NI: Avoid alcohol or using hazardous equipment, take w food to decrease GI distress, increase fluids, read OTC labels, contraindicated in narrow-angle glaucoma, BPH, pregnancy, bladder neck obstruction, and peptic ulcer disease, take 30-60 mins before traveling for motion sickness.
Intranasal glucocorticoids? names? MOA? TU? AE?
They are the most effective for treatment and prevention of rhinitis.
Names: Intranasal Cromolyn sodium, and symphathomimetics (decongestants).
MOA: Anti-inflammatory actions, prevents or surpasses major symptoms: congestion, rhinorrhea, sneezing, nasal itching, and erythema.
TU: Use for pts w mild to moderate rhinitis.
AE: most common is drying of nasal mucosa or sore throat, burning or utching sensation, etc. Rarely, systemic effects (adrenal suppression and slowing of linear pediatric growth)
Intranasal Cromolyn? trade name? group? MOA? TU?
MOA: Surpasses release of Histamine from the mast cells.
TU: rhinitis. Best used for phrophylaxis, not for treatment. Response may take 1-2 weeks to develop.
Sympathomimetics (oral/nasal) tradename? common names? MOA? AE? TU? Contraindications?
Names:Phenylephrine, ephedrine, pseudoephedrine.
MOA: Reduce nasal congestion by activation alpha1-adrenergic (bronco-relaxation)receptors on nasal blood vessels. However, it does not reduce rhinorrhea, sneezing, or itching)
Considered the most effective anti asthma drug available.
TU: Chonic controlled of asthma. Usually administer by inhalation, but IV and oral are also options.
MOA:Suppress inflammation, decreased synthesis and release of inflammatory mediators, decreased infiltration and activity of inflammatory cells, decreased edema of the airway mucosa.
AE: Minor when taken acutely, can be severe when log-term used (adrenal suppression, osteoporosis, hyperglycemia, and others), Oropharyngeal candidiasis and dysphonia- gargle after use and use of spacer.
Examples: budesonide (pulmicort/symbicort) and fluticasone (flovent), triamcinolone (azmacort).
Keukotriene modifiers? MOA? examples?
Less effective than inhaled glucocorticoids.
MOA: Suppress effects of leukotrienes.
Examples: zileuton (zyflo), Zafirlukast (accolate), Montelukast (singulair) most popular.
Cromolyn? MOA? TU? AE?
MOA: Suppresses bronchial inflammation-Mast cell stabilizer. anti-inflammatory effects are less than the ones from glucocorticoids.
TU: Chronic asthma-Used for phophylaxis, not quick relief. Common routes are: Nebulizer, MDI.
AE: safest of all anti asthma medications, cough, bronchospasm.
Bronchodilators? types? characteristics?
They provide symptomatic relief but do not alter the underlying disease process (inflammation). So used to rescue.
Usually need to be accompanied by a glucocorticoid for long-term suppression of inflammation.
Principal brochodilators are the beta2-adrenergic agonists.
Beta2-adrenergic agonist? examples? TU? MOA? AE?
Most effective drug in relieving acute bronchospasms and prevention of exercise-induces bronchospasms.
EX: -ROL suffix, albuterol (proventil/ventolin), Salmeterol (serevent), Terbutaline, etc.
TU: Use for asthma: both quick and long-term control.
MOA: Activate beta2 receptors in smooth muscle of lung, promoting bronchodilation and thereby relieving bronchospasm.
Also suppress histamine release in lung and increase ciliary mobility.
AE: Inhaled preparations- systemic effects=tachycardia, angina, and tremor.