{[ promptMessage ]}

Bookmark it

{[ promptMessage ]}

Atopic asthma exercise induced asthma some cases of

Info iconThis preview shows page 1. Sign up to view the full content.

View Full Document Right Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: r – Blocks muscarinic receptors – Not drying • probably due to poor lipid solubility • Systemic side effects not seen so far. • Currently recommended for COPD but not asthma. – May have value in asthma as adjunct Asthma prophylactic Asthma cromolyn (Aaranene®, Intal®), nedocromil (Tilade®) (Aaranene® Intal ®), nedocromil (Tilade® AKA: Mast Cell Stabilizers/ Histamine Release Inhibitors • Therapeutic Uses Takes two weeks to become effective with 4-6 doses/day. – Atopic asthma – Exercise induced asthma – Some cases of intrinsic asthma – Not used for bronchitis/emphysema – Advantage: no cardiac stimulation • Mechanism of Action prevents release of histamine and other mediators • Is therefore “anti-inflammatory” • Interferes with bronchoconstriction that is histamine based. • Caution – inhalation occasionally causes bronchospasm, throat irritation, headache and unpleasant taste Leukotriene Receptor Antagonists Leukotriene montelukast (Singulair®), zafirlukast (Accolate®), zileuton (Zyflo®) montelukast (Singulair®), zafirluk zafirlukast (Accolate®), zileuton (Zyflo® zileuton Anti-inflammatory agents For prophyllaxis only - not a “rescue” drug – Efficacy similar to cromolyn but more side effects. • Mechanism of Action – prevents leukotrienes from causing inflammation. • Side Effects and Cautions – Headache – GI upset – Liver enzyme changes • Inhibits P450 enzymes so decreases metabolism of many other drugs. Corticosteroids Corticosteroids Beclomethasone dipropionate (Beclovent®, Vanceril®), dexamethasone Beclomethasone dipropionate (Beclovent®, Vanceril ), dexamethasone Vanceril®), dexamethasone (Decadron®) flunisolide (Aerobid®), triamcinolone (Azmacort®) ), triamcinolone (Decadron®) flunisolide Aerobid®), triamcinolone (Azmacort®) flunisolide • Used only if other therapy does not control symptoms. • Positive interaction of inhaled corticosteroids and long acting sympathomimetics • Corticosteroid available as aerosol, tablets, and injections. Note: when these medications are needed, side effects of inhalers are much more acceptable than consequences of non-treatment. Corticosteroids Corticosteroids • Therapeutic Uses – asthma and other severe COPD – status asthmaticus (associated with bronchospasms) • Mechanism of Action – suppression of antibody formation (including IgE responsible for allergy attacks) – increases cyclic AMP which is needed for bronchodilation – decreases cyclic GMP which causes bronchoconstriction Corticosteroids Corticosteroids • Side Effects – local (with inhaler use) • hoarseness, dry mouth, local infections in mouth and pharynx – systemic (minimized by inhaler) • irreversible – osteoporosis (Ca++, protein, vitamin D helps), cataracts, stunting of growth in children • reversible – proneness to infections. Poor wound healing (including proneness to ulcers) (vitamin C helps), salt and water retention, signs of CNS stimulation (restlessness, insomnia, even manic states including depressive episodes in some individuals) Corticosteroids Corticosteroids • Cautions – drugs must be withdrawn slowly - body has decreased capacity to produce its own glucocorticoids. Also must gradually switch to inhaler from oral forms of medication) – during times of stress, patient may need extra glucocorticoid – Full effect of steroid therapy may take two to four weeks to be seen. Warning: Corticosteroid inhaler is not for treatment of acute attacks (not to be confused with a catecholamine inhaler)...
View Full Document

{[ snackBarMessage ]}

Ask a homework question - tutors are online