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Drug used in asthma and COPD - Coggle Diagram
Drug used in asthma and COPD
Relievers (bronchodilators)
beta2-adrnoceptor agonist
MOA: increase cAMP level --> relax airway smooth muscle
Side effect: tachycardia
short acting drug --> Albuterol, Terbutaline
long acting drug --> Salmeterol, Formoterol
ultra-long acting drug --> Indacaterol, Olodaterol
theophylline
MOA: inhibition of phosphodiesterase --> anti-inflammatory
Side effect: seizure, arrhythmia *low therapeutic index
Drugs: Theophylline, Aminophylline,
Roflumilast
(selective PDE4 inhibitor, COPD only)
muscarinic antagonist
MOA: M3 blocade --> bronchodilation, decrease secretion
Side effect: dry mouth, tachycardia
Drugs: Ipra
tropium
, Tilo
tropium
Supporters
mucolytics
N-acetylcystine (NAC)
MOA: destroy disulfide bond --> 化痰
Indication: +acetaminophen overdose, 顯影劑
antitussives
Codeine
Indication: analgestic, antitussive
Side effect: addiction, respiratory depression, constiption (便祕)
Dexthromethophan
Indication: antitussive (do not affect ciliary activity)
no addiction, no analgestic effect (與morphine併用可增強其止痛作用)
Controllers
corticosteriod
MOA: 促使生成lipocortin-1(可抑制phospholipase A2) --> antiinflammatory
Indication: 任何發炎疾病
Side effect: osteoporosis, increase infection risk, GI symptoms
Drugs: Fluticasone, hydrocortisone, Beclomethasone,
Cicletasonide
(prodrug)
leukotriene inhibitor
MOA: inhibit LT1 --> increase cAMP level --> antiinflammatory
Side effect: inhibit metabolism of theophylline (Zileuton)
Drugs: Zileuton, Zafirlukast, Montelukast
cromolyns
MOA: inhibit mast cell degranulation, inhibit cell activation --> antiinflammatory
Side effect: throat irritation, coughing
Drugs: Cromolyn sodium, Nedocromil (all inhaled only)
Antibodies
anti-IgE monoclonal antibody
MOA: an antibody targeting IgE molecules
Drug: Omalizumab
anti-IL-5 monoclonal antibody
MOA: an antibody targeting IL-5 molecules or their receptors
Drugs: Mepolizumab, Resizumab (anti-IL-5) ,Benralizumab (anti-IL-5R)
Contraindiction禁忌用藥
beta blocker
ACEI
NSAID