- Drug therapy
- Three types of anti-inflammatory drugs
- Corticosteroids (e.g., beclomethasone, budesonide)
- Suppress inflammatory response
- Reduce bronchial hyper-responsiveness
- Decrease mucous production
- Inhaled form is used in long-term control
- Systemic form to control exacerbations and manage persistent asthma
- Oropharyngeal candidiasis, hoarseness, and a dry cough are local side effects of inhaled drug
- Can be reduced using a spacer or by gargling after each use
- Leukotriene modifiers or inhibitors (e.g., zafirlukast, montelukast, zileuton)
- Block action of leukotrienes—potent bronchoconstrictors
- Have both bronchodilator and antiinflammatory effects
- Not indicated for acute attacks
- Used for prophylactic and maintenance therapy
- Monoclonal antibody to IgE
- Anti-IgE (e.g., Xolair)
- Decrease in circulating IgE levels
- Prevents IgE from attaching to mast cells, preventing release of chemical mediators
- Subcutaneous administration every 2 to 4 weeks
- β-Adrenergic agonists (SABAs)
- Examples: albuterol, pirbuterol
- Effective for relieving acute bronchospasm
- Onset of action in minutes and duration of 4 to 8 hours
- Prevent release of inflammatory mediators from mast cells
- Not for long-term use
- Methylxanthines (e.g., theophylline)
- Less effective long-term bronchodilator
- Alleviates early phase of attacks but has little effect on bronchial hyper-responsiveness
- Narrow margin of safety
- Anticholinergic drugs
- Block action of acetylcholine
- Promote bronchodilation
- Short-acting drugs used for severe acute asthma exacerbation
- Anti-IgE (e.g., Xolair)
- Corticosteroids (e.g., beclomethasone, budesonide)
- Patient teaching related to drug therapy
- Correct administration of drugs is a major factor in success
- Inhalation of drugs is preferable to avoid systemic side effects
- MDIs, DPIs, and nebulizers are devices used to inhale medications
- Using an MDI with a spacer is easier and improves inhalation of the drug
- DPI (dry powder inhaler) requires less manual dexterity and coordination
- DPIs are simpler to use than MDIs.
- The DPI contains dry, powdered medication and is breath-activated. No propellant is used.
- Instead an aerosol is created when the patient inhales through a reservoir containing a dose of powder.
- Correct administration of drugs is a major factor in success
- Three types of anti-inflammatory drugs
Healthy Eating and the Holidays
KEY POINTS ‘Tis the season for family, festivity, and food—lots of food. How do you manage diabetes during the holidays when food temptations are just
