Pulmonology Medications Part 4 PDF

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BoundlessObsidian4130

Uploaded by BoundlessObsidian4130

Debra Forzese, Pharm. D.

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pulmonary medications asthma treatment pharmacology medicine

Summary

This document provides information on various medications used in pulmonology, specifically focusing on treatments for asthma. It covers different classes of drugs, including monoclonal antibodies, antitussives, and mucolytics. The document also details mechanisms of action, adverse effects, precautions, and dosing guidelines for each class of medication.

Full Transcript

PULMONOLOGY MEDICATIONS PART 4 MONOCLONAL ANTIBODIES FOR TREATMENT OF ASTHMA MONOCLONAL ANTIBODIES - AGENTS Omalizumab (Xolair) Mepolizumab (Nucala) Reslizumab (Cinqair) Benralizumab (Fasenra) Dupilumab (Dupixent) Tezepelumab (Tezspire) MONOCLONAL ANTIBODIES Target the following substances to...

PULMONOLOGY MEDICATIONS PART 4 MONOCLONAL ANTIBODIES FOR TREATMENT OF ASTHMA MONOCLONAL ANTIBODIES - AGENTS Omalizumab (Xolair) Mepolizumab (Nucala) Reslizumab (Cinqair) Benralizumab (Fasenra) Dupilumab (Dupixent) Tezepelumab (Tezspire) MONOCLONAL ANTIBODIES Target the following substances to treat asthma • Immunoglobulin E (IgE) - antibody produced during an allergic reaction (higher levels with allergic asthma) • Cytokines -signal molecules that boost the immune response § Type 2 cytokines associated with asthma are interleukins (IL) § Asthma interleukins include IL-4, IL-5, and IL-13 § Interleukins play a major role in producing inflammation leading to asthma symptoms in 50% of asthmatics • Eosinophils (WBC) involved in the production of mucus and fluid that can trigger bronchospasms MONOCLONAL ANTIBODIES • Reduce exacerbation rates, less ER visits • Improve lung function (improved FEV) • Greater asthma control and better quality of life • Less need for inhaled and oral corticosteroids • Used in most severe cases of asthma, without control despite using high doses of ICSs MONOCLONAL ANTIBODIES ž Add on therapy, not replacement ž Useful in patients with severe asthma refractory to combination therapy that includes high dose ICS § Potential for reduction in ICS dose in some ž Have elevated allergic inflammatory biomarkers (serum IgE, blood eosinophil count) MONOCLONAL ANTIBODIES Most common adverse effects • Injection site pain • Fatigue • Headache • Sore throat • Muscle aches ( • Back pain ( MONOCLONAL ANTIBODIES Caution ž Can cause an allergic reaction including anaphylaxis ž Avoid use in patients with severe infection—especially a parasitic infection, because the body typically fights parasites with IgE and eosinophils MONOCLONAL ANTIBODIES These agents target IL-5 and the overproduction of eosinophils • adults and children 12 and older • adults 18 and over with severe asthma • - adults and children 12 and older Targets IL-4 •Dupilumab Targets • OMALIZUMAB • • • • OMALIZUMAB ž o o OMALIZUMAB Dosing ž Initiate in a healthcare setting due to risk of anaphylaxis ž Adult – dose based on body weight and IgE level ž Pediatric -dose based on weight and IgE level ž Renal impairment – no dose adjustment ž Hepatic impairment – no dose adjustment ž Administered subQ every 2 to 4 weeks OMALIZUMAB • § § OMALIZUMAB Adverse Effects • Major side effect is anaphylaxis, uncommon (<0.1%) • Injection site reaction • Urticaria • Headache OMALIZUMAB ž ž ž OMALIZUMAB ž ž ž OMALIZUMAB ž ž OMALIZUMAB • • • ANTITUSSIVES ANTITUSSIVES • § § • § ANTITUSSIVES ž ž ž ž ž ANTITUSSIVES Dextromethorphan (Delsym) Benzonatate (Tessalon Perles) Opiates - Codeine Gabapentin (Neurontin), Pregabalin (Lyrica) DEXTROMETHORPHAN ž ž ž DEXTROMETHORPHAN • § § • § § DEXTROMETHORPHAN ž ž § § DEXTROMETHORPHAN ž ž ž § § BENZONATATE ž ž ž BENZONATATE • • • BENZONATATE ž ž ž ž OPIATES - CODEINE ž § § § OPIATES - CODEINE ž • • GABAPENTIN • § GABAPENTIN ž § GABAPENTIN ž ž ž ž GABAPENTIN ž ž ž ž ž GABAPENTIN ž § MUCOLYTICS MUCOLYTICS ž ž ž ž N-ACETYLCYSTEINE • • •

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