Sympathomimetics sympathomimetics older agents full

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Unformatted text preview: any choices: There S im p le B ron ch od ilators S ymp ath omimetics Xanthines A n tich olin erg ics B ron ch od ilators with An tiin flam m atory Effects Asth m a P rophylactics crom olyn L eu kotrien e Mod ifiers Corticosteroid s In haled or System ic Combination therapy is often most effective with some agents potentiating others. Sympathomimetics Sympathomimetics • Older agents full beta agonists: – epinephrine, isoproterenol (Isuprel®) • Ephedrine should no longer be used (too much cardiac and CNS stimulation). • Newer agents more beta 2 selective: – metaproterenol, albuterol and terbutaline are effective and less cardiac stimulation • Long acting agents (8-12hrs) – Not a “rescue” drug – 2002 studies show that long acting agents “prime” inactive corticosteroid receptors – Salmeterol (Serevent®) – New Warning (8/04) May blunt response to “rescue” Sympathomimetics Sympathomimetics • Therapeutic Uses – asthma or other cases of COPD • Mechanism of Action – β2 agonist - relaxes bronchiole smooth muscle • Most products can be inhaled • some may be injected • ephedrine can be taken orally • Cautions and Side Effects – C.V. - tachycardia, palpitations, hypertension – G.I. - nausea and vomiting – CNS - headache, dizziness • (Note: not a CNS stimulant as xanthines are) Note: For status asthmaticus terbutaline inhaler seems as effective as subcutaneous epinephrine. Xanthines Xanthines Aminophylline (Theophylline) Theophylline) • Therapeutic Uses – Asthma - Pulmonary edema • Mechanism of Action – Smooth muscle relaxant • Side Effects and Cautions – G.I. • direct irritation - gastric irritation, nausea, vomiting • stimulation of emetic center – CNS • restlessness, anxiety, convulsions – C.V. • hypotension, headache Anticholinergic Anticholinergic ipratropium (Atrovent®) (Atrovent® • Bronchodilato...
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This document was uploaded on 02/07/2014.

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