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Respiratory Drugs (Asthma/COPD Drugs (Inhaled Corticosteroids: best when…

- - - - MOA
        
        Short-Acting: short side chains, hydrophilic
        
        short duration and rapid onset
      - Uses: Acute Exacerbations
    - - MOA
        
        Long-Acting: long-side chains, lipophilic
        
        Formoterol: Intermediate, Long duration, Rapid Onset
        
        Salmeterol: Lipophilic, Long duration, Slow onset
      - Uses
        
        Prophylaxis
      - Adverse Effects
        
        Tremor
        
        Arrythmia
  - - - May cause oral thrush
      - System Effects
        
        The smaller the steroid particle size, the higher the potential for systemic effects
      - Oral Deposition
        
        The bigger the particle size, the higher the potential for mouth deposition
    - - Low oral bioavailability
      - High receptor binding affinity
      - Renal insufficiency at high doses
    - - High oral bioavailability
      - High lung deposition (systemic effects)
    - - Only one good for pregnant women
      - Lipid conjugation - gets to the lung and stays in the lung
  - - - Block leukotriene receptors
      - Uses: Especially good for aspirin-induced and exercise-induced asthma
    - - MOA: 5-lipooxygenase pathway inhibitor. Blocks the conversion of arachidonic acid to leukotrienes.
      - Adverse Effects: Hepatotoxic
  - - - Competitively block muscarinic receptors, preventing bronchoconstriction
      - Reduce vagal tone, bronchospasm, and mucus secretion
    - - Mostly COPD
      - Recently approved for Asthma
  - - - Likely causes bronchodilation by inhibiting PDE via adenosine receptors, increasing cAMP due to decrease cAMP hydrolysis
    - - Narrow therapeutic index, usage limited, cardiotoxic and neurotoxic
      - Metabolized by cytochrome P450, many drug interactions
      - Blocks adenosine
  - - - MOA: binds mostly unbound serum IgE and blocks binding to FceRI
      - Uses
        
        Allergic Asthma (with IgE levels resistant to inhaled steroids and long acting beta agonists)