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37 Cards in this Set
- Front
- Back
Other names for an adrenergic bronchodilator |
Sympathometic or B2 agonist |
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What is the duration of action for the following subgroups of adrenergic bronchodilators |
Ultra short acting <3hrs Short acting 4-6hrs Long acting 12hrs or more |
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Indications for ultra short and short relief agents |
Relief of an acute reversible airflow obstruction in asthma or other obstructive airway diseases/conditions |
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Another term for Ultra short acting and short acting agents |
Rescue agents or medications |
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Indications for long acting agents |
Maintenance bronchodilation and control of bronchospasm or control of nocturnal symptoms in asthma or other obstructive airway diseases |
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Cause of cyclic 3’5’ AMP AND PURPOSE |
B2 stimulation—adenylate cyclase (+Mg and ATP)—cyclic 3’5’ AMP. Produces bronchial smooth muscle relaxation and bronchodilation. |
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Cause of break down of cyclic amp and response to breakdown |
Enzyme phospodiesterase breaks it down and reverses effects of bronchodilation which causes any baseline broncoconstriction to return |
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Side effects of adrenergic bronchodilators |
Tremors, nervousness and shakiness, ^BP, insomnia, tolerance to bronchodilator effect, bronchoconstriction reactions to the solution additives (SVN), and propellants, tachycardia, headache, nausea, dizziness |
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Important facts of catecholamine category |
Rapid onset and degradation, ineffective orally, could cause pink rain out of tubing or sputum, cardiac adverse effects, inactivated by light, heat, or air |
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Important facts of Noncatecholamine category |
More specific to B2 receptors, less adverse cardiac effects, suitable for oral administration, delayed degradation, prolonged bronchodilation |
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Important facts about Ultra short acting adrenergic catecholamine bronchodilators |
Lack B2 specifically which causes strong B1 effects, metabolized rapidly, onset 1-3mins, duration 1-3hrs |
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Epinephrine |
Ultra short acting sympathomimetic Brand name- Adrenalin (S) Cardiac stimulant, one of the strongest bronchodilators, tx for hypersensitivity reactions, management of acute asthma episodes (injection), MDI OTC is primatine mist |
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Racemic Epinephrine |
Ultra short acting sympathomimetic Brand name- Micronephrine or Vaponephrin Strong alpha effects, vasoconstriction to help reduce airway swelling (stridor) |
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Important facts ab SABAS |
More b2 than catecholamines, rescue agents to relieve acute bronchospasm, rapid onset 1-10mins, short duration 4-6hrs |
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Albuterol |
SABA (S,M) Brand names-Proventil, ventolin, proair (MDI) Primarily B2, less B1 compared to others, can be given orally too |
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Levalbuterol |
SABA (S,M) Brand name-Xopenex Only single R isomer available, less heart rate and tremor w this compared to others (HR>150) |
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Important facts about LABAS |
Maintenance therapy only, not suited for relief of acute airway obstruction or bronchospasm, not recommended for rescue administration, slow peak effect, duration 12hrs or more |
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Salmeterol |
LABA Brand name-Serevent (D) Stronger B2 effects than B1, pts usually require a fast acting beta agonist for periods of dyspnea between doses |
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Formoterol |
LABA Brand name- Foradil, Performist (D,S) Selective B2 w long acting effects, indicated for maintenance of asthma (5 and older), or in conjunction w other meds in COPD |
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Arformoterol |
LABA Brovana (S) Single R isomer or Foradil, selective B2 w long side effects, indicated for maintenance tx of bronchoconstriction in COPD |
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Olodaterol |
LABA Brand name-Striverdi Respimat (M) ULTRA LABA Tx in COPD, very rapid onset, not currently for asthma |
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Vilanterol |
LABA ULTRA LABA similar to olodaterol, ONLY AVAILABLE IN COMBO MEDS |
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Why are LABAS not suited for relief of acute airflow obstructions |
Repeated administration can risk pt for accumulation and toxicity. Long onset of action doesn’t give quick relief. |
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Other names for Anticholinergic bronchodilators |
Parasympatholytics, anti muscarinic agents, LAAC or LAMA |
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Clinical uses for anticholinergic bronchodilators |
Maintenance tx of bronchoconstriction in COPD including chronic bronchitis, emphysema and severe asthma and for reducing COPD exacerbations |
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Side effects of Ipratropium and other anticholinergics |
MDI & SVN- dry mouth and cough (VERY COMMON) MDI- (occasional) nervousness, irritation, dizziness, headache, rash, and palpitations SVN-pharyngitis, dyspnea, flulike, bronchitis, nausea, upper airway infection, eye pain, urinary retention, use caution in pts that are allergic to peanuts, soy |
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Use caution w anticholinergics with what pts |
Glaucoma, prostatic hypertrophy, and urinary retention |
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What needs to be protected when pt uses anticholinergic via MDI or aerosol mask |
Eyes due to ^intraocular pressure that may result |
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Ipratropium |
Parasympatholytic Brand name-Atrovent (S,M) SVN generic, shortest duration of all meds in category |
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Tiotropium |
Parasympatholytic Brand name-Spiriva respimat & handihaler (M,D) When a higher level of baseline bronchodilation is required, respimat only LAMA approved for routine use in asthma (6 and older) |
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Aclidinium |
Parasympatholytic Brand name- Turdoza Pressair (D) Contraindicated in pt w lactose intolerance |
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Umeclidinium |
Parasympatholytic Brand name-Incruse Elipta (D) Contraindicated w pts w lactose intolerance |
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Revefenacin |
Parasympatholytic Yuperli (S) Only nebulized 24hr Parasympatholytic |
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Clinical uses of Inhaled Drug combinations |
Bronchodilation, better control of obstruction, reduced drug dosages, avoidance of steroids |
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Albuterol & Ipratropium |
SABA/Parasympatholytic combo Brand names- DUONEB (S), combvient respimat(M) |
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Vilanterol and Umeclindinuim Bromide |
LABA/Parasympatholytic combo Brand name-Anoro Elipta (D) Not indicated for asthma, contraindicated for pts w lactose intolerance |
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Olodaterol and Tiotropium Bromide |
LABA/Parasympatholytic combo Brand name- Stioloto Respimat (M) Not indicated for Asthma |