Airway Control

Question 0

Name a short acting beta2 agonist.

Answer 0

Salbutamol

Question 1

List the drugs used in airway control (step 1-5).

Answer 1

• Inhaled short acting beta2 agonist
• Inhaled steroid
• Inhaled long acting beta2 agonist (LABA)
• Increase steroid/ addition of fourth drug
• Addition of oral steroid tablet/ anti-IgE therapy

Question 2

Name a LABA.

Answer 2

Salmeterol.

Question 3

Name some ADRs associated with bronchodilators.

Answer 3

Systemic adrenergic effects such as:

• Tachycardia
• Palpitations
• Tremours

Question 4

What is the main DDI associated with bronchodilators?

Answer 4

Adverse interaction with beta antagonist (propranolol) causing severe asthma refractive to any treatment with beta2 agonists. Beta blockers bind to both beta 1 and 2 receptors.

Question 5

What is the MoA of bronchodilators?

Answer 5

Bronchial smooth muscle relaxation.

Binding to beta2 receptors to increase cAMP and decrease intracellular calcium.

Question 6

Do corticosteroids have better treatment response in patients who have eosinophilic asthma or non-eosinophilic asthma?

Answer 6

Eosinophilic asthma

Question 7

What are the ADRs of inhaled corticosteroids and how can they be reduced?

Answer 7

Oropharyngeal effects such as croaky voice, sore throat and thrush. These can be reduced by using a spacer.

Question 8

What is the MoA of Leukotriene Receptor Antagonists (LRAs)?

Answer 8

Inhibits the release of LTC from mast cell and eosinophils. Thus preventing bronchoconstriction, mucus secretion and mucosal oedema.

Question 9

What is the MoA of anti-cholinergics?

Answer 9

Act as muscarinic receptor antagonists (M3), preventing bronchoconstriction and mucus secretion.

Question 10

When are anti-cholinergics used?

Answer 10

When beta agonists are contra-indicated. E.g. Beta blockers are already prescribed for IHD.

Question 11

Give an example of an anti-cholinergic.

Answer 11

Tiotropium and Ipatropium.