Medications.pdf

MEDICATIONS

The medications used to treat asthma help relieve the symptoms caused by an asthma episode,
and/or treat chronic inflammation in children with asthma. Campers will learn to identify their
medications as Controllers or Relievers. Controller medications are used to prevent frequent
asthma symptoms and decrease airway hyper-responsiveness. Reliever medications are used to
treat the symptoms of an asthma episode. Campers learn that asthma is controlled with daily
medications and monitoring. Symptoms may still occasionally occur and are relieved with the
proper medications.
Asthma Medications & More
Asthma Medications - Bronchodilators
Asthma is a disease characterized by inflammation leading to hyperreactivity. Bronchoconstriction is often the first and most noticeable symptom a patient with asthma feels. Relaxation of the airways and bronchodilation occurs when these medications stimulate beta type 2 (ß2) receptors in the lungs. Brand Name
Pharmacology
Adverse Effects/Other
Quick-Acting Inhaled Bronchodilators
• Relievers
• Tremor, CNS stimulation, tachycardia, by stimulation of ß2 receptors resulting • Opens airways to let oxygen and other • Albuterol and terbutaline can be given • Peak 0.5-2 hours • Duration 3-5 hours Long-Acting Inhaled Bronchodilators
• Controller
by stimulation of ß2 receptors resulting • May become "tolerant" to salmeterol. • Peak 3 hours • Duration up to 12 hours Long-Acting Oral Bronchodilators
• Controllers
by stimulation of ß2 receptors resulting • A water-soluble form of theophylline • Peak 2-3 hours • Duration 6-12 hours Inhaled Anticholinergic Medications
• Anticholinergic side effects: dry mouth, • Relievers
• Reduce bronchoconstriction and
(red) skin. • Side effects can limit use.  2001, Consortium of Children’s Asthma Camps Asthma Medications & More
Asthma Medications - Anti-inflammatory
Inflammation of the airways and release of mediators of inflammation results in prolonged bronchial hyperreactivity. Blocking the release of these mediators and preventing inflammation is a long-term goal in any patient with asthma. Brand Name
Pharmacology
Adverse Effects
Inhaled Corticosteroids
• Controllers
• Hoarseness and possibly thrush. Thrush • Should be given 5 minutes after short acting bronchodilator only if symptomatic. • Mainstay of all asthma therapy (except • Fluticasone (Flovent) comes in three patients with mild intermittent asthma). • Budesonide (Pulmicort) comes as a dry Oral Corticosteroids
• Reliever or controller
• Short-term use: irritability, "hyperactivity", water retention, stomach pain, increased • Given in "bursts" for uncontrolled acute exacerbations or chronically (daily or every growth retardation, central obesity, peptic ulcers, hypertension, risk of infections, and • Take with food to prevent gastritis. Inhaled Anti-inflammatory Medications
• Controllers
• Prevents release of inflammatory mediators • Unlikely to be effective unless used prevent of exercise-induced) • Onset of effect - 2-4 weeks Leukotriene Medications
• Controllers
• Leukotrienes are mediators of inflammation that are thought to be very important in • All have drug interactions with other inflammation. - Zileuton - prevents the production of leukotrienes. • Oral medications. Take Zafirlukast on an EMPTY stomach twice daily. Take Zileuton with or without food four times daily. Take Montelukast with or without food daily in the evening. • Onset of effect - 2-3 weeks.  2001, Consortium of Children’s Asthma Camps Asthma Medications & More
Asthma and Other Medications
New medications aimed at the effects of leukotrienes in asthma have recently been approved by the FDA. These medications are equally effective to inhaled corticosteroids in patients with mild-moderate asthma. These medications decrease bronchconstriction through a mediator called leukotriene. The CNS stimulants are used for ADHD; DDAVP is used for bedwetting. Brand Name Generic Name
Pharmacology
Adverse Effects
CNS Stimulants
- Ritalin SR tablets: 8 hrs - give several hrs before hs • Facial flushing, water intoxication, • Peak effect: 1-5 hrs • Duration of effect: 5-21 hrs  2001, Consortium of Children’s Asthma Camps Asthma Medications & More
Antihistamine and Decongestant Medications
Antihistamines block the effects of histamine that are usually associated with allergies (runny nose, watery eyes, sneezing, etc.). Decongestants are sometimes used for allergy symptoms such as nasal congestion, but do not prevent the symptoms from occurring. Brand Name Generic Name
Pharmacology
Adverse Effects
Standard Antihistamines
Non-sedating (or Less-sedating) Antihistamines
• Claritin may cause rash, dry skin, or • Claritin comes in a redi-tablet that • Zyrtec is a derivative of hydroxyzine. • Allegra is the "son of Seldane". Decongestants
• Dry mouth, increased blood pres sure,  2001, Consortium of Children’s Asthma Camps Asthma Medications & More
Nasal Medications
These medications are used to control nasal symptoms of allergic/non-allergic rhinitis. Only local side effects are seen, in general. Nasally inhaled corticosteroids cannot be used as a substitute for oral steroids in patients who are dependent on them. Brand Name Generic Name
Pharmacology
Adverse Effects
Inhaled Corticosteroids
• Potential Candida, hoarseness, and Inhaled Anti-inflammatory Medication
• Onset of effect – 2 weeks of regular use. • Systemic absorption unlikely. Cough, itching in allergic/non-allergic rhinitis  2001, Consortium of Children’s Asthma Camps Asthma Medications & More
INHALED STEROID COMPARISON CHARTS
Estimated Daily Dosages
ADULT*
Medium Dose
High dose
* adapted from Facts and Comparison. Feb 1999. pp 180e-180f Estimated Daily Dosages
CHILDREN*
Medium Dose
High dose
* adapted from Facts and Comparison. Feb 1999. pp 180e-180f  2001, Consortium of Children’s Asthma Camps

Source: http://www.mys1cloud.com/asthmacamps/toolkit/medical/Medications.pdf