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19 Cards in this Set

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Xanthines
bronchiodilator

therapeutic uses

1. asthma
2. Pulmonary edema

not really used anymore for asthma or pulm. edema
smooth muscle relaxant

usually oral maintenance but may use IV bolus in emergencies
What is the mechanism of action for Xanthines as bronchiodilators?
Xanthines
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
Anticholinergic
aka ipratropium and atrovent
Anticholinergic
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
asthma prophylactic
aka cromolyn or mast cell stabilizers or histamine release inhibitors
asthma prophylactic or cromolyn
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
cromolyn
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.
cromolyn
Caution

inhalation occasionally causes bronchospasm, throat irritation, headache and unpleasant taste.
Leukotriene Receptor Antagonists
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
Leukocyte Receptor Antagonists
Mechanism of action

prevents leukotrienes from causing inflammation
prevents leukotrienes from causing inflammation
What is the mechanism of action for Leukotrienes Receptor Antagonists?
Leukotriene Receptor Antagonists
Caution

headache, GI upset, LIVER ENZYME CHANGES, INHIBITS P450 ezymes so decreases metabolism of many other drugs.
Corticosteriods
used only if other therapy does not control symptoms

if nothing else works, then use this
Corticosteriods
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)
hoarseness
dry mouth
local infection in mouth and pharynx
What are the LOCAL side effects for corticosteriods?
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)
What are the SYSTEMIC side effects for corticosteriods?
Corticosteroids
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
corticosteroids
_____________ inhaler is NOT to for treatment of acute attacks (not to be confused with catecholamine inhaler).