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11 Cards in this Set
- Front
- Back
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Drug delivery methods
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MDI- Meter Dosed Inhaler- require skill
Nebulizer- passive breathing |
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Asthma- pathophys
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Mast cell activation (IgE-cytokines)
Bronchoconstriction (Parasympathetic- ACh and muscarinic) Ca vs cAMP on smooth muscle tone |
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nocternal asthma
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primarily due to parasympathetic activity which is higher at night
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3 components to asthma therapy
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Avoidance- avoid trigger
Anti-inflammatory/hypersensitivity Bronchdilators |
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Glucocorticoids
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"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 |
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Degranulation Inhibitors
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"Cromolyn sodium"-ie Intal
bloack mast cell degranulation and eosinophil chemotaxis via K channel aerosol only- only absorbed via lungs (not GI) |
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Beta-adrenergic agonists
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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) |
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Muscarinic Antagonist
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"Ipratropium"- ie Atrovent
Anticholonergic- block smooth muscle contraction mostly works on parasympathetic driven cases No systemic effects- not absorbed aerosol only |
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Methylxanthine
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"Theophylline"
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 |
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Leukotriene Antagonist
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"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) |
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NHLBI Guidelines for TX
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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 |
