NURS 488 - Lec 3 Test With
Complete Solution
Long-term medications to treat asthma - ANSWER - leukotriene receptor
antagonists
- mast cell stabilizers
- inhaled and oral glucocorticoids
- anticholinergic drugs
- inhaled long-acting ß2-agonists (LABAs)
- combo inhaled glucocorticoid and inhaled LABA
- theophylline
- LABAs in combo with inhaled corticosteroids
rapid-relief meds to treat asthma - ANSWER - inhaled short-acting
ß2-agonists
- inhaled ipratropium (rare)
- inhaled corticosteroids and LABAs > specifically budesonide and formoterol
combo (used as relief for patients 12 YO and older if using combo as
maintenance)
asthma management - ANSWER I. step 1: mild intermittent
- short-acting inhaled ß2-agonist PRN and early introduction of low-dose
inhaled glucocorticosteroid (adults and ≥ 6 YO)
,ii. step 2: moderate persistent
- short-acting inhaled ß2-agonist PRN and medium-dose inhaled
corticosteroid
- inhaled corticosteroid and LABA combo inhaler (adults and ≥ 12 YO)
- leukotriene receptor antagonist
iii. step 3: severe uncontrolled
- in addition to above therapies:
> oral prednisone (FEV, less than 60%)
> anti-IgE antagonist (omalizumab) in adults and ≥ 12 YO
Leukotriene Receptor Antagonists MOA - ANSWER - leukotrienes are
released when a trigger, such as cat hair or dust, starts a series of chemical
reactions in the body
- antileukotrienes modify or inhibit activity of leukotrienes, decreasing
arachidonic acid-induced inflammation and allergen-induced
bronchoconstriction, as well as mucus production
corticosteroid MOA - ANSWER - prevent inflammation commonly provoked
by substances released from mast cells
- stabilize membranes of cells (leukocytes or WBC) that release harmful
broncho-constricting substances
- increase responsiveness of bronchial smooth muscle to ß-adrenergic
stimulation
mast cell stabilizers (sodium cromoglycate and nedocromil) MOA - ANSWER
- stabilize the cell membranes of mast cells where Ag-Ab reactions take
, place, preventing release of substances such as histamine
bronchodilaters - ANSWER - ß-adrenergic agonists
- anticholinergics
- xanthine derivatives
non-bronchodilating resp drugs - ANSWER - leukotriene receptor
antagonists
- corticosteroids
ß-agonists - ANSWER - AKA sympathomimetic bronchodilators
- used during acute phase of asthmatic attacks
- quickly reduce airway constriction and restore normal airflow
- stimulate ß2-adrenergic receptors throughout the lungs
3 types of ß-agonists - ANSWER 1. nonselective adrenergics:
- stimulate α , ß1 (cardiac), and ß2 (respiratory) receptors
- include epinephrine (adrenaline; epipen)
2. nonselective ß-adrenergics:
- stimulate both ß1 and ß2 receptors
- include isoproterenol
3. selective ß2 drugs:
- stimulate only ß2 receptors
- includes salbutamol (airomir, ventolin)
Complete Solution
Long-term medications to treat asthma - ANSWER - leukotriene receptor
antagonists
- mast cell stabilizers
- inhaled and oral glucocorticoids
- anticholinergic drugs
- inhaled long-acting ß2-agonists (LABAs)
- combo inhaled glucocorticoid and inhaled LABA
- theophylline
- LABAs in combo with inhaled corticosteroids
rapid-relief meds to treat asthma - ANSWER - inhaled short-acting
ß2-agonists
- inhaled ipratropium (rare)
- inhaled corticosteroids and LABAs > specifically budesonide and formoterol
combo (used as relief for patients 12 YO and older if using combo as
maintenance)
asthma management - ANSWER I. step 1: mild intermittent
- short-acting inhaled ß2-agonist PRN and early introduction of low-dose
inhaled glucocorticosteroid (adults and ≥ 6 YO)
,ii. step 2: moderate persistent
- short-acting inhaled ß2-agonist PRN and medium-dose inhaled
corticosteroid
- inhaled corticosteroid and LABA combo inhaler (adults and ≥ 12 YO)
- leukotriene receptor antagonist
iii. step 3: severe uncontrolled
- in addition to above therapies:
> oral prednisone (FEV, less than 60%)
> anti-IgE antagonist (omalizumab) in adults and ≥ 12 YO
Leukotriene Receptor Antagonists MOA - ANSWER - leukotrienes are
released when a trigger, such as cat hair or dust, starts a series of chemical
reactions in the body
- antileukotrienes modify or inhibit activity of leukotrienes, decreasing
arachidonic acid-induced inflammation and allergen-induced
bronchoconstriction, as well as mucus production
corticosteroid MOA - ANSWER - prevent inflammation commonly provoked
by substances released from mast cells
- stabilize membranes of cells (leukocytes or WBC) that release harmful
broncho-constricting substances
- increase responsiveness of bronchial smooth muscle to ß-adrenergic
stimulation
mast cell stabilizers (sodium cromoglycate and nedocromil) MOA - ANSWER
- stabilize the cell membranes of mast cells where Ag-Ab reactions take
, place, preventing release of substances such as histamine
bronchodilaters - ANSWER - ß-adrenergic agonists
- anticholinergics
- xanthine derivatives
non-bronchodilating resp drugs - ANSWER - leukotriene receptor
antagonists
- corticosteroids
ß-agonists - ANSWER - AKA sympathomimetic bronchodilators
- used during acute phase of asthmatic attacks
- quickly reduce airway constriction and restore normal airflow
- stimulate ß2-adrenergic receptors throughout the lungs
3 types of ß-agonists - ANSWER 1. nonselective adrenergics:
- stimulate α , ß1 (cardiac), and ß2 (respiratory) receptors
- include epinephrine (adrenaline; epipen)
2. nonselective ß-adrenergics:
- stimulate both ß1 and ß2 receptors
- include isoproterenol
3. selective ß2 drugs:
- stimulate only ß2 receptors
- includes salbutamol (airomir, ventolin)
