Pharm 2 Final: Respiratory Drugs

Fluticasone

MOA: Inhaled corticosteroid. Use: Prevention of asthma. SE: Oral candidiasis (thrush); given twice daily.

Prednisone

MOA: Oral corticosteroid. Use: Long-term treatment of COPD. SE: Weight gain, hyperglycemia.

Fluticasone/Salmeterol (Advair)

MOA: Inhaled corticosteroid + long-acting beta-2 agonist combination. Use: Asthma and COPD maintenance therapy. SE: See individual components.

Cromolyn Sodium

MOA: Mast cell stabilizer; prevents degranulation and release of histamine and leukotrienes. Use: Asthma, allergic rhinitis. SE: Minimal side effects.

Montelukast (Singulair)

MOA: Leukotriene receptor antagonist. Use: Asthma prevention (especially when steroids cannot be used). SE: May be used as add-on to corticosteroids (less effective than steroids alone).

Roflumilast (Daliresp)

MOA: Phosphodiesterase type 4 (PDE4) inhibitor. Use: Reduce COPD exacerbations in chronic bronchitis patients with history of exacerbations. SE: Psychiatric side effects.

Albuterol

MOA: Rapid-acting beta-2 agonist; directly relaxes bronchial smooth muscle. Use: Prevent or treat acute bronchospasm. SE: Tachycardia, hypertension, hyperglycemia; systemic effects decreased with inhaled route; dose every 4–6 hours in acute exacerbations (onset 5–30 min).

Salmeterol

MOA: Long-acting beta-2 agonist; directly relaxes bronchial smooth muscle. Use: Long-term treatment of asthma and emphysema. SE: Tachycardia, hypertension, hyperglycemia; duration up to 24 hours; must be used with ICS in asthma.

Ipratropium (Atrovent)

MOA: Muscarinic receptor antagonist. Use: COPD (combined with albuterol as "DuoNeb"); moderate-to-severe asthma (combined with beta-2 agonist). SE: Dry mouth; other anticholinergic effects (constipation, tachycardia, urinary retention).

Tiotropium (Spiriva)

MOA: Muscarinic receptor antagonist. Use: Long-term once-daily treatment for mild-to-severe COPD. SE: Dry mouth.

Umeclidinium (Incruse Ellipta)

MOA: Muscarinic receptor antagonist. Use: Long-term treatment for mild-to-severe COPD. SE: Dry mouth.

Omalizumab (Xolair)

MOA: IgE antagonist. Use: Moderate-to-severe allergic asthma in patients ≥12 years. SE: Can cause allergic reactions.

Dextromethorphan (Delsym/Robitussin DM)

MOA: D-isomer of a potent opioid agonist; antitussive. Use: Cough suppression. SE: Most widely used opioid antitussive.

Guaifenesin (Mucinex)

MOA: Expectorant. Use: loosen and thin mucus in the airways, suppress cough SE: N/A.