1011

Question 1

Front (Question)

Answer 1

Back (Answer)

Question 2

What are the main phenotypes of asthma?

Answer 2

Allergic asthma (childhood onset, triggered by allergens), Non-allergic asthma, Adult-onset asthma (late-onset, often in women), Asthma with obesity.

Question 3

What are the two subtypes of asthma inflammation?

Answer 3

Type-2 high (driven by Th2 and ILC2 cells, producing IL-4, IL-5, IL-13) and Type-2 low.

Question 4

What are Short-acting Beta Agonists (SABA)?

Answer 4

Examples: Albuterol (Salbutamol), Pirbuterol, Terbutaline. Bronchodilation lasts 3–4 hours. Onset: 5–10 minutes.

Question 5

What are Long-acting Beta Agonists (LABA)?

Answer 5

Examples: Formoterol (onset: 5 mins), Salmeterol (onset: ~20 mins). Duration: 12 hours. Must combine with ICS.

Question 6

What is the MOA of Beta-2 agonists?

Answer 6

Increase cAMP → inhibit calcium release → relax airway smooth muscle. Inhibit mast cell mediator release and reduce microvascular leakage.

Question 7

What is a common side effect of Beta-2 agonists?

Answer 7

Skeletal muscle tremor, Hypokalemia, Palpitations.

Question 8

What is the MOA of antimuscarinic drugs in asthma?

Answer 8

Block M3 receptors → inhibit smooth muscle contraction and mucus secretion. Less effective than Beta-agonists.

Question 9

What are examples of Antimuscarinic drugs?

Answer 9

SAMA: Ipratropium (onset: 15 mins, duration: 4–8 hours). LAMA: Tiotropium, Umeclidinium (duration: 24 hours).

Question 10

What is Theophylline, and how does it work?

Answer 10

A methylxanthine: Inhibits phosphodiesterase (↑cAMP → relax smooth muscle) and antagonizes adenosine receptors.

Question 11

What are side effects of Theophylline at high plasma levels?

Answer 11

> 40 mg/L: Seizures, Arrhythmias, Vomiting, Abdominal pain. Narrow therapeutic index (10–20 mg/L).

Question 12

What is the MOA of corticosteroids in asthma?

Answer 12

Binds glucocorticoid receptors → downregulates inflammatory mediators (e.g., IL-4, IL-5) and upregulates anti-inflammatory mediators.

Question 13

What are examples of Inhaled Corticosteroids (ICS)?

Answer 13

Fluticasone, Budesonide, Beclomethasone, Mometasone.

Question 14

What are side effects of inhaled corticosteroids?

Answer 14

Oropharyngeal candidiasis, Hoarseness. Long-term use: increased systemic effects.

Question 15

What are Cromolyn and Nedocromil, and what is their use?

Answer 15

Mast cell stabilizers. Used for exercise-induced bronchoconstriction and chronic asthma.

Question 16

What is the MOA of Leukotriene Receptor Antagonists (LTRAs)?

Answer 16

Block CysLT1 receptors to prevent bronchoconstriction, mucus secretion, and inflammation.

Question 17

Name two LTRAs and their uses.

Answer 17

Montelukast, Zafirlukast: Used for chronic asthma control and prevention of exercise- or aspirin-induced bronchoconstriction.

Question 18

What is Zileuton, and how does it work?

Answer 18

A lipoxygenase inhibitor: Prevents leukotriene synthesis.

Question 19

What is Omalizumab, and how does it work?

Answer 19

Anti-IgE monoclonal antibody: Binds free IgE, reducing its binding to mast cells and subsequent mediator release.

Question 20

What are Anti-IL-5 monoclonal antibodies?

Answer 20

Mepolizumab, Reslizumab: Block IL-5 to reduce eosinophil activation and inflammation.

Question 21

What is Roflumilast, and what is its use?

Answer 21

A PDE-4 inhibitor: Reduces inflammation in COPD.

Question 22

What are mucolytics used for?

Answer 22

Reduce mucus viscosity. Examples: N-acetylcysteine, Dornase alfa.

Question 23

What are expectorants, and give an example.

Answer 23

Promote mucus expulsion by increasing volume and reducing adhesivity. Example: Guaifenesin.

Question 24

What are the types of rhinitis?

Answer 24

Allergic, Infectious, and Non-allergic (e.g., drug-induced, hormone-induced).

Question 25

What are intranasal corticosteroids (INCS) used for?

Answer 25

Controlling rhinitis symptoms. Examples: Fluticasone, Budesonide.

Question 26

What are decongestants, and how do they work?

Answer 26

Alpha-sympathomimetics: Vasoconstrict nasal blood vessels, relieving congestion. Examples: Pseudoephedrine, Oxymetazoline.

Question 27

What are antitussives, and give examples.

Answer 27

Suppress cough reflex. Central: Dextromethorphan, Benzonatate (local anesthetic).