Glucocorticoids, Beta2-Adrenergic Agonists, Anticholinergics, Theophylline, Leukotriene Modifiers

Glucocorticoids

Anti-inflammatory drugs that decrease asthma symptoms by reducing edema and mucus production

Glucocorticoids Schedule

Must be taken on a fixed schedule

Glucocorticoid Precautions

Pregnancy, breastfeeding, glaucoma, diabetes, Cushing syndrome, active infections, immunocompromised

Glucocorticoid Side Effects

Candidiasis, hoarseness, speaking difficulty (rinse mouth after use)

Glucocorticoid Adverse Effects

Adrenal suppression and bone loss

Beta2-Adrenergic Agonists

Bronchodilators used to relax airway smooth muscle

Short-Acting Beta2 Agonist

Albuterol; used in acute asthma attacks (“band-aid”)

SABA Onset and Duration

Onset 10–25 minutes; duration 3–4 hours

Long-Acting Beta2 Agonist

Salmeterol; used for chronic asthma management

Beta2 Agonist Contraindications

Hypertension, cardiac dysrhythmias, risk of stroke

SABA Side Effects

Tremor, anxiety, headache, palpitations

SABA Adverse Effects

Palpitations, ectopy, tachycardia, chest pain, blood pressure changes

LABA Adverse Effects

QT prolongation and ventricular arrhythmias

Anticholinergics (Respiratory)

Block acetylcholine to reduce parasympathetic activity and bronchoconstriction

Anticholinergics Use

Manage bronchospasms in COPD; cause airway relaxation and decreased secretions

Anticholinergic Side Effects

Dry mouth, blurred vision, nasal congestion, palpitations, urinary retention, nausea, vomiting, cramps, cough

Anticholinergic Adverse Effects

Worsening angle-closure glaucoma, acute eye pain, hypotension

Theophylline

Used for chronic stable asthma when other drugs are ineffective or not tolerated

Theophylline Teaching

Limit caffeine intake

Theophylline Drug Interactions

Cimetidine and fluoroquinolones increase theophylline levels

Leukotriene Modifiers

Oral drugs used adjunctively to reduce inflammation in asthma

Zafirlukast

Take 1–2 hours before meals

Montelukast

May cause nausea and suicidal thoughts

Anticholinergic Examples

Aclidinium and tiotropiu

long acting beta agonists are NEVER used for what?

acute treatment