Chapter 17: Drugs for the tx or respiratory disorters and allergic rhinitis

Diseases that are treated with respiratory drugs include ________

asthma, chronic obstructive pulmonary disease (COPD), seasonal allergies, and upper respiratory tract infections

A common reversible airway obstruction associated with reduction in expiratory airflow resulting in inflammation, secretions and bronchoconstriction

asthma

Patients with ______ experience symptoms less than twice a month, and the symptoms do not interfere with normal activity. ______ asthma occurs anywhere from than twice a week to all day long. ______ can cause minor limitation of normal activities, and severe _______ asthma can severely limit the patient’s normal activities

intermittent, persistant , persistent, persistent

Signs of asthma include _______, chest tightness and pain, and coughing

shortness of breath, wheezing upon exhaling, trouble sleeping,

Beta 2 Agonists (long and short acting), oral inhaled, corticosteroids, oral corticosteroids, combo oral inhaled/long acting Beta 2, Leukotriene, Antagonists, Mass Cell Stabilizers, anti IgE antibody, anti interleukin 5, antibodies, and methyxanthines are all treatment drug classes for _____

asthma

____ an irreversible airway obstruction which occur with either chronic bronchitis or emphysema. Chronic inflammation and excessive sputum

Chronic obstructive pulmonary disease

Antimuscarinics are the first line agents, but B2-adrenergic agonists are also used to produce bronchodilation in patients with this disease

Chronic obstructive pulmonary disease

______ is a result of chronic inflammation of the airways and excessive sputum production

chronic bronchitis

______ is characterized by alveolar destruction with air space enlargement and airway collapse

emphysema

Symptoms for chronic obstructive pulmonary disease include

breathing difficulty, cough, sputum production, and wheezing

This drug’s advantages include quick onset, compact portable, minimally side effects, sterile and low toxicity

Metered-Dose inhalers

Disadvantages of _____ includes tolerance builds, reduces affect of drug, difficult to use, spacer needed

Metered-Dose inhalers (MDI)

Anticholinergics (inhaled short and long), beta 2 agonists(inhaled short and long), beta 2 agonists and anticholinergic (both short), _______, and phosphodiesterase 4 inhibitor (reduces aiway inflammation, not through bronchodilation) are all treatment drug classes for ______

inhaled corticosteroids and long acting beta 2 agonists, chronic obstructive pulmonary disease (COPD)

_____ is inflammation of the nasal airways that occurs when an allergen is inhaled in an individual with a sensitized immune system. It triggers antibody Immunoglobulin E (IgE), which binds to _____ and basophils containing _____

allergic rhinitis, mast cells, histamine

Symptoms of ____ include histamine release causing itchy, watery eyes and runny nose. Symptoms vary in severity among those affected by _____

allergic rhinitis, allergies

Allergic rhinitis has two types seasonal and perennial. _____ is usually caused by pollen from trees, grass, and flowers and lasts several weeks to months. _____ is a result of sensitivity to different allergens, such as house dust and animal dander, and lasts throughout the year. The most effective method of treating allergic rhinitis is to eliminate the source of allergen, if not _____ is necessary

seasonal allergic rhinitis, perennial, medication

Histamine 1 blocker (blocks histamine, blocks vasodilation → less edema, itching, pain CNS depression, xerostomia) is the treatment drug classes of

allergic rhinitis

A 1st generation class of H1 blockers include

Diphenhydramine (Benadryl)

A 2nd generation class of H1 blockers include

Loratadine, Allegra D, Claritin D

Intranasal corticosteroids, leukotriene modifiers, mass cell stabilizers, and decongestants (Pseudoephedrine and phenylephrine) are used for the tx of _____

Allergic rhinitis

Short-acting β2 agonists cause __________ by stimulating β2 receptors. A common example of a short-acting β2 agonist is _____

bronchodilation, Albuterol

Albuterol brand names include __________, __________, and __________.

ProAir, Proventil, Ventolin

Common adverse effect of short-acting β2 agonists are increased _____, ______, and patients using these agents should _____ after use to reduce oral effects.

heart rate (HR), xerostomia, rinse mouth

Long-acting β2 agonists cause __________ by stimulating β2 receptors. A common example of a long-acting β2 agonist is __________, and its brand name is ______

bronchodilation, Salmeterol, Severent Diskus

Long-acting β2 agonists are used for __________ control of asthma symptoms. LABAs are NOT used for __________ relief.

long-term (or maintenance), immediate (or quick/rescue)

LABAs should be used in combination with __________ in asthma patients that is not well-controlled by low-dose inhaled corticosteroids alone

low-dose-inhaled corticosteroids

Most effective long-term treatment option for control of symptoms in all patients with mild, moderate, or severe persistent asthma

Orally inhaled corticosteroids

The _____ are specially useful in reducing _____ and, therefore, the secretions and swelling that occur within the lungs after an asthma attack

orally inhaled corticosteroids, inflammation,

Orally inhaled corticosteroids primarily act as __________ agents. The main purpose of inhaled corticosteroids is to reduce __________ in the airways.

anti-inflammatory, inflammation

Orally inhaled corticosteroids may cause oral __________, __________, unpleasant __________, __________ suppression (long-term), __________ suppression, and poor __________ __________

candidiasis, xerostomia, taste, adrenal, immunosuppression, wound healing

Examples of inhaled corticosteroids include __________, __________, and __________.

Flovent, Pulmicort, Advair (or Symbicort)

Oral corticosteroids are __________ acting anti-inflammatory drugs. A common example is ______, and they are used to reduce __________ in the body.

slower, prednisone, inflammation

Combination drugs of inhaled corticosteroids and LABAs provide both __________ and __________.

anti-inflammatory effects, bronchodilation

Examples of combination inhaled corticosteroid/LABA medications include __________, __________, __________, __________, __________, and __________.

Advair HFA, Advair Diskus, AirDuo RespiClick, Breo Ellipta, Symbicort, AirDuo

Leukotriene antagonists work as ______, leukotriene modifiers, and ______

leukotriene blockers, blocks bronchoconstriction

Leukotrienes are responsible for __________ and __________ in the airways. Leukotriene antagonists help prevent __________ of the airways.

inflammation, bronchoconstriction, bronchoconstriction

Leukotriene antagonists are often used when β2 agonists and __________ are not effective. They may cause _____

corticosteroids, stomach irritation

Common leukotriene antagonists are _____ and _____.

montelukast, zafirlukast

The brand name for montelukast is ________, and for zafirlukast is

Singulair, Accolate

Leukotriene antagonists can have drug interactions with __________, __________, and __________.

erythromycin, aspirin, warfarin

Mast cell stabilizers work by preventing the release of ______. They stabilize __________ cells to reduce inflammation.

histamine, mast cells

Common mast cell stabilizers are ____ and ____

Cromolyn (Intal, NasalCrom), Nedrocromil (Tilade)

Compared to other asthma medications, mast cell stabilizers are considered ______ toxic. They can be used __________ exercise to prevent symptoms, and they act ______ histamine is released.

less, before, before

Anticholinergics also known as_______ agents, work by blocking the effects of _____, leading to relaxation of _____ muscle in the airways.

antimuscarinic , acetylcholine, smooth

The primary effect of anticholinergics in the lungs is _______.

bronchodilation,

A commonly used short-acting anticholinergic is __________ __________.

ipratropium bromide (Atrovent)

A commonly used long-acting anticholinergic is __________.

Tiotropium (Spiriva)

Common side effect of anticholinergics are____, ____, and

xerostomia, bad taste

Anticholinergics may have cross-reactivity in patients with __________ or __________ allergies.

soybean, peanut

Ipratropium Bromide (Atrovent) may have an __________ effect when used with β2 agonists.

additive

Anti-IgE antibodies work by binding to IgE and by doing so, these drugs prevent the release of __________ mediators.

inflammatory

_______ and _____ are the first in a new class of drugs approved by the FDA to treat severe asthma in patients with elevated eosinophil levels

Mepolizumab (Nucala) and reslizumab (Cinqair)

_____ is the first in a new class of medications introduced to treat asthma due to ____. This drug is administered as a subcutaneous injection every 2 to 4 weeks and is EXPENSIVE

Omalizumab (Xolair), allergens

Anti-IgE antibodies are administered by ______, and these injections are typically given every _____. A common side effect of anti-IgE therapy is __________ at the injection site.

injection, 2 to 4 weeks, bruising

A serious potential adverse effect of anti-IgE antibodies is ________

anaphylaxis

Anti-IgE antibodies prevent IgE from binding to __________ cells. And act ________ allergen exposure to reduce the immune response.

mast cells, after

Anti–IL-5 antibodies work by targeting _____. These drugs inhibit the signaling of interleukin-5 which blocks the production of eosinophils and results in decreased ______ and a reduction in _____ symptoms

interleukin-5 (IL-5), inflammation, asthma

Interleukin-5 is primarily responsible for the growth and activation of __________.

eosinophils

Anti–IL-5 antibodies are administered by ______, and they help decrease asthma __________ and improve control.

injection, symptoms

A reported adverse effect of reslizumab (Cinqair) is __________ pain.

oropharyngeal

Reslizumab is administered intravenously every 4 weeks in a health care setting by health professional because of the risk of ____

anaphylaxis

______ a bronchodilator, Theophylline (Theo-Dur, Slobid), used when other agents don’t work

Methylxanthines

Nasal decongestants work as ________ adrenergic agonists. Their primary mechanism is _____ in the nasal mucosa

alpha, vasoconstriction

Two common nasal decongestants are ________ and ________.

pseudoephedrine, phenylephrine

Long-term topical use of nasal decongestants can cause ________ swelling and congestion. Therefore they should not be used for more than a few days

rebound

Nasal decongestants should be used cautiously in patients with ________ or cardiovascular disease.

hypertension

Pseudoephedrines include _____

Sudafed, Sucrets, Actifed

Phenylephrine include ____

Neo-Synephrine, Sinex, and Allerest

______ remove exudate or mucous from respiratory passages

Expectorants

Guaifenesin (Robatussin) works by promoting the removal of ________ from respiratory passages, and is classified as a(n) ________.

secretions (or mucus/exudate), expectorant

Mucolytics differ from expectorants because they ________ or dissolve mucus directly. Acetylcysteine is classified as a(n) ________.

break down, mucolytic

Acetylcysteine is commonly used in the treatment of ________ fibrosis, ______ toxicity, and ______

cystic, acetaminophen, infection

______ opioid-like compound that suppresses cough center in the brain and does not cause histamine release

Dextromethorphan

_____ containing cough preparations are commonly used, but their histamine-releasing properties may precipitate _____

Codeine, bronchopasm

______ may be opioids or related agents used for the symptomatic relief of nonproductive _____. _____ are the most effective, but bc of their addicting properties, other agents are used

Antitussives, coughing, Opioids