Term
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Definition
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Term
| Isoproterenol, metaproternol |
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Definition
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Term
| albuterol, levalbuterol, terbutaline |
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Definition
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Term
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Definition
ONSET OF ACTION: rapid
PEAK EFFECT: 30-60 min
DURATION: 4-6 hrs
good for rescue and prophylatically, bad for chronic management and nocturnal |
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Term
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Definition
(LABA) long acting Beta agonists
-have lipophilic side chains that resist degradation
12-24 hr duration, Slower onset- not for acute use
*NOT FOR MONOTHERAPY, need ANTI-INFLAMMATORY
*cardiac toxicity potential due to some b1 agonism
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Term
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Definition
Class: Anti-cholinergics
MOA: Highly absorbed across respiratory epithel thus not used for Asthms
A/E: Tachycardia, nausea, dry mouth, GI upset |
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Term
| Atrovent (ipratropium bromide) |
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Definition
Class: Anticholinergic
salt derivative of atropine
Not significantly absorbed in resp epith.
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Term
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Definition
| Like Atrovent, but longer acting (slow dissociation from receptors)-qDay dosing |
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Term
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Definition
Competative antagonists at muscarinic ACh rc
M3 receptor most important
-mediates smooth muscle relaxation and mucus gland secretion in the airway
-good for treatment of COPD
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Term
| Theophylline, aminophylline |
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Definition
Class: Methylxanthines
MOA: Non-selective inhibition of PDE (phosphdiesterase which breaks down cAMP) which causes bronchodilation and are anti-inflammatory.
Off target: antagonize adenosine receptor allowing ventilation during hypoxia, endurance of diaphragm, decreased mast cell release
Admin: Oral, but Narrow therapeutic index
Metabolized: CYp450 1A2 (cigarette smoking induces this enzyme)
A/E: n/v/d ha, irritability, insomnia, sz, brain damage |
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Term
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Definition
MOA: alter genetic transcription by increasing b2 rc and anti-inflammatory proteins
-decreasing pro-inflamm proteins
-induce apoptosis in inflammatory cells (eosinophils, Th2, lymphocytes)
- Indirectly inhibits mast cells over time
*suppressive not cure
Admin: Inhaled, only 25% reach airways
-higher airway concentration than same dose given PO due to First-pass
A/E: less with inhaled than systemic...osteopenia, delayed grown, candidiasis, hoarseness, hyperglycemia
Interaction- drugs that inhibit first-pass, this can increase levels even if inhaled due to amount that is Absorbed GI
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Term
| Cromolyns (cromlyn nedocromil) |
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Definition
MOA: stabilize mast cells by inhibiting release of inflammatory mediators
*do not relieve an allergic response after initiation
Use: prophylactic therapy
Metabolism: less systeic absorption
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Term
| Leukotriene inhibitors (motelukast, zafirluukast, zileuton |
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Definition
Administration:oral, therapeutic not as small as methylx
A/E: few, hepatotoxicity with aileuton
Metabolism: hepatic |
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Term
| Anit-IgE Antibody (omalizumab) |
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Definition
Humanized mouse monoclonal antibody
MOA: binds to IgE in order to decrease circulation and prevents binding of IgE to mast cells-->down regulation of receptor
Administration: sq q2-4 weeks
A/E: triggering an immune resoonse |
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