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18 Cards in this Set
- Front
- Back
treatment for mild asthma (2)
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Remove allergen
Use meds before exposure if possible: 1. beta 2 agonist inhaler 2. cromolyn |
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treatment for moderate asthma
(2) or (4 if nocturnal or exacerbated symptoms) |
1.inhaled B2 agonist (as needed only!)
2.inhaled corticosteroids or cromolyn daily if symptoms persist: 3.theophylline or oral b2 agonist 4.oral corticosteroids-short course(severe exacerbations) |
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treatment for severe asthma-(know main difference from moderate asthma treatment*) (2) or (4)
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1.inhaled b2 agonist daily*
2.inhaled corticosteroids 3.optional b2 agonist oral or theophylline 4. burst oral corticosterois for active symtpoms |
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Give specific examples of b2 agonist inhalers
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1. albuterol
2. terbutamine 3. salmeterol |
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Inhaled b2 agonist:
1.Onset of action 2.duration of action 3.4 mechanisms of action |
1. within minutes
2. 6-12 hrs 3. bronchial smooth muscle relaxtion, increased mucociliary clearance, decreased microvascular permeability, inhibited mediator release from mast cells |
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Problems with Inhaled B2 agonists
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1. diminished control asthma
2. doesn't relieve inflammation. 3. masks progressive problem |
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B2 agonist via nebulization (2 pros and 1 con)
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1. delivers higher dose of drug
2. good for ER acute airway obstruction 3. higher side effect incidence-->tremor, tachycardia |
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1. Why is oral b2 agonist not used often?
2. What is it used for if at all? |
1. need higher doses, increased cardiac and CNS effects,less bronchodilation
2. nocturnal symptoms. |
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Theophylline (methylxanthines)
1. when to use 2. how it works |
1. Usually given orally for nocturnal exacerbations
2. phosphdiesterase inhibitor--->increases cAMP/GMP--->bronchodilation |
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Problems with theophylline use
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1. increased side effects of GI or toxicity (nausea, CNS-seizures, tachycardia)
2. decreased or increased metabolism/effect of drug by liver--->need serum monitoring |
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What are some problems that cause decreased theophylline metabolism---> increase effect/toxicity
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liver disease, CHF, cimetidine, quinoline, fever, antibiotics, old age
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What increases theophylline metabolism and increase clearance from body?
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smoking, young age, phenytoin
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Which anticholinergic drug is preferred to treat asthma (especially status asthmaticus)?
Which two anticholinergic are not preferred. |
Unlike atropine and scopolamine, Inhaled Ipratropium- is a QAC that doesnt effect CNS. Without side effects. Localized to airway and localized action.
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How do inhaled corticosteroids work?
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1. antiinflammatory processes that decrease growth factors, arachoidonic acids metabolites, and mucous secretion.
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What are side effects of corticosteroids?
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1. depressed immune system
2. thrush, hoarse, mood swings, depression, increased appetite, ACTH suppresion*-hairy fat person |
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When is oral corticosteroids used? How is best administered.
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Drug of last resort-uncontrolled asthma, administered best by burst
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Name two leukotriene modifiers and how they work?
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1. Zafirlukast-LKT Receptor antagonist
2. Ziletuon-LOX inhibitor (oral meds) |
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How is inhaled cromolyn Na treat or effective in prophylaxis of asthma?
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prevents release of mast cell mediators release
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