Subclass, Drug Mechanism of Action Effects Clinical Applications Pharmacokinetics, Toxicities •MepolizumabHumanized anti-IL-5 antibody; reduces circulating and tissue eosinophils Reduces frequency of asthma exacerbations Severe asthma inadequately controlled by above agents, with associated eosinophilia Parenteral•duration2–4wk•Toxicity: Injection site reactions (anaphylaxis extremely rare) •DupilumabHumanized antibody against IL-4α receptor for IL-4 and IL-13 Reduces frequency of asthma exacerbations; improves pulmonary function Severe asthma inadequately controlled by ICS/LABA therapy Parenteral injection every 2–4 wk
Reslizumab and benralizumab: Similar to mepolizumab
Albuterol Generic, Proventil, ProAir, Ventolin
Epinephrine Generic, Adrenaline
Metaproterenol Generic, Alupent
Terbutaline Breathaire, Brethine SHORT-ACTING ANTIMUSCARINIC BRONCHODILATOR
Ipratropium Generic, Atrovent Budesonide Pulmicort
Flunisolide AeroBid, Aerospan
Vilanterol/fluticasone Breo Vilanterol/umeclidinium Anoro LEUKOTRIENE INHIBITORS Montelukast Generic, Singulair
Beclomethasone QVAR, Beclovent, Vanceril
PHOSPHODIESTERASE INHIBITORS, METHYLXANTHINES
Dyphylline Dilor, Dylix, Lufyllin
Theophylline Generic, Elixophyllin, Slo-Phyllin, Uniphyl, Theo-Dur, Theo-24
Pathophysiology of Airway Disease
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Papi A et al: Beclomethasone-formoterol as maintenance and reliever treatment in patients with asthma: A double-blind, randomised controlled trial. Lancet Respir Med 2013;1:23.