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Questions and Answers
What type of immune cell is responsible for releasing histamine and other inflammatory chemicals in an allergic reaction?
What type of immune cell is responsible for releasing histamine and other inflammatory chemicals in an allergic reaction?
What is the primary function of cromolyn sodium in treating asthma?
What is the primary function of cromolyn sodium in treating asthma?
Which of the following is a characteristic of a severe systemic allergic reaction?
Which of the following is a characteristic of a severe systemic allergic reaction?
What is the mechanism by which cromolyn sodium prevents mast cell degranulation?
What is the mechanism by which cromolyn sodium prevents mast cell degranulation?
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Which of the following drugs is an antileukotriene that inhibits leukotriene synthesis?
Which of the following drugs is an antileukotriene that inhibits leukotriene synthesis?
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What type of drug is omalizumab?
What type of drug is omalizumab?
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How does omalizumab reduce allergic reaction severity?
How does omalizumab reduce allergic reaction severity?
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What is the primary indication for using cromolyn sodium?
What is the primary indication for using cromolyn sodium?
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Which of the following is NOT a mechanism of action of anti-asthma drugs?
Which of the following is NOT a mechanism of action of anti-asthma drugs?
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What is the role of IgE in allergic reactions?
What is the role of IgE in allergic reactions?
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Study Notes
Bronchodilator Medications
- MDI Formulation: Epinephrine (Epi) delivers 0.22 mg/puff with a duration of action of 1-3 hours.
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Racemic Epinephrine: Contains S-2 and is available in SVN 2.25% solution (0.25-0.5 ml, 5-11 mg, given qid).
- Onset: 3-5 minutes, Peak effect: 5-20 minutes, Duration: 0.5-2 hours.
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Metaproterenol (Alupent): A β2 agonist available as SVN (0.4-0.6% solution, tid/qid), tablets (10-20 mg, tid/qid), and syrup (10 mg/5 ml).
- Onset: 1-5 minutes, Peak: 60 minutes, Duration: 2-6 hours.
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Albuterol (Proventil, Ventolin HFA): Another β2 agonist; SVN 0.5% solution (1.25 or 2.5 mg tid/qid), MDI (90 mcg/puff, 2 puffs tid/qid), tablets (2, 4, 8 mg bid, tid, qid).
- Onset: 15 minutes, Peak: 30-60 minutes, Duration: 5-8 hours.
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Pirbuterol (Maxair): MDI formulation (200 mcg/puff, 2 puffs q4h).
- Onset: 5 minutes, Peak: 30 minutes.
Inhaled Anticholinergic Bronchodilators
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Ipratropium Bromide: Affects M1, M2, and M3 receptors.
- Dosage: HFA MDI (17 mcg/puff, 2 puffs qid), SVN (0.02% solution, 500 mcg tid/qid), nasal spray (21-42 mcg, 2-4 times daily).
- Onset: 15 minutes, Peak: 1-2 hours, Duration: 4-6 hours.
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Ipratropium and Albuterol Combination: Contains 18 mcg/puff of ipratropium and 90 mcg/puff of albuterol.
- Onset: 15 minutes, Peak: 1-2 hours, Duration: 4-6 hours.
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Tiotropium Bromide: Highly selective for M3.
- Dosage: SVN (Ipratropium 0.5 mg and albuterol 2.5 mg), DPI (18 mcg/inhalation, 1 inhalation daily).
- Onset: 30 minutes, Peak: 1-3 hours, Duration: 24 hours.
Mechanism of Action
- Anticholinergic bronchodilators block acetylcholine at muscarinic receptors in bronchial smooth muscles, reducing mucus production.
Mucolytics and Mucokinetics
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Mucolytic Agents: Disrupt chemical bonds in mucoproteins, liquefying mucus for easier removal.
- Examples: N-Acetylcysteine (NAC), Dornase Alpha (Pulmozyme), Hyperosmolar saline.
- Expectorants: Increase secretions and decrease mucus viscosity, facilitating easier sputum removal.
Adverse Effects of Mucolytics
- Notable side effects include nausea, vomiting, hypersensitivity, rash, fever, and bronchospasm risk in asthmatics.
Corticosteroids (Anti-inflammatories)
- Used to treat inflammation, allergies, asthma, and arthritis.
- Can be endogenous (produced by the body) or exogenous (prescribed when body levels are low).
Adverse Effects of Corticosteroids
- General effects from systemic corticosteroids include immunosuppression, fluid retention, and increased blood sugar.
- Specific effects of aerosolized steroids include dysphonia, cough, and risk of local infections.
Non-Steroidal Anti-inflammatory Anti-asthma Drugs
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Types:
- Cromolyn-like agents (Mast Cell Stabilizers; e.g., Cromolyn Sodium).
- Antileukotrienes (e.g., Montelukast).
- Monoclonal antibody (e.g., Omalizumab).
- Mechanism: Cromolyn Sodium inhibits mast cell degranulation and histamine release. Antileukotrienes block leukotriene receptor activity.
Indications of Cromolyn Sodium
- Serves as a prophylactic treatment for asthma, preventing attacks in individuals with bronchial asthma.
Allergy Mechanism
- Allergic reactions involve B cells producing IgE antibodies upon initial allergen exposure, which attach to mast cells. During re-exposure, these mast cells release histamine, causing local inflammation and respiratory issues.
- Severe systemic reactions are termed anaphylaxis, which can be life-threatening.
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Description
This quiz covers various medications used to treat asthma, including their dosage, duration, and onset of action. It includes MDI, Racemic Epi, Micronefrin, and Metoproterenol.
