0917 - Respiratory Drugs - RM

Question 1

What is the clinical definition of asthma?

Answer 1

A chronic inflammatory disorder of the airways involving both widespread inflammation and variable airflow obstruction that IS reversible, either spontaneously or with treatment. Symptoms include wheezing, breathlessness, chest tightness, and coughing.

Question 2

What is the clinical definition of COPD?

Answer 2

A disorder characterised by airway inflammation and airflow limitation that is NOT fully reversible. Can be caused by any of a combination of Emphysema, Chronic Bronchitis, and asthma.

Question 3

What are the common pharmacological targets in the treatment of asthma and COPD (4)?

Answer 3

Beta2 receptors - smooth muscle relaxation (expressed in airways) - targeted by beta 2 agonists.
Muscarinic ACh receptors - Targeted by antagonists, thereby lessen bronchoconstriction and mucous production.
Leukotrienes - Leukotriene antagonists, minimise the inflammation aspect.
Steroid receptors - Inhaled corticosteroids as preventative therapy in asthma.

Question 4

What are the common drugs used to treat asthma and COPD?

Answer 4

Beta 2 agonists - Salbutamol (short acting), salmeterol (long acting)
Muscarinic Antagonists - Ipratroprium bromide (short-acting) and tiotropium (long-acting)
Leukotriene Antagonists - Montelukast sodium - can be chewed, so good for kids
Inhaled corticosteroids - Fluticasone Propionate (preventative)

Question 5

Why is it important to not treat an asthma attack solely with a beta-agonist?

Answer 5

2 components - airway obstruction and inflammation. Need to treat both, rather than just the airway obstruction.