5. lower res PROTOTYPES

Albuterol - class, action, USE

CLASS: Bronchodilator, SABA

MOA: Relaxes bronchial smooth muscle via beta2 receptor stimulation → bronchodilation

USE: Quick relief of acute bronchospasm; prevents exercise- induced bronchospasm

Albuterol: ADR, consideration, preg

ADR: Anaphylaxis, paradoxical bronchospasm, Chest pain, tachycardia, palpitations, nervousness,
tremors, headache, restlessness, muscle cramps, GI symptoms, hyperglycemia

Consider:

Routes: Inhaler or nebulizer (nebulizer preferred for severe exacerbations or patients who cannot use inhaler effectively)
• Use as a rescue inhaler only; not for daily control
• Proper technique: inhale deeply/slowly, hold 10 sec
• Report chest pain, severe tremors, palpitations, or worsening SOB

Preg: C

Salmeterol - Class, MOA, USE

CLASS: Bronchodilator, LABA

MOA: Stimulates beta2-adrenergic receptors in bronchial smooth muscle, leading to bronchodilation; effects last approximately 12 hours.

USE: Long-term control of bronchospasm and prevention of asthma symptoms; improves airflow in COPD patients.

Salmeterol - ADR, teaching, preg

ADR: Asthma-related death if used as monotherapy without IC, , Tremors, nervousness, tachycardia,
headache, palpitations, risk of asthma-related death when used without an inhaled corticosteroid (ICS)

Consider:

Not for acute attacks; use a SABA for rescue
• Always use with an ICS to reduce risk of severe asthma events
• Use proper inhaler technique (inhale deeply and slowly, hold breath ~10 seconds)
• Report palpitations, chest pain, or severe tremors to your healthcare provider

Preg: C

Beclomethasone - Class, MOA, USE

CLASS: anti-nflammatory, Corticosteroid (inhaled or intranasal)

MOA: educes airway inflammation and immune response, decreasing frequency and severity of asthma
attacks. Decreases nasal congestion. Preferred for long-term asthma control.

USE: Asthma, allergic rhinitis

Beclomethasone - ADR, teaching, preg

ADR: Hoarseness, dry mouth, nasal irritation, nosebleed Cataracts, growth inhibition in children

Consider:

Rinse mouth after each inhalation to reduce risk of oral thrush
• Use proper inhaler technique (shake, exhale fully, inhale slowly, hold breath 10 seconds).

Preg: C

Ipratropium - Class, MOA, USE

CLASS: Bronchodilator, SAMA

MOA: Blocks cholinergic receptors in bronchial smooth muscle → reduces parasympathetic tone; decreases nasal hypersecretion

USE: Quick relief of acute bronchospasm; prevents asthma- and COPD-related bronchospasm

Ipratropium - ADR: consideration, preg

ADR: Dry mouth, cough, epistaxis, hoarseness, dysgeusia, paradoxical bronchospasm, worsened glaucoma

Consider:

Routes: Inhaler or nebulizer; ensure proper technique
• Use: Acute relief and prevention; not for long-term control
• Monitor/report: Eye pain, vision changes, severe dry
mouth, paradoxical bronchospasm
• Caution: Glaucoma, urinary obstruction

Preg: B

Tiotropium - CLass, MOA, USE

CLASS: Bronchodilator, Long-acting anticholinergic (Lama)

MOA: Blocks muscarinic (cholinergic) receptors in bronchial smooth muscle → reduces parasympathetic tone → bronchodilation; provides prolonged bronchodilation (~24- hour duration)

USE: Long-term maintenance to prevent bronchospasm in COPD and asthma

Tiotropium - ADR, consideration, preg

ADR: Dry mouth, cough, epistaxis, paradoxical bronchospasm (rare), hoarseness, dysgeusia, exacerbation of glaucoma

Consider:

Routes: Inhaler (HandiHaler/Respimat); ensure proper technique
• Use: Long-term maintenance only; not for acute attacks
• Monitor/report: Eye pain, vision changes, severe dry mouth, paradoxical bronchospasm
• Caution: Glaucoma, urinary retention

Preg: C

Montelukast - class, MOA, USE

CLASS: Asthma prophylaxis, allergic rhinitis, leukotriene receptor antagonis

MOA:Blocks leukotriene receptors → reduces airway inflammation, edema, and bronchoconstriction

USE: Long-term control of asthma; prevention of exercise- induced bronchospasm; management of allergic rhinitis

Montelukast - ADR, consideration, preg

ADR: h/a, abd pain, cough, nasopharyngitis, influenza-
like symptoms

Consider:

Routes: Oral tablet or chewable; take in evening for asthma control
• Use: Long-term maintenance; not for acute attacks
• Monitor/report: worsening asthma symptoms, abdominal pain
• Caution: Use with CYP450 inducers (e.g., carbamazepine) → may reduce effectiveness

Preg: B

Cromolyn Sodium - Class, MOA, USE

CLASS: Anti-inflammatory, Mast cell stabilizer

MOA: Stabilizes mast cells → prevents degranulation and release of inflammatory mediators after antigen exposure

USE: Long-term prophylaxis for mild-to-moderate asthma; prevents inflammation in COPD and asthma; alternative when corticosteroids are contraindicated

Cromolyn Sodium - ADR, consideration, preg

ADR: Bronchospasm, throat irritation, cough

Consider:

Routes: inhalation (nebulizer or MDI) for asthma prophylaxis; nasal or ophthalmic for allergic
rhinitis/conjunctivitis; ensure proper device technique
• Use: Long-term prophylaxis; not for acute attacks
• Monitor/report: Worsening asthma, throat irritation, cough, or bronchospasm

Preg: B

Theophylline - class, MOA, USE

CLASS: Bronchodilator, Methylxanthine

MOA:Relaxes bronchial smooth muscle → bronchodilation; suppresses airway responsiveness to
stimuli

USE: Symptomatic relief or prevention of asthma; reverses bronchospasm

Theophylline - ADR, consideration, preg

ADR: NV, h/a, irritability; dose-related toxicity

Consider:

Routes: Oral or IV; monitor serum drug levels for toxicity
• Use: Long-term maintenance or acute exacerbation management
• Monitor/report: Nausea, vomiting, palpitations, seizures, signs of toxicity
• Interactions: CYP450 drugs (ciprofloxacin, some benzodiazepines) → may increase theophylline levels
• Overdose treatment: Gastric lavage, activated charcoal, supportive care

Preg: C