What is the MOA of a mast cell stabilizer? What is the prototype?
Cromolyn Sodium (Intal): stabilizes the cytolasmic membrane of mast cells preventing release of histamine, eosinophils and other inflm cells; NOT a bronchodilator!
When is a mast cell stabilizer administered?
15 minutes before exercise or a forseen exposure to an allergen
How many puffs per day can be taken with cromolyn?
What is the prototype anti-cholinergic asthma drug?
What is the MOA of Ipratropium?
Muscarinic Antagonist: it blocks the ACh in bronchial smooth muscle which results in a decrease in GMP, a B.Constrictor.
Ipratropium: when do effects start, when do they reach 50% and how long do they last?
Start: 30 seconds
50%: 3 minutes
Last: 6 hours
What type of drug is taken with Ipratropium?
What is the indication for Ipratropium?
Allergy and Exercise induced asthma
Ipratropium is contraindicated for who?
People with glaucoma, it can make it worse or they could go blind.
Why can someone with glaucoma not take Ipratropium? What other drug is contraindicated for glaucoma?
Iprotropium is a derivitive of atropine which is an M-antagonist Anti-cholinergic drug. So it dilates the pupils. When the pupils are dilated, the irises are crowded into the angle of the anterior chamber which stops drainage of aquaeous solution from the champer increasing the pressure. Benadryl also has M-antagonist and anti-cholinergic effects.
What are some side effects of Ipratropium? What is the most severe?
Histamine H1-receptor antagonist; competative antagonist so it binds to receptor therefore histamine can not cause inflm, edema, and B.C. Also, M-receptor antagonist so it blocks ACh in bronchial smooth muscle = ↓GMP = ↓B.C.
What are side effects of 1st gen Diphenhydramine?
crosses the BBB so there is drowsiness, dizziness, confustion. Also has anit-cholinergic effects, dry mouth, constipation, urinary renention
What do you not take when you are taking dihydramine?
Other drugs that have effects on CNS, like alcohol, anti-anxiety, anti-depressives
What is the absolute contraindication for diphenhydramine?
What is different about 2nd gen diphenhydramines? Name some.
Do not cross BBB so no drowsiness or anti-cholinergic effects. Allegra, Clarinex, Zyrtec
What is the most effective drug for seasonal rhinitis, histamine and inflammatory mediator activity?
What are side effects of nasal fluticasone proprionate?
burning, itching, sores, perforation of nasal mucosa, headache, nose bleeds
Why use a intranasal cromolyn sodium spray instead of an intranasal fluticasone propionate nasal spray?
Although less effective, the comolyn sodium spay has only irritation of the nasal mucosa as its side effect so the pt can take it for a long time.
Why are nasal glucocorticoids absorbed so quickly from the nasal mucosa? What is the prototype of the nasal glucocorticoid?
Fluticasone propionate (Flonase) nasal spray: high potency and high lipophilic properties
What is the MOA for Intranasal cromolyn sodium spray?
OTC: provides a protective layer that shields mast cells lining the nasal passage and prevents them from breakin gdown and releasing histamines and inflammatory agents.
When does a pt take intranasal cromolyn sodium?
One full week before contact with allergy trigger and then tid