Lower Respiratory System
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8 terms
Terms | Definitions |
|---|---|
 2 Main Pharmacological Classes | Anti-inflammatory: Glucocorticoids-->administered on a fixed schedule only and used for prophylaxis of CHRONIC asthma Bronchodilators:Beta2 Agonists-->used long-term or for acute attacks and can be administered on a fixed schedule or PRN |
| Zyflo | Leukotriene Modifier MOA: blocks Leukotriene synthesis by inhibiting 5-lipoxygenase ADR: hepatotoxic; ALT is monitored monthly for 3 months then every 3 months for the remainder of the year; concurrent use can raise theophylline to toxic levels |
| Accolate and Singulair | Leukotriene Modifiers MOA: blocks Leukotriene receptors (actions blocked but no production) ADR: very dark urine, dark/light stool b/c no bile, nausea, ab pain |
| Intal | Mast Cell Stabilizer Via nebulizer or MDI Indication: prophylactic for chronic mild asthma, prevention of bronchospasm from exercise (given 15 mins. prior) and prevent seasonal allergen attacks (prior to onset) MOA: stabilizes the cytoplasmic membrane of mast cells, prevents rupture of mast cell AFTER exposure by an antigen, blocks calcium channel essential for mast cell degranulation (prevents histamine vesicles from fusing and degranulating-release) |
| Proventil | Beta-2 Adrenergic Agonists "Rescue Drug" MOA: stimulate these receptors in bronchi and bronchioles, suppress histamine release in lungs (brochodilator), increase ciliary motility Indications:prevent bronchospasm from exercise, management of acute or chronic asthma Precautions: CVD, DM, hyperthyroidism ADR:headaches, nervousness, anxiety, tachycardia, arrhythmia, HTN, hyperglycemia Other facts: Method for classifying beta-adrenergic agonists is by their duration of action |
| Theophylline and Aminophylline | Xanthine Derivatives Theophylline:PO route Aminophylline: IV route PO Indication: available ONLY in sustained-release form, maintanence therapy of chronic stable asthma, pt.'s with nocturnal attacks, decrease frequency and severity IV Indication: emergencies only, administer slowly to prevent hypotension, loading then maintenance dose MOA: increase force of diaphragmatic contractions, bronchodilation (block adenosine receptors) Other facts: therapeutic serum level is 5-20 mcg/mL; serious ADRs occur when level exceeds 30 mcg/mL Avoid caffeine, determine smoking habits, initial dosage based on age/weight |
| Atrovent | Inhaled Anticholinergics MOA: antagonizes the action of acetylcholine at vagal-mediated receptor sites-->decreased smooth muscle contractility and reduces bronchospasm Indications: prophylactic to reduce frequency and severity of asthma, NOT for an actual asthma attack in progress Other Facts: combined with Beta2-agonist for additive effect |
| Combination Therapies | Combivent: Atrovent and Proventil Glucocorticoids/LABA: Fixed Doses Symbicort: budesonide/formoterol Advair: fluticasone/salmeterol Glucocorticoids: produces the anti-inflammatory effect Long acting beta agonist (LABA): provide bronchodilation |
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