Pharm Unit 7-2

Front 1

Xanthines

Back 1

bronchiodilator

therapeutic uses

1. asthma
2. Pulmonary edema

not really used anymore for asthma or pulm. edema

Front 2

smooth muscle relaxant

usually oral maintenance but may use IV bolus in emergencies

Back 2

What is the mechanism of action for Xanthines as bronchiodilators?

Front 3

Xanthines

Back 3

Side effect and cautions

1. GI - direct irritation and stimulation of emetic center - gastric irritation, nausea, vomiting
2. CNS - restlessness, anxiety, convulsions
3. C.V.- hypotension, headache

Front 4

Anticholinergic

Back 4

aka ipratropium and atrovent

Front 5

Anticholinergic

Back 5

bronchiodilator

NOT drying probably due to poor lipid solubility

systemic side effects not seen so far

currently recommended for COPD but not asthma

may have value in asthma as adjunct

Front 6

asthma prophylactic

Back 6

aka cromolyn or mast cell stabilizers or histamine release inhibitors

Front 7

asthma prophylactic or cromolyn

Back 7

Therapeutic uses

hemps prevent asthma attack from occuring

cannot treat symptoms once that appeared

takes 2 weeks to become effective with 4 to 6 doses/day.

works on exercise induced asthma and some cases of intrinsic asthma as well as the obvious atopic asthma.

not used for bronchitis/emphysema

ADVANTAGE: esp. for older patient with exercise induced asthma - no cardiac stimulation

Front 8

cromolyn

Back 8

Mechanism of action

prevents release of histamine and other mediators of the allergic response and is therefore ANTI-INFLAMMATORY

not specifically a bronchiodilator but does interfere with bronchoconstriction that is histamine based.

Front 9

cromolyn

Back 9

Caution

inhalation occasionally causes bronchospasm, throat irritation, headache and unpleasant taste.

Front 10

Leukotriene Receptor Antagonists

Back 10

anti-inflammatory agent for prophylaxis only

not a RESCUE drug

These are also being used for treatment of allergic rhinitis

Efficacy similar to cromolyn but MORE side effects

Front 11

Leukocyte Receptor Antagonists

Back 11

Mechanism of action

prevents leukotrienes from causing inflammation

Front 12

prevents leukotrienes from causing inflammation

Back 12

What is the mechanism of action for Leukotrienes Receptor Antagonists?

Front 13

Leukotriene Receptor Antagonists

Back 13

Caution

headache, GI upset, LIVER ENZYME CHANGES, INHIBITS P450 ezymes so decreases metabolism of many other drugs.

Front 14

Corticosteriods

Back 14

used only if other therapy does not control symptoms

if nothing else works, then use this

Front 15

Corticosteriods

Back 15

aerosol, tablet, injections

WHEN THESE MEDS ARE NEEDED, the side effects of inhalors are much more acceptable than consequences of non-treatment.

mech of action

suppresses of antibody formation (including IgE responsible allergy attacks)

Front 16

hoarseness
dry mouth
local infection in mouth and pharynx

Back 16

What are the LOCAL side effects for corticosteriods?

Front 17

minimized by inhaler

irreversible - osteoporosis (Ca+, protein, Vit. D helps), cataracts, stunting of growth in children

reversible - proneness to infections, salt and water retention, signs of CNS stimulation (restlessness, insomnia, even manic states including depressive episodes in some individuals)

Back 17

What are the SYSTEMIC side effects for corticosteriods?

Front 18

Corticosteroids

Back 18

Cautions

drugs must be withdrawn slowly - body has decreased capacity to produce its own glucocorticoids. Also must gradually switch to inhaler from oral forms of medication)

during times of stress, patient may need extra glucocorticoid

Front 19

corticosteroids

Back 19

_____________ inhaler is NOT to for treatment of acute attacks (not to be confused with catecholamine inhaler).