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18 Cards in this Set

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assignmnent 6

chapter 11 page 181 to 194 Rau

Rau workbook chapter 9 finish

Chapter 11 109 to 112

Non steroidal anti inflammatory

Chromylin sodium (Intal)

:Prevents degranulation of the mast cell

:therefore muting allergic stimuli

Nedocromil sodium (tilade)

:inhibits mast cells, eosinophils, airway epithelial cells from releasing inflammatory cytokines

:increases eosinophil production (present in allergic reactions)

Anti leukotrine

Slide of life

When the antigen antibody reaction takes place, it decreases cyclic 35 amp.

Cromolyn sodium and nedyl cromosodium prevent degranulation from occuring

Non steroidal anti inflammatory

Montelukast (singulair)

:leukotriene receptor antagonist

:Thus preventing bronchoconstriction, mucus secretions, vascular permeability... inflammation

Non steroidal anti inflammatory

Cromolyn like drugs (mast cell stabilizers)

Antileukotrienes (anti LTs)

Monoclonal antibodies (prevent release of leukotrienes for asthma)

Non steroidal anti infmallamtory indications

Prophylactic management (control) of mild persistent asthma

:Cromolyn and anti Luekotriene as alternatives to ICS (inhaled cortico steroid) in asthma requiring step 2 care

Generel indications for Cromolyn

:cromolyn is often used with infants and young children as alternatives to ICS in asthma requiring step 2 care because of safety profiles of ICS

:Anti leukotrienes can be useful in combination with ICS to reduce the steroid dose

Immunological (allergic) response

Allergic response of asthma involves mast cells and IgE

Mast cells release





:Platelet activating factor (PAF)


Cascade of mediators

Inflammatory response manifests as

:vascular leakage(occurs in the interstitium and tissue leading to edema)


:mucus secretions

:mucosal swelling

All of these lead to obstruction of airflow in the bronchioles

Accumulation and activation of eosinophils lead to damage of the airway

Cromolyn Mast cell stabilizing agent

Prophylactic agent in the treatment of asthma

Cromylyn sodium (disodium cromoglycate)

:Dosage and administration

::SVN 20 mg/ampule or 20 mg/2ml (1%)

:Mechanism of action

::Prevents mast cell degranulation

Cromolyn sodium (disodium cromoglycate)

:side effects


::Nasal congestion



::nose burning

Anti Leukotrine (they are anti inflammatories, but not steroids)

Cromolyn prevents a release of IgE and protaglandins via mast cell stabalization.

Leukotriene receptors are blocked so the

Antileukotriene agents

Leukotrienes and inflammation

Leukotrienes are potent bronchoconstrictors and stimulate other cells to cause

:Airway edema

:Mucous secretion

:Ciliary beat inhibition

::Recruitment of other inflammatory cells

Antileukotriene agents

5-LO inhibitor

:Zileuton (Zyflo, Zyflo CR)

Leukotriene receptor antagonists

:Zafirlukast (Accolate)

:Montelukast (Singulair)

Monoclonal antibodies

:Omalizumab (Xolair)

ANtileukotriene agents

Omazlizymab (Xolair)

Dosage and administration

:Oral administration

:600 mg tables qid

Mechanism of action

:inhibits 5:LO enzyme

Hazards and side effect

:Headache, abdominal pain, oss of stregth, dyspepsia

:Monitor liver functions

:Interacts with theophylyine and warfarin

Zafirlukast (accolate)


::Oral administration

::10 mg bid children 5 to 11 years old

::20 mg bid 12 years old and older

:mechanism of action

::Leukotrine receptor antagonists

:Hazardsa and side effects

::Headache, infection, nausea, diarrhea, generalized and abdominal pain

Antileukotriene agents

Montelukast (Singulair)

:Dosage and administration

::Oral administration

::4mg and 10 mg

::5 mg chewable

:Mechanism of action

::Leukotriene receptor antagonists

::Binds with high affinity and selectivity to CysLT, receptor subtype

Antileukotriene agents

Montelukast (singulair)

:Hazards and side effects

::Diarrhea, nausea

::Laryngitis, pharyngitis

::Otitis, sinusitis, viral infection

Antileukotriene agents advantages

Oral administration, possible once daily dosing

Safe, with few side effects to date

Effective in aspirin sensitivity and often in exercise induced asthma

Systemic distribution reaches entire lung through the circulation

Additive effect with inhaled steroids

May reduce steroid dose or prevent an increase in steroid dose

Formulation approved for pediatric dosing (montelukast)

Antileukotriene agents disadvantages

Antiinflammatory action limited to one mediator pathway

Unknown long term toxicity

Variable response

:Effective in about 50% to 70% of patients

Systemic drug exposure

Generally not useful as monotherapy

Antiinflammatory overview

Inhaled steroids, cromolyn like and antileukotreines all have a brochoprotective effect

All are given prophyllactically (preventative, before the horse gets out)

All are the maintenance drugs of choice for asthma