- 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
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