pharm exam3 asthma

  1. Stepwise Approach to asthma
    • classification of severity
    • mild intermittent, mild persistant, moderate persistant, severe persistant
  2. Glucocorticoids
    suppress inflammation Ex)budesonide (pulmicort), fluticasone (flovent), Triamcinolone (azmacort)
  3. Glucocorticoids ADRs
    • Oropharyngeal Candidiasis (gargle/spit after each use, use a spacer)
    • Growth delay in young children (admin lowest effective dose)
    • Bone loss (lowest effective dose for long term use, Ca & vit D, weight bearing exercises)
    • Adrenal suppression-long term high dose therapy
  4. Beta-2 agonists
    • selectively activates B2 receptors of lung resulting in bronchodilation  Ex) short- albuterol (ventolin, proventil), long-salmeterol (serevent), formoterol (foradil)
  5. Theophylline
    • no longer drug of choice (safer options)
    • A methylxanthine, (caffeine)
    • narrow therapeutic range-10-20 if >25 dysrhythmias, seizures, death
    • ADRs-GI, insomnia/restles
    • smoking <effects, cimetidine, fluoroquinolones > levels
  6. Inhaler types
    • Metered Dose Inhaler (MDI)- Puffer
    • Dry-Powder Inhaler (DPI)- inhale products of a capsule
    • Nebulizer- creates a mist, good for elderly & children. (admin over 5 min)
    • Spacer=A device that directly attaches to the metered dose inhaler & serves to increase delivery of drug to the lungs & decrease deposition of drug to oropharyngeal mucosa (especially important in admin of glucocorticoids)
  7. correct order/ admin of inhaler
    • Short B2, Long B2, Glucocorticoid
    • 1 min btwn each puff, 5 min btwn each Med
  8. Cromolyn (intal)
    • preferred to glucocort- safer & non-steroidal
    • mast cell stabilizer- <histamine release suppress inflam.
    • effective prophylaxis to seasonal allergy & can be used for exercise induced
  9. leukotriene modifiers
    • singular-maintenance/prophylaxis >6mo oral only not for acute asthma
    • well tolerated slight suicide risk
  10. Combination med
    • advair
    • fluticasone (inhalled glucoco)
    • salmeterol (inhaled long B-2 agonist)
  11. Anticholinergic for COPD
    • Ipratropium (atrovent), tiotropium (spiriva), combovent (ipratropium + albuterol)
    • block cholinergic receptors in bronchi to cause bronchodilation
    • ADR-systemic effects rare- dry mouth/throat
    • (inhaled)
  12. Antihistamine use/action
    • blocks H1 receptors to block effects of histamine
    • use: mild allergic disorder, motion sickness, OTC sleep aid, cold med
  13. Antihistamine 1st gen
    Dimetapp, chlor-trimeton, tavist, Benadryl
  14. 1st gen ADRs
    • sedation, neurologic effect (dizzy, uncoordinated, confusion), paradoxical effect (staying awake, anxiety), anticholinergic effect
    • Dont give to elderly
  15. 2nd gen antihistamine
    Zyrtec, Xyzal, Allegra, Claritin, Clarinex, Astelin (nasal spray)
  16. intranasal decongetants action & ADR
    • Afrin, Neo-synephrine (oral or nasal)
    • rapid onset of action->intense but shorter in duration
    • ADR- rebound congestion (esp >3-5 days), >BP & HR when used in excess
  17. Oral decongestant
    • Neo-Synephrine, Sudafed
    • CNS stimulant, >BP, abuse potential
  18. Drugs for cough
    • Dextromethorphan (robitussin DM)-most effective nonopiod
    • Benzonatate (Tessalon)- <sensitivity resp t
    • Opiods (Robitussin AC, Tussionex)-dont drive
    • Guifenesin (mucinex, Robetussin)- expectorant
Card Set
pharm exam3 asthma
athma pp vocab