Term
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Definition
B-adrenergic agonist
Use: asthma
Mechanism: B2 binding causing bronchodilation
PHK: 1-2 hour duration
Other drug: Metaproterenol (Alupent) |
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Term
| Albuterol (Ventolin®; Proventil®) |
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Definition
Selective B2 agonist
Use: Asthma attack (in progress)
Mechanism: B2 agonist, bronchodilation
PHK: acts immediately; lasts 4-6 hrs
Side effects: Tachy, nervousness, dizzy, tremor, tolerance? (steroid inhibits this), increased death?
Other drugs: Levalbuterol (XopenexTM)
Pirbuterol (Maxair®)
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Term
Salmeterol (Serevent®)
Salmeterol/fluticasone (Advair) |
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Definition
Selective B2 agonist
Use: Asthma Prophylaxis, NOT FOR ATTACK (use short acting instead i.e. albuterol)
Mechanism: long acting B2 agonist
PHK: effects take 20-30 min
Should always be combined with a steroid (advair) as the inhibit downregulation and increase sensitivity
Side effects: Tachy, nervousness, dizzy, tremor, tolerance? (steroid inhibits this), increased death? (B agonists w/o steroid)
Other drugs: Formoterol (Foradil®)
Formoterol/mometasone (Dulera)
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Term
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Definition
Muscarinic antagonist
Use: Asthma Pt intolerant of B2 agonist; COPD
Mechanism: M antagonist = Bronchodilator
Usually combined w/ albuterol
Other drugs: Tiotropium (Spiriva®)
Aclidinium (Tudorza Pressair)
Theophylline (Theo-Dur®) - low therapeutic index; increases cAMP-phosphodiesterase inhibitor, blocks adenosine receptor; relaxes smooth muscle, stimulates CNS and heart; for asthma NOT controlled by B2 agonist
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Term
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Definition
Inhaled Corticosteroid
Mechanism: decreases inflammation, improve symptoms and decrease requirement for B-agonist
Side effects: thrush, hoarseness, decrease bone density (women)
Other Drugs: Beclomethasone (Beclovent®; Vanceril®) Flunisolide (Aerobid®)
Triamcinolone (Azmacort®)
Budesonide (Pulmicort®) |
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Term
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Definition
Leukotriene Inhibitor
Use: Asthma prophylaxis, NOT FOR ATTACK
Mechanism: inhibits leukotriene induces inflammation, specifically synthesis and receptor binding of leukotrienes
Side effects: sleepiness
Other drugs: Zafirlukast (Accolate®)
Pranlukast (Ultair®)
Zileuton (Zyflo®)
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Term
| Cromolyn sodium (Intal®, Aarane®); NOT BOLDED |
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Definition
Asthma med
Use: Asthma (children) prophylaxis
Mechanism: Inhibits release of histamine from mast cells- not a bronchodilator
PHK: needs to be used several timesa day, chronically
Other drugs: Nedcromil (Tilade®)
Omalizumab (Xolair) |
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Term
| Diphenhydramine (Benadryl®) |
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Definition
Sedating Antihistamine
Use: Asthma, allergies
Mechanism: Block H1 receptors AND muscarinic receptors, significant anticholinergic effect
Other drugs: Dimenhydrinate (Dramamine®) - motion sickness
Acute poisoning: will look like atropine poisoning
Doxylamine (Unisom®)
Promethazine (Phenergan®) - vomiting/motionsickness
Hydroxyzine (Atarax®; Vistaril®)
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Term
| Brompheniramine maleate (Bromamine®, Dimetane®) NOT BOLDED |
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Definition
Moderately-sedating antihistamines
Use: Allergies
Mechanism: blocks H1 receptor AND muscarinic receptor
Mechanism: has little sedative effect
Other drugs: Chlorpheniramine maleate (Chlor-Trimeton®)
Clemastine (Tavist®)
Cyclizine (Merezine®)
Meclizine (Bonine®)
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Term
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Definition
2nd Generation (non-sedating) H1 antagonists
Mechanism: Larger than 1st gen, don't enter CNS
Side effects: Decrease seizure threshold
Other drugs: Desloratidine (Clarinex®)
Levocetirizine (Zyxal®) - excreted by kidney; use if pt has liver dx or drug interaction
Certirizine (Zyrtec®) - excreted by kidney; use in liver dx or drug interactions
Acrivistine/Pseudoephredrine (Semprex®)- excreted by kidney; use in liver dx or drug interactions
Fexofenadine (Allegra®)
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Term
| Azelastine (Astellin NS; Astepro) |
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Definition
Nasal H1 (non-competitive) antagonist
mechanism: inhibits histamine release
Other drug: levocabastine (livostatin) |
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