drugs for asthma and COPD

BAM

1. B - beta agonists (albuterol)
2. A -anticholinergics (ipatropium)
3. M - methylxanthines (theophylline)

bronchodilators

open up the bronchioles in increase gas exchange and ventilation

do bronchodilators treat inflammation?

no

what drugs are most effective against acute bronchospasms?

inhaled beta 2 andrenergic agonists

PO beta 2 andrenergic agonists used for

long term on a fixed schedule (PO albuterol)

inhaled long acting beta 2 andrenergic agonists

used for a long term on a fixed schedule for COPD (salmeterol/formoterol)

inhaled short acting beta 2 andrenergic agonists

PRN, used for ongoing attack but not for prevention (albuterol)

What is the fastest acting rescue inhaler?

albuterol

what are the adverse effect of albuterol?

tachycardia, angina, muscle tremor, anxiety, insomnia

DO NOT TAKE ALBUTEROL WITH? WHY?

beta blockers and nsaids. can cause bronchospasms.

what is used for bronchoconstriction

epinephrine (adrenaline)

route for epinephrine n how long until effects start?

subQ injection/inhalation. 5 minutes

anticholinergic bronchodilators

blocks mucus receptors (decreasing mucus) and reduces bronchoconstriction (dilates em)

anticholinergic bronchodilators are called ____ for asthma

ipatropium/tiotropium

side effects for anticholinergic bronchodilators

cough, nervousness, GI upset, headache, dizziness

what condition is anticholinergic bronchodilators contraindicated for

glaucoma bc paradoxical bronchospasm has occured

methylxanthines prototype drug

theophylline

what should you tell a patient taking theophylline

avoid cimetidine, ciprofloxacin, and caffeine (coffee, energy drinks, etc.)

what do methylxanthines (theophylline) do

relax bronchial smooth muscle

can methylxanthines (theophylline) be used to treat COPD?

yes but only as a second line drug (ie. use the obvious options first)

methylxanthines (theophylline) toxicity is?

>20 mcg/mL, leads to seizures,tachycardia, dysrhythmias