.png){kind=logo}
Methylxanthines
Who is at risk for toxicity and why?
Older patients are at much higher risk for toxicity when taking methylxanthines.
Systemic anticholinergics are included in Beers Criteria for Potentially Inappropriate Use inÂ
Older Adults; they should not be substituted for inhaled anticholinergics
These drugs are contraindicated for patients with untreated seizure disorders or peptic ulcerÂ
disease.
Use with caution in patients with heart disease (can exacerbate dysrhythmias), liver dysfunctionÂ
(increased risk for toxicity), peptic ulcer disease (can exacerbate condition), or seizure disordersÂ
(can exacerbate seizures).
Asthma & COPD
Step 1 therapy
Complete this sentence: Manage with a ______ as needed.
SABA
symptoms associated with mild persistent asthma
Symptoms: More than 2 d/wk but less than daily
nighttime awakenings:
3–4 times/month
SABA use= more than 2 days/week but less than daily AND no more than 1 time on any day.
Effect on activity= minimal activity limitation.
Risk for exacerbations requiring systemic glucocorticoids= 2 or more times/6 months ORÂ
wheezing lasting more than 1 day 4 or more times/year (2 or more times/year for 5 y.o. & up).
symptoms associated with moderate persistent asthma
Symptoms: Daily
nighttime awakenings:Â
3-4 times/month More than once/week but less than nightly
SABA use= daily.
Effect on activity= some activity limitation.
Risk for exacerbations requiring systemic glucocorticoids= increased frequency & intensity of
exacerbations or wheezing.
symptoms associated with severe persistent asthma
symptoms: several times daily
nighttime awakenings: often nightly
SABA use= several times a day
Effect on activity= severe activity limitation.
Risk for exacerbations requiring systemic glucocorticoids= even greater increased frequency &Â
intensity
of exacerbations or wheezing.
symptoms associated with intermittent asthma
symptoms: 2d/wk or lessÂ
nighttime awakenings: 2 times/month or less
effect on activity: none
SABA use= 2 days/week or less.
Risk for exacerbations requiring systemic glucocorticoids= 0-1 time/year.
What are some examples of a SABA?
albuterol, levalbuterol
benefits of SABA
Rescue inhaler, all asthma patients should have a SABA, they are for prophylaxis of exerciseinduced bronchospasms and to relieve ongoing asthma attacks and COPD exacerbations
.png)