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17 Cards in this Set
- Front
- Back
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COPD/Asthma drugs |
Bronchodilators: -Beta-2 Adrenergic Agonists -Anticholinergics -Theophylline Anti-Inflammatory: -Corticosteroids -Cromolyn/Nedocromil -Leukotriene Modifiers -Omalizumab -Mepolizumab |
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Short Acting Beta(2) Agonists |
ALBUTEROL LEVALBUTEROL TERBUTALINE (systemic) Increase cAMP -sm mm relaxation (bronchodilation) -mast cell stabilization For ACUTE Asthma/COPD Exacerbation Tox -Tachycardia/palpitations -transient K+ decrease -tremors -lactic acidosis |
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Long Acting Beta(2) Agonists |
SALMETEROL FORMOTEROL INDACATEROL VILANTEROL Increase cAMP -sm mm relaxation (bronchodilation) -mast cell stabilization Maintenance Therapy for Asthma/COPD Tox -tachycardia/palpitations -transient K+ decrease -tremors -lactic acidosis -increase risk of LABA MONOTHERAPY Asthma death (pair with CORTICOSTEROIDS!) |
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Anticholinergics the "iums" |
IPRATROPIUM (short acting) TIOTROPIUM (long) ACLIDINIUM (long) UMECLIDINIUM (long) Block M1R/M3R responsible for bronchoconstriction SHORT: Acute Asthma/COPD LONG: Maintenance for COPD Tox -well tolerated! -classic (blurred vision, dry mouth, urinary retention, CNS, CVS) -do NOT use IPRA to treat acute exacerbation in someone on anticholinergic maintenance therapy! they will compete |
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Sytemic Methylxanthines |
THEOPHYLLINE AMINOPHYLLINE (IV prodrug) Phosphodiesterase inhibitors Anti-Inflammatory AdoR antagonists (drive CA release) Used in ACUTE Asthma Tox -SERIOUS LIMITING TOXICITY (salvage tx) -narrow therapeutic window! -N/V/Gastric upset -Tachyarrhythmia -Jitteriness -Insomnia -HA -seizures |
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Corticorticosteroids |
HYDROCORTISONE (most MR pot) PREDNISONE METHYLPREDNISONE DEXAMETHASONE (most antiinflam pot and longest duration) Inhibit NFkB and AP1 Decrease immune activation/recruitment Decrease vascular permeability Systemic oral CS are the cornerstone of ACUTE asthma treatment ACUTE Asthma/COPD (inhaled) MAINTENANCE Asthma/COPD (inhaled) Allergic Rhinitis (intranasal) Acute Side Effects -Hyperglycemia -HTN Long-Term Side Effects -HPA suppression -growth retardation -osteoporosis |
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Cromolyn Nedocromil |
Stabilize mast, eosinophil, epithelial cells Inhibit neural bronchoconstriction LONG TERM ASTHMA prevention Preventative prior to exercise/allergen exposure Side effects -MINIMAL (well tolerated) -cough+wheezing |
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Leukotriene Modifiers |
ZAFIRLUKAST (LR antagonist) MONTELUKAST (LR antagonist) ZILEUTON (5 lipoxygenase inhibitor) Inhibit eosino recruitment, bronchoconstriction, mucus secretion, plasma exudation LONG TERM ASTHMA control Allergic Rhinitis Tox -WELL TOLERATED -HA/N/Ab pain for LR antag (PREFERRED!) -Liver tox/hyperbilirubinemia for Zileuton (not as well tolerated) |
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Omalizumab |
Blocks IgE Fc (inhibits binding to mast cells) POORLY CONTROLLED ALLERGIC ASTHMA (when pt has high baseline IgE) Tox -anaphylaxis |
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Mepolizumab (IV, SubQ) |
Binds IL-5 poorly controlled EOSINOPHILIC asthma Tox -must R/O PARASITIC or HHV3 Zoster infections before administration!!! -Hypersensitivity rxn -Injection site rxn -HA, myalgia |
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Antihistamines |
H1 Antagonist 1st gen NONSPECIFIC (antagonize AChR) 2nd gen HR SPECIFIC Allergic rxns Allergic rhinitis 1st gen are anti-emetics Tox -1st gen sedative (lipophilic) -1st gen anticholinergic -LESS FOR 2ND GEN!! |
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Opioid Antitussives |
CODEINE HYDROCODONE HYDROMORPHINE Central (medulla, NST) respiratory depression Increase threshold for cough Tox -N/V -Sedation -CONSTIPATION!! |
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Dextromethorphan |
Central (medulla, NST) respiratory depression Common cold, allergy antitussive Tox -high dose CNS: confusion, excitation, nervousness, irritability -respiratory depression at very high doses -MAO inhibitor, monitor for SEROTONIN SYND! |
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Benzonatate |
Antitussive Peripheral stretch receptor and vagal anesthetization (bronchi, alveoli, pleura) Common cold, bronchitis Tox -nausea -mucosal numbness |
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Guaifenesin |
Expectorant Loosen/thin lower respiratory secretions Tox -N/V/D (diarrhea due to sorbitol formulation) -dizziness |
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Pirfenidone |
Inhibits TGFb, TNFa, IL-1 IDIOPATHIC PULMONARY FIBROSIS Tox -CYP1A2 interactions -skin rash, photosensitivity -N/V -liver toxicity |
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Nintedanib |
Tyrosine kinase inhibitor (PDGFR, FGFR) IDIOPATHIC PULMONARY FIBROSIS Tox -CYP3A4 Interacitons -D/N/V/Ab pain -increased liver enzymes -MI -bleed risk (VEGF inhibition) |
