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Chapter 76 Drugs for Asthma
Pharm exam 4
Terms in this set (17)
What causes the symptoms of asthma?
Bronchoconstriction, inflammation, secretion of mucous and immune cells. Wheezing- air rushing through closing space.
How might an asthma attack look?
Wheezing, sense of breathlessness, cough, high respiratory rate, low O2, anxiety.
What drug do we give to "rescue" a patient suffering from an acute asthmatic attack?
· Albuterol a beta 2 agonist (bronchodilator)
How can a patient take his albuterol (which route)?
· Route for albuterol: inhaled, oral
what is an MDI (metered dose inhaler, a spacer bar, a dry-powder inhaler? Why is a spacer recommended (see Fig 76-3)? What advantage does a DPI have over an MDI?
· MDI: metered-dose inhalers: small hand-held, pressurized device that delivers a metered dose
· Why should a spacer be used? Increase delivery of drug to the lungs and decrease deposition of drug on the oralpharyngeal mucosa
· Advantages of DPI over MDI? Dry powder, breath activated so do not require hand-breath coordination like an MDI. They deliver more medication to the lungs and spacers are not needed.
A patient is written for albuterol, 2 puffs, every 4 hours, prn, wheezing or shortness of breath. How long should this patient wait between puffs 1 and 2? Why?
· Should wait 1 minute between each puff
· Why need to wait? I don't know
What makes salmeterol different from albuterol?
· Salmeterol is different than albuterol in that it is a LABA, albuterol is a SABA.
Can salmeterol be given as a rescue medication?
No, you cannot use as is a LABA
In which patients would we use a LABA. With which drug should a LABA always be combined? Do LABAs reduce the risk of asthma-related death?
· LABA used in patients experiencing frequent asthma attacks, is fixed dosing, not prn.
· LABA also used in COPD.
· LABA needs to be combined with a glucocorticoid as monotherapy has been associated with asthma associated death
Recognize the drugs beclomethasone, budesonide, fluticasone, and triamcinalone. What group of drugs does the -one ending make you think of? How do these drugs work in the treatment of asthma? Are they used for rescue during an acute attack or for prophylaxis?
· Glucocorticoids, which are anti-inflammatory
· Are taken daily, they are not used for rescue but rather prophylaxis
A patient is taking his albuterol for asthma symptoms. He also needs to take his morning dose of fluticasone. Which inhaler should he use first? Why?
· Give SABA first, wait 5 minutes, then give glucocorticoid (fluticasone) as the albuterol "opens up" the contricted airway so the glucocorticoid can penetrate deeply into the lungs.
How are glucocorticoids typically given to an asthmatic patient? Why is this route preferable?
· Foundation for asthma therapy, taken daily for long term control
· Preferred route: inhaled as goes straight to lungs
while inhaled glucocorticoids are typically well tolerated, they can produce a few local adverse effects-what are these? How might these local effects be prevented?
· Adverse effects: minor, but can cause dysphonia (throat irritation) and oropharyngeal candidiasis, which can be prevented by rinsing or gargling mouth after taking the medication
To which class of drugs does montelukast (Singulair) belong? How is it administered? Can it be useful in asthma?
· Leukotriene receptor blocker (modifier)- suppresses effects of leudotrienes
· Administered PO
Does Singulair work as well as the glucocorticoids?
· Not as effective as glucocorticoids but can be used for prophylaxis and maintenance therapy of asthma, prevention of exercise induced bronchospasm, and relief of allergic rhinitis
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