Asthma

Question 1

Name 5 classes of drugs used to treat asthma

Answer 1

• Salbutamol
• Fluticasone
• Mometasone
• Budesonide
• Montelukast

Question 2

What is the mechanism of action of salbutamol?

Answer 2

Agonist at the β2 adrenergic receptor on airway smooth muscle cells reduces Ca2+ entry and this prevents smooth muscle contraction

Question 3

What is the mechanism of action of fluticasone?

Answer 3

Directly decreases inflammatory cells and the number of cytokines they gen by acting on the glucocorticoid receptor

Question 4

What is the mechanism of action of mometasone?

Answer 4

Directly decreases inflammatory cells and the number of cytokines they gen by acting on the glucocorticoid receptor

Question 5

What is the mechanism of action of budesonide?

Answer 5

Directly decreases inflammatory cells and the number of cytokines they gen by acting on the glucocorticoid receptor

Question 6

What is the mechanism of action of montelukast?

Answer 6

Antagonism of CysLT1 leukotriene receptor on eosinophils, mast cells and airway smooth muscle cells decreases eosinophil migration, broncho-constriction and inflammation induced oedema

Question 7

What are some side effects of salbutamol?

Answer 7

• Palpitations/agitation
• Tachycardia/arrythmias - beta-2 selectivity is not absolute so beta- 1 (cardiac) effects can be seen
• Hypokalaemia (at higher doses) - due to effect on sodium-potassium ATPase

Question 8

What are some side effects of fluticasone?

Answer 8

Local:
Sore throat, hoarse voice, opportunistic oral infections

Systemic:
- Growth retardation in children
- Hyperglycaemia
- Decreased bone mineral density
- Immunosuppression
- Effects on mood

Question 9

What are some side effects of mometasone?

Answer 9

Local:
Sore throat, hoarse voice, opportunistic oral infections

Systemic:
- Growth retardation in children
- Hyperglycaemia
- Decreased bone mineral density
- Immunosuppression
- Effects on mood

Question 10

What are some side effects of budesonide?

Answer 10

Local:
Sore throat, hoarse voice, opportunistic oral infections

Systemic:
- Growth retardation in children
- Hyperglycaemia
- Decreased bone mineral density
- Immunosuppression
- Effects on mood

Question 11

What are some side effects of montelukast?

Answer 11

• Diarrhoea
• Fever
• Headaches
• Nausea or vomiting
• Mood changes
• Anaphylaxis