Ipratropium (Atrovent) - Answers Anticholinergic Bronchodilator
MOA: Inhibits cholinergic receptors in bronchial smooth muscle --> bronchodilation
Uses: FDA approved for COPD bronchospasm, used off label for asthma induced or exercise induced
bronchospasm
Side effects: dry mouth, hoarseness, drying of respiratory secretions*, activate cardiac system*
*contraindicated for peanut allergy because may contain soy lecithin
*Primary anticholinergic drug because no CNS effects
*when used in combination with albuterol, has been shown to be effective during acute severe asthma
in significantly improving lung function and reducing hospitalizations in children coming to the ED.
Albuterol (Proventil) - Answers Adrenergic Bronchodilator
(β-Adrenergic agonists)
MOA: Binds to B2-adrenergic in airway smooth muscle (decreases intracellular calcium --> relaxation)
Uses: treatment or prevention of bronchospasm, ACUTE exacerbations
Side effects: nervousness, tremor, paradoxical bronchospasm, chest pain, palpitations
Montelukast (Singulair) - Answers Leukotriene Receptor Antagonist
MOA: suppress the effects of leukotrienes reducing inflammation, bronchospasm, airway edema, and
mucus production
, Uses: long term therapy of asthma, prevent exercise induced bronchospasm, NOT ACUTE
Side effects: depression, suicidal idealization, Stevens-Johnson syndrome, toxic epidermal necrolysis
Magnesium Sulfate - Answers Minerals/Electrolytes
MOA: essential for activity of many enzymes, important role in neurotransmission and muscular
excitability
Uses: potent muscle relaxant, acts to decrease inflammation and improves pulmonary function and peak
flow rate among pediatric patients treated in the ED with moderate to severe asthma.
(also magnesium deficiency, torsade de pointes, adjunctive treatment for bronchodilation in severe
acute asthma, seizure prevention in preeclamsia/eclampsia)
Side effects: decreases RR, drowsiness, bradycardia, flushing, muscle weakness
Pancrelipase (Creon) - Answers Pancreatic Enzyme/Digestive Agent
MOA: contains lypolytic, amylolytic, and proteolytic activity
Uses: cystic fibrosis, chronic pancreatitis, pancreatic insufficiency, ductal obstruction from tumor
Side effects: fibrosing colonopathy, abdominal pain, diarrhea, nausea, cramps
Corticosteroids (inhalation) - Answers Antiasthmatic / anti-inflammatory
MOA: locally acting anti-inflammatory and immune modifier
Uses: maintenance (long term) treatment of asthma as prophylactic therapy,