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31 Cards in this Set

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Name drugs used for long term control of asthma (daily drugs)
Corticosteroids -inhaled and oral

Cromolyn/nedocromil

Long acting beta 2 agonists

Methylxanthines

Leukotriene modifiers

Immunomodulators
These drugs are highly lipophilic and rapidly enter airway cells and bind to receptors
Inhaled corticosteroids
Beclomethasone

Budesonide

Flunisolide

Fluticasone propionate

Mometasone

Triamcinolone

What is class of drugs
Inhaled corticosteroids
These drugs are indicated for long term prevention of symptoms of asthma, suppression, control and reversal of inflammation, reduce need for oral corticosteroids
Inhaled corticosteroids
What are the adverse effects of inhaled corticosteroids
Cough, dysphonia, oral thrush
Most potent and consistently effective long term control medications for asthma, safe and well tolerated at recommended dosage
Inhaled corticosteroids
How can you reduce potential for adverse effects with inhaled corticosteroids
Use spacer and rinse mouth, use lower dose possible, use in combination with long acting beta agonist, monitor growth in kids and consider adding Ca or vit D in adults to prevent osteoporosis
Name systemic corticosteroids used for treatment of asthma
Prednisone
Prednisolone
Methylprednisolone
These drugs are used for long term prevention of symptoms in severe persisten asthma and suppresion , control and reversal of inflammation
Systemic corticosteroids
What are the potential side effects of systemic corticosteroids with short term use
Reversible abnormalities in glucose metabolis

Increased appetite

Fluid retention

Weight gain

Peptic ulcer

Aseptic necrosis of femur -RARE
What are the potential side effects of systemic corticosteroids with long term use
Adrenal axis suppression

Growth suppression

Dermal thinning

Hypertension

Diabetes

Cushing disease

Cataracts

Muscle weakness

Impaired immune function

Osteoporosis
Name two cromones used in treatment of asthma
Cromolyn sodium

Nedocromil
This drug is used for long term prevention of symptoms, may modify inflammation, can be used as preventive treatment prior to exposure to exercise or known allergen
Cromolyn

Nedocromyl
What are the side effects of cromones
Cough, irritation, unpleasant taste from nedocromyl
Name long acting beta 2 agonists
Salmeterol

Formoterol

Albuterol
This drug is used for long term prevention of asthma symptoms added to anti inflammatory therapy, prevention of exercise induced bronchospasm

NOT TO BE USED FOR TREATMENT OF ACUTE SYMPTOMS OR EXACERBATION
Long acting beta 2 agonists
What are the potential side effects of long acting beta 2 agonists
Tachycardia, skeletal muscle tremor, hypokalemia, prolongation of QT interval in overdose
Can long acting beta agonists be first line drug
NO - should not be first medication used, should ne added only if other meds do not control asthma, including low or medium dose inhaled corticosteroids
What can relieve sudden wheezing in asthma patients
Short acting bronchodilator
Name methylxanthines used for treatment of asthma
Theophylline
This drug can be used for long term control and prevention of symptoms in mild persistent asthma, adjunctive with inhaled corticosteroids in moderate persistent asthma
Theophylline
What is the mechanism of action of theophylline
Increase cAMP by competetive inhibition of phosphodiesterase
What are the potential side effects of theophylline
Tachycardia, nausea/vomitting, tachyarrhythmia, CNS stimulation, headache, seizures, hematemesis, hyperglycemia and hypokalemia
Which anti asthmatic drug has narrow therapeutic index and requires close serum concentration monitoring
Theophylline
Name factors that DECREASE theophylline concentrations
Food

Age 1-9 years old

Phenobarbital

Phenytoin

Carbamazepine

Rifampin

Smoking
Name factors that increase theophylline concentrations
Fatty foods

Influenza

Macrolides

Fluoroquinolones

Cimetidine

Ticlopidine
Name leukotriene inhibitors
Zafirleukast

Monoleukast

Zileuton
Which leukotriene modifier has been removed off market because of side effects
Zileuton
What do you need to monitor in patient on Zileuton
LFT
Anti IGE monoclonal body used for treatment of asthma
Omalizumab
Name short acting inhaled beta 2 agonists
Albuterol

Pirbuterol

Levalbuterol