Topic 3 Meds

Cetirizine (Zyrtec) and Loratadine (Claritin)

antihistamines that relieve acute symptoms of allergic response like itching, sneezing, and rhinorrhea

SE: minimal sedation; very few if none

has rapid onset of action, more expensive that traditional antihistamines

prednisone

an oral corticosteroid that is used to treat asthma and COPD

SE: hyperglycemia, fluid retention

Considerations: may take 2 weeks for those with severe COPD exacerbation, take in morning with food, if long term requires Vit D and calcium supplements, discontinue gradually

Fluticasone (Flonase)

an inhaled corticosteroid that is used to treat asthma via MDI or DPI

SE: HA, cold S/S

Considerations: rinse mouth after use to prevent oral candidiasis, use spacer with MDI, may not have results for 2 weeks

Montelukast (Singuolair)

a PO Leukotriene Receptor Antagonist (LTRA) that is used to treat asthma

SE: HA, fatigue, dizziness, GI distress

Considerations: do not use in acute attack, can prevent wheezing and SOB during exercise

albuterol

inhaled SABA that is used to treat asthma and COPD; produces bronchidilation within 5 minutes and lasts for 2-5 hours

Route: nebulizer, oral, MDI

SE: tremors, HA, tachycardia, nausea, HTN, CNS stimulation, risk fo dysrhythmias

Considerations: Shake MDI before use (faster route), use in caution in those with cardiac disorders

metered-dose and dry powder inhalers

• slow inspiration

• may need shaken (albuterol) or not

• space make increase delivery and reduce change of oral candidiasis

• some have external counting device

• often 2 inhalations/dose

dry powder inhaler

• rapid inspiration

• does not need shaken before use or need a space

• have counter to count doses remained

• often one inhalation/dose

short acting B2 adrenergic agonist (SABA)

a mainstay of COPD treatment; effective in relieving acute bronchospasm and plays a role in asthma management, bronchodilation, and increased mucociliary clearance

should not be used alone for recurrent, repeated asthma attacks or for long-term control\

SE: increased BP and HR, CNS stimulation, dysrhythmias

albuterol

what is the MC SABA

Salmeterol (Servant) 

what is the most widely used LABA

Long acting B2 agonist (LABA)

class of medications that treat asthma and COPD

SE: increased BP and HR, CNS stimulation, dysrhythmias

Should not be used as primary treatment, only if patient doesn’t respond to other drugs, do not use to treat wheezing that is getting worse, are effective for 12 hours

Salmeterol (Servant) 

a LABA that is used to treat COPD through a DPI and can prevent exercise induced asthma in those with persistent asthma

SE: tremors, tachycardia, muscle pain, cold symptoms

Considerations: do not use more than twice a day

Fluticasone/Salmeterol (Advair)

a combination of an ICS with a LABA that is used to treat asthma and COPD via a DPI or MDI

SE: HA, cold symptoms

Considerations: do not use in acute attacks, long-term therapy only, rinse mouth after using

Budesonid/Formoterol (Symbicort)

a combination of an ICS and LABA that is used to treat asthma via an MDI

SE: HA, cold symptoms

Considerations: do not use in acute attacks, long-term therapy only; rinse mouth after using

Ipratropium/Albuterol (Combivent)

a combination of an SAMA and SABA that is used to treat COPD via a nebulizer or MDI

Considerations: do not use in acute attack, long term therapy only