asmthma

Question 1

immediate relief

Answer 1

B2 agonist
muscarinic ant
methylxanthines

Question 2

long term

Answer 2

corticosteroid
long acting B2 agonist
leukotriene antagonists
newer anti IgE Ab’s

Question 3

Selective B2 adrenoreceptor agonists

Answer 3

• Muscle tremor or arrhythmias
• Drug tolerance
• Given by inhaler or nebulizer
o Albuterol (rapid onset and short acting)
o Salmeterol (slow onset and long acting)
o Indacterol (long acting for COPD)
o Fluticasone/salmeterol=Advair diskus is an inhaler with a glucocorticoid

Question 4

theophylline

Answer 4

• Useful methylxanthine in tx asmthma
• Oral
• Met by CYP450

Question 5

muscarinic rec antagonists

Answer 5

• Ipratropium/tiotropium (more useful for COPD)
o Longer acting
o Aerosol

Question 6

mast cell stabilizer

Answer 6

•	Cromolyn
o	Not used in US
o	Hard to get into blood (used as eye drops)
o	Dec release of inflammatory
o	Can develop allergies to this drug

Question 7

corticosteroids

Answer 7

• Chronic use leads to adrenal suppression
• Changes in oropharyngeal flora lead to candidiasis
• Mild growth retardation
o Budenosdie
o Fluticasone
o Nasal spray
♣ Mometasone
♣ Fluticasone
o Intravenous (given in asthmatic attack)
♣ Prednisolone
♣ Hydrocortisone

Question 8

leukotriene antagonist

Answer 8

• Montelukast/ zafirlukast
o Antagonist at LTD4 rec, and block LTE4 rec
o Effective in exercise induced bronchospasm
o NOT for acute asthma
o Zafirlukast may be used in children at half dose
o Montelukast used in children as 6-12 mo

Question 9

lipoxygenase inhibitor

Answer 9

• Zileuton
o Children over 12
o Can increase liver enzymes

Question 10

anti-IgE Ab

Answer 10

• Omalizumab
o Humanized monoclonal Ab to human IgE
o Binds to IgE on mast cells and prevents asthma triggers