7: Pharmacology of Asthma II Flashcards
What are the two classes of asthma treatment?
Relievers (bronchodilators)
Controllers/preventors (anti-inflammatories)
What are some relievers (bronchodilators) used to treat asthma?
Short acting ß2 agonists (SABAs)
Long acting ß2 agonists (LABAs)
Leukotriene antagonists
What are some preventors (anti-inflammatories)?
Inhaled corticosteroid
Cromomoglicate
IgE antibodies
ß2 adrenoceptor agonists act as ___ of spasmogens.
antagonists
ß2 adrenoceptor agonists inhibit the enzyme ___, which would promote smooth muscle contraction, and stimulate the enzyme ___, which promotes smooth muscle relaxation.
PDE (phosphodiesterase)
PKA (protein kinase A)
What is the first line treatment for asthma?
Short acting ß2 agonist (SABA)
Give an example of a SABA.
Salbutamol
How are SABAs, e.g salbutamol, normally administered?
Inhaled
What type of ß2 agonist is useful for controlling nocturnal asthma or asthma that is poorly controlled with other drugs?
Long acting ß2 agonist (LABA)
Give an example of a LABA.
Salmeterol
Formoterol
Which class of drug should always be used in combination with a LABA?
Inhaled corticosteroid
Apart from SABAs and LABAs, which other class of drug acts as a reliever (bronchodilator)?
Leukotriene antagonists (CysLT1)
Name an example of a leukotriene antagonist.
Montelukast (hint is in the name)
Say you had a patient who was reacting poorly even with a combination of a SABA/LABA/ICS - what CysLT1 receptor antagonist could you give them?
Montelukast
Which class of drug act as both relievers and preventors?
Methylxanthines
Give an example of a methylxanthine (drug which acts as both a reliever and a preventor)?
Theophylline
Aminophylline
Which enzyme, involved in smooth muscle contraction, are methylxanthines thought to inhibit?
Phosphodiesterase (PDE)
Which class of drug are used to reduce inflammation in asthma?
Glucocorticosteroids
Give some examples of ICS which would be used to treat moderate asthma.
Hydrocortisone
Beclometasone
Fluticasone
Give an example of a corticosteroid which would be used to treat severe asthma.
How is it administered?
Prednisolone
Orally
Which immune cells do corticosteroids act on to reduce inflammation?
Mast cells
Eosinophils
T lymphocytes
Which structural cells do corticosteroids act on?
Epithelial cells
Smooth muscle cells
Mucous glands
How do corticosteroids tend to be administered?
Inhaled
What are some common side effects of ICS therapy? Why do they occur?
Oral candidiasis (deposition of steroid in oropharynx)
Hoarseness and weak voice - steroid side-effects
