Steroids
Uses: Most effective agent for ___ term treatment and ___ of asthma exacerbation
long term; prevention
Hyperglycemia, N/V/HA, Insomnia, growth suppression
What are oral steroid SE?
Monitor ___ in children- avoid prolonged use!
growth
Uses:
Prevention and long term control of ___ symptoms
____ form is used for seasonal allergies (NasalCrom)
May be given orally, ___, ____, or ___ ___
Prevention and long term control of asthma symptoms
Intranasal form is used for seasonal allergies (NasalCrom)
May be given orally, nebulized, nasal spray, or eye drops
Methyxanthines
MOA:
inhibits production of cytokines, leukotrienes, and prostaglandins
Many ____ ____ with systemic steroids!
drug interactions
Assess ___ ___ before treatment and then periodically after.
peak flow
MOA:
poorly understood, seems to inhibity the release of inflammatory mediators by stabilizing the mast cell membrane
Which drug do you use caution with impaired liver function?
Leukotrienes ( L for no Liver)!!
____- mainstay of therapy- NOT FOR RESCUE!
Inhaled
Ex: fluticasone
Long term systemic use can cause:
Weight gain, swelling of the face (moon face), and buffalo hump (fat behind neck)
Caution use with elderly AND with ___.
Also caution pts about exposure to ___.
diabetics- will elevate blood sugars
exposure to illness (steroids lower immune response)
Not used as a rescue, takes __ to __ weeks to show benefit
Which drug should be administered with a full glass of water and why?
Guaifenesin (expectorants) to loosen mucus. Also watch hydration status if vomiting and diarrhea
____ - should be used for the SHORTEST period of time and at the lowest dose possible
Systemic
More long term systemic use effects:
Hyperglycemia, insomnia, gastric ulcers, stunted growth in children, impaired wound healing, HTN, personality changes, decreased immune response, cataracts, hyperlipidemia, osteoporosis
Give oral doses ___ meals/food to minimize gastric distress.
Give steroids with food
Low incidence of side effects, but some SE are
postnasal drip , cough/ HA, bronchospasm, pharyngeal and tracheal irritation, wheezing, bad taste in the mouth
What are some side effects of the medication that is used to cystic fibrosis?
sore throat, hoarseness, voice changes, and cough (Dornase Alpha)
Mouth irritation, oral candidiasis, coarse and hoarseness
What are inhaled steroid side effects?
Patients should NOT ______. This can cause adrenal insufficiency which can be fatal.
SHOULD NOT STOP SYSTEMIC STEROIDS ABRUPTLY!!!
Spacers should be used and washed ___.
everyday and instruct pt to rinse mouth each time after inhaler use to prevent thrush
___ ___ is a serious SE of cromolyn. This drug ___ ___ ___ stopped ___
REBOUND BRONCHOSPASM is a serious SE of cromolyn and should not be stopped abruptly.
If more than one puff is prescribed for this med, wait __ minutes between puffs.
wait 2 minutes between puffs for bronchodilators (B2 adrenergic agonists) such as albuterol