7: Pharmacology of Asthma II

Question 1

What are the two classes of asthma treatment?

Answer 1

Relievers (bronchodilators)

Controllers/preventors (anti-inflammatories)

Question 2

What are some relievers (bronchodilators) used to treat asthma?

Answer 2

Short acting ß₂ agonists (SABAs)

Long acting ß₂ agonists (LABAs)

Leukotriene antagonists

Question 3

What are some preventors (anti-inflammatories)?

Answer 3

Inhaled corticosteroid

Cromomoglicate

IgE antibodies

Question 4

ß2 adrenoceptor agonists act as ___ of spasmogens.

Answer 4

antagonists

Question 5

ß2 adrenoceptor agonists inhibit the enzyme ___, which would promote smooth muscle contraction, and stimulate the enzyme ___, which promotes smooth muscle relaxation.

Answer 5

PDE (phosphodiesterase)

PKA (protein kinase A)

Question 6

What is the first line treatment for asthma?

Answer 6

Short acting ß2 agonist (SABA)

Question 7

Give an example of a SABA.

Answer 7

Salbutamol

Question 8

How are SABAs, e.g salbutamol, normally administered?

Answer 8

Inhaled

Question 9

What type of ß2 agonist is useful for controlling nocturnal asthma or asthma that is poorly controlled with other drugs?

Answer 9

Long acting ß2 agonist (LABA)

Question 10

Give an example of a LABA.

Answer 10

Salmeterol

Formoterol

Question 11

Which class of drug should always be used in combination with a LABA?

Answer 11

Inhaled corticosteroid

Question 12

Apart from SABAs and LABAs, which other class of drug acts as a reliever (bronchodilator)?

Answer 12

Leukotriene antagonists (CysLT₁)

Question 13

Name an example of a leukotriene antagonist.

Answer 13

Montelukast (hint is in the name)

Question 14

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?

Answer 14

Montelukast

Question 15

Which class of drug act as both relievers and preventors?

Answer 15

Methylxanthines

Question 16

Give an example of a methylxanthine (drug which acts as both a reliever and a preventor)?

Answer 16

Theophylline

Aminophylline

Question 17

Which enzyme, involved in smooth muscle contraction, are methylxanthines thought to inhibit?

Answer 17

Phosphodiesterase (PDE)

Question 18

Which class of drug are used to reduce inflammation in asthma?

Answer 18

Glucocorticosteroids

Question 19

Give some examples of ICS which would be used to treat moderate asthma.

Answer 19

Hydrocortisone

Beclometasone

Fluticasone

Question 20

Give an example of a corticosteroid which would be used to treat severe asthma.

How is it administered?

Answer 20

Prednisolone

Orally

Question 21

Which immune cells do corticosteroids act on to reduce inflammation?

Answer 21

Mast cells

Eosinophils

T lymphocytes

Question 22

Which structural cells do corticosteroids act on?

Answer 22

Epithelial cells

Smooth muscle cells

Mucous glands

Question 23

How do corticosteroids tend to be administered?

Answer 23

Inhaled

Question 24

What are some common side effects of ICS therapy? Why do they occur?

Answer 24

Oral candidiasis (deposition of steroid in oropharynx)

Hoarseness and weak voice - steroid side-effects