cell degranulation and eosinophil chemotaxis via K channel
aerosol only- only absorbed via lungs (not GI)
Beta-adrenergic agonists
smooth muscle relaxants in the lungs

Albuterol (short acting)- rapid onset- good for acute exhascerbations

Salmeterol (Serevent)- long acting- slower onset (aerosol only)

Side Effects- excitability, arrhythmias (some B1 effects)
Muscarinic Antagonist
"Ipratropium"- ie Atrovent
Anticholonergic- block smooth muscle contraction
mostly works on parasympathetic driven cases
No systemic effects- not absorbed
aerosol only
Adenosine receptor inhibitors (A3 subtype) in Mast cells- both bronchodilator and anti-hypersensitivity effects
Side Effects: lots- related to caffeine, low TI, requires careful monitoring
Leukotriene Antagonist
"Montelukast" aka Singulair
blocks cell membrane lipids conversion to lipoxygenase to leukotrienes- block hypersensitivity and bronchoconstriction
Use depends on level of leukotriene involvement (ex asprin sensitivity, etc)- prophylaxis only
oral (no aerosol)
NHLBI Guidelines for TX
1. increased severity calls for increasingly complicated drug therapy
2. all pts need Albuterol for acute brochodilation
3. increasing need for steroids with increased severity