Pharmacology Of Asthma

Front 1

treatment for mild asthma (2)

Back 1

Remove allergen
Use meds before exposure if possible:
1. beta 2 agonist inhaler
2. cromolyn

Front 2

treatment for moderate asthma
(2) or (4 if nocturnal or exacerbated symptoms)

Back 2

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)

Front 3

treatment for severe asthma-(know main difference from moderate asthma treatment*) (2) or (4)

Back 3

1.inhaled b2 agonist daily*
2.inhaled corticosteroids
3.optional b2 agonist oral or theophylline
4. burst oral corticosterois for active symtpoms

Front 4

Give specific examples of b2 agonist inhalers

Back 4

1. albuterol
2. terbutamine
3. salmeterol

Front 5

Inhaled b2 agonist:

1.Onset of action
2.duration of action
3.4 mechanisms of action

Back 5

1. within minutes
2. 6-12 hrs
3. bronchial smooth muscle relaxtion, increased mucociliary clearance, decreased microvascular permeability, inhibited mediator release from mast cells

Front 6

Problems with Inhaled B2 agonists

Back 6

1. diminished control asthma
2. doesn't relieve inflammation.
3. masks progressive problem

Front 7

B2 agonist via nebulization (2 pros and 1 con)

Back 7

1. delivers higher dose of drug
2. good for ER acute airway obstruction
3. higher side effect incidence-->tremor, tachycardia

Front 8

1. Why is oral b2 agonist not used often?

2. What is it used for if at all?

Back 8

1. need higher doses, increased cardiac and CNS effects,less bronchodilation
2. nocturnal symptoms.

Front 9

Theophylline (methylxanthines)
1. when to use
2. how it works

Back 9

1. Usually given orally for nocturnal exacerbations
2. phosphdiesterase inhibitor--->increases cAMP/GMP--->bronchodilation

Front 10

Problems with theophylline use

Back 10

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

Front 11

What are some problems that cause decreased theophylline metabolism---> increase effect/toxicity

Back 11

liver disease, CHF, cimetidine, quinoline, fever, antibiotics, old age

Front 12

What increases theophylline metabolism and increase clearance from body?

Back 12

smoking, young age, phenytoin

Front 13

Which anticholinergic drug is preferred to treat asthma (especially status asthmaticus)?

Which two anticholinergic are not preferred.

Back 13

Unlike atropine and scopolamine, Inhaled Ipratropium- is a QAC that doesnt effect CNS. Without side effects. Localized to airway and localized action.

Front 14

How do inhaled corticosteroids work?

Back 14

1. antiinflammatory processes that decrease growth factors, arachoidonic acids metabolites, and mucous secretion.

Front 15

What are side effects of corticosteroids?

Back 15

1. depressed immune system
2. thrush, hoarse, mood swings, depression, increased appetite, ACTH suppresion*-hairy fat person

Front 16

When is oral corticosteroids used? How is best administered.

Back 16

Drug of last resort-uncontrolled asthma, administered best by burst

Front 17

Name two leukotriene modifiers and how they work?

Back 17

1. Zafirlukast-LKT Receptor antagonist
2. Ziletuon-LOX inhibitor (oral meds)

Front 18

How is inhaled cromolyn Na treat or effective in prophylaxis of asthma?

Back 18

prevents release of mast cell mediators release