Anti-asthma Drugs

Question 1

Fluticasone is a…and …controller/reliever
Mechanism of cartoon

Answer 1

Inhaled Corticosteroid and a controller (anti-inflammatory)

Decreases expression of cytokines, and COX-2 5-LOX
Increases expression of Beta 2 receptors on airway smooth muscle (aids B agonist)

Question 2

Fluticasone has a director bronchodilator effect

Answer 2

No, only controller

Question 3

Fluticasone is used for nocturnal asthma

Answer 3

Yes

Question 4

Montelukast causes bronchodilation during asthma attack

Answer 4

NO, causes bronchoconstriction so Ned to use with reliever!!

Question 5

Mechanism of action of Montelukast

Answer 5

Competitive antagonist of cysteinyl leukotriene receptor

Question 6

Fluticasone is a more effective anti-inflammatory drug for asthma compared to Montelukast and inhaled Na cromoglycate

Answer 6

Yes

Question 7

Mechanism of action of inhaled Na Cromoglycate (3)

Answer 7

Inhibit lgE induced mast cell degranulation
Promote secretion of annexin A1
Inhibit neutrophils, eosinophils and macrophages

Question 8

Function of B2 Agonists, its types, duration of acting and onset

Answer 8

Act as bronchodilators.
SABA 4-6h: salbutamol (rapid onset)
LABA 12h: Formoterol (rapid onset), Salmeterol
LABA 24h: Indaceterol

Question 9

Mechanism of action of B2 agonists

Answer 9

Bind to b2 receptors on ASM > increase cAMP > increase K+ conductance, decrease intracellular CA2+ and myosin light chain kinase > relax ASM

Question 10

What is the preferred reliever of choice

Answer 10

Formoterol
- Long acting and rapid onset
- Provide long term maintenance of asthma (nocturnal asthma)

Question 11

Mechanism of action of theophyllines

Answer 11

Inhibit phosphodiesterase > prevent breakdown of cAMP > increase cAMP > ASM relaxation
Increase epinephrine
Block adenosine receptor > inhibit ASM constriction

Question 12

B2 agonists are less effective than theophylline and muscarinic antagonists

Answer 12

No they are most effective bronchodilators

Question 13

Theophylline has a narrow therapeutic range

Answer 13

Yes

Question 14

Difference between ipratropium bromide and tiotropium bromide

Answer 14

Ipratropium: short acting 3-5h and non selective
Tiotropium: long acting 24h and M3 selective

Question 15

Mechanism of action of muscarinic antagonists

Answer 15

Binds and blocks M3 receptors on ASM > inhibit bronchoconstriction
Binds and blocks M3 receptors on submucosal gland > decrease bronchospasm and mucous secretion

Question 16

What is tiotropium bromide used for?

Answer 16

A muscarinic antagonist bronchodilator used for chronic obstructive pulmonary disease and severe asthma, once daily (more potent)