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Ipratropium Bromide and Albuterol Sulfate
What is albuterol Sulfate MOA?
Albuterol stimulates Adenyl cyclase, which increases c-AMPfrom ATP. Increase in c-AMP is associated with relaxation of smooth muscle causing a relaxation of the smooth muscle via stimulation of Beta 2 receptors.
What is ipratropium Bromide MOA?
It has anti-secretory properties from the serous and seromucous glands lining the nasal mucosa.
What drug interactions does Combivent have?
Sympathomimetics, tricyclic antidepressants, MAOI, and hypokalemia may worsen with nonpotassium sparing diuretics
Precautions with combivent?
1. Allergy to soy or peanuts.
2. Not for acute attacks.
3. Use with caution with people with narrow angle glacoma, prostatic hypertrophy, hypertension, or diabetes.
What is the pregnancy category for combivent?
What is the major adverse effect of Combivent?
Headache and Bronchitis
What is Combivent normally used for?
What is the normal dose of COmbivent?
2 inhilation 4x a day, max of 12
Fluticasone Propionate
What is the MOA of Flovent
Adrenocorticoids bind to for a steroid complex. It inhibints mRNA and carrys out an antiinflammatory or antihistamine action.
Drug interactions with Flovent.
Do not give other steroids increase the affects and precautions
Precautions for Flovent?
1. Watch when patients are being transfered for systemic to aerosolized steroids. (adrenal insufficienty)
2. Not for rapid relief of brochodilation.
3. Yeast infections can occur in the oral cavity.
What is one of the main things you need to inform the patient to do?
Rinse their mouth out after use.
Flucticasone Propionate and Salmeterol Xinafoate
What is the normal dose of Advair?
2 puffs 12 hours apart
What is the age cut off for a patient with Advair?
>12 years
What is the MOA of Advair?
Fluticasone Propionate binds to certain receptor on the cytoplasm to form a steroid complex. It then inhibits or activates mRNA . This leads to it anti-inflammatory or antihistamine affects.
Salmeterol stimulates adenyl cyclase which increases the formation of cAMP. cAMP increases the relaxation of bronchial smooth muscle through beta 2 receptors.
Major drug interactions of Advair?
1. Beta blockers
2. other steroids
3. Tricyclic antidepressants
What are the precautions for Advair?
1. Watch for adrenal insufficiency if one is transfering from aerosolized steroids.
2. Not for rapid relief.
3. watch for fungal infections.
4. Watch patients with hypertension, hyperthyroid, diabetes mellitus, and nursing mothers or pregency.
What is the pregency category for Advair?
What are some adverse effects?
1. Angioedema
2. Rash
3. Bronchitis
4. cough
5. Headache
Inhalation Solution
Levabuterol Hydrochloride
Normal dose of Xopenex?
Normal Adult dose is 0.63 TID. If they do not respond to this dose increase to 1.25 TID. Children < 12 can receive 0.31mg tid if they do not resond increase to 0.63 tid. Do not exceed this dose.
What class is Xopenex?
What is Xopenex MOA?
Levabuterol is a sympathomimetic which stimulates adenyl cyclase which increases c-AMP. This excess for cause relaxation of smooth muscle by beta 2 adrenergic receptors. But levaabuterol has a two fold binding affinity to beta-adrenergic receptors than a racemic albuterol.
Drug interactions with levabuterol?
2. Sympathomimetics
3. Antidepressants
4. May increase Digoxin levels
Contraindications for Xopenex?
1. CV disorders
2. hypertension
3. hyperthyroid
4. diabetes mellitus
5. pregnancy
Advers effects for Xopenex?
1. Nervousness
2. Tremors
3. anxiety
4. tachycardia
5. Dizziness
Patient information on Xopenex?
1. once open use within two weeks
2. Replace unused vials back in foil for storage
3. Discard if colorchange
4. protect from light
Pregnency Class of Xopenex?
Albuterol Sulafate (salbutamol)
What class is Proventil?
Dose for Albuterol sulfate?
2.5 mg QID (diluted))
0.083% solution does not need diluted
What are two ways of taking Proventil?
1. Maintenance - 2 inhalatons qid
2. Excercise induced - 2 inhalation 15 minutes before excerise
What is the MOA of Abuterol Sulfate?
increases the formation of c-AMP. This leads to relaxation smooth muscle via the beta 2 adrenergic receptors.
Drug interactions of Albuterol Sulfate?
1. Sympathomimetics
2. Tricyclics Antidepressants
4. May increase Digoxin levels
Precautions for Proventil?
Use caution in patients with hypertension, CV disorders, hypertyroidism, diabetes, or pregnency
What is the pregency category of Proventil?
What are some of the adverse effects of Proventil?
Neausea, vomiting, nervousness, HA, Insomina Tachycardia
Pirbuterol Acetate
What class is Maxair?
Antiasthmatic/ Bronchdilator
How do you use Maxair?
1 to 2 inhalations every 4 to 6 hours: max is 12
What is Pirbuterol acetate MOA?
Stimulates adenyl cyclases the formation of c-AMP, this causes the relaxation of smmoth muscle through the stimualtion of beta 2 adrenergic receptors
How long does it take for effcts to work?
30-60 minutes
What drug interactions does Pirbuterol acetate have?
1. Sympathomimetics
2. tricyclic antidepressants
Precautions with Maxair?
1. hypertension
2. CV disorders
3. diabetes
4. pregnency
What is the pregnency category?
Salmetrol Xinafoate
What is the dosage of Serevent?
1. 1 inhalation twice daily approximately 12 hours apart
2. 30 to 60 minutes prior to excercise
What is MOA of Salmeterol Xinafoate?
It is a sympathomimetic which stimulates adenyl cyclaeand make c-AMP , this causes a relaxation of smooth muscle through stimulation of the beta 2 adrenergic receptors
Drug intractions with Serevent?
1. Sympathomimetics
2. Tricyclic antidepressants
4. Beta blocker can decrease the effectiveness
Precautions of serevent?
1. watch for increase use of short acting beta blockers, means worseing asthma
2. do not use in place of longer acting steroids
3. use with caution in diabetes, pregnency, hypertension or hyperthyroid
what is the pregency catageory of serevent?
Adversa effct of serevent?
1. Upper respiratory tract infections
2. simus headache
3. Lower respiratory tract infection
4. tremors
5. GI upset

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