Asthma Flashcards
What is the early phase of asthma characterized by?
bronchospasm
What is the late phase of asthma characterized by?
inflammation
What are the 4 main types of drugs that can be used to reverse bronchospasm? (hint: these drugs are bronchodilators)
beta agonists
theophylline/aminophylline
cysteinyl leukotrine receptor antagonists
muscarinic antagonists
Which phase of asthma do beta2 agonists treat? Explain the beta2 agonist mechanism behind of action in treating asthma?
phase: bronchospasm/constriction
mechanism: Gs STIMULATION –> activate adenylate cyclase –> increase cAMP –> activate PKA –> DECREASE Ca2+ –> bronchodilation
are beta2-agonists usually given to asthma patients via inhalation, oral route, or injection?
inhalation
What are 2 short acting beta2 agonists? What is the duration of action? Are they taken as needed or as adjunctive therapy?
drugs: salbutamol and terbutaline
duration: 3-5 hours
taken as needed
What are 2 long-acting beta2 agonists? What is the duration of action? Are they taken as needed or as adjunctive therapy?
drugs: salmeterol and formoterol
duration: 8-12 hours
adjunctive therapy
What are the adverse effects of beta2 agonists in treating asthma?
tachycardia
dysrhythmias
tremor
peripheral vasodilation
hypokalemia
hyperglycemia
Are theophylline/aminophylline usually given to patients via inhalation, oral route, or injection?
oral route
Which phase of asthma do beta2 agonists treat? What is theophylline/aminophylline’s mechanism of action?
phase: bronchospasm/constriction
mechanism: INHIBIT PHOSPHODIESTERASE –> prevent breakdown of cAMP –> increase cAMP levels –> decrease Cas2+ –> bronchiole dilation
What are the side effects of taking theophylline and aminophylline as treatment for asthma?
dysrhythmia
headache
seizure
nausea and vomiting
insomnia and restlessness
What are the 2 cysteinyl leukotrine receptor antagonistic drugs used to treat asthma?
montelukast and zafirlukast
What phase of asthma do montelukast and zafirlukast treat? What are the therapeutic actions of montelukast and zafirlukast in treating asthma?
phase: bronchospasm/constriction
actions: bronchodilation, decrease secretion
TRUE or FALSE: Montelukast and Zafirlukast are more effective at relaxing airways than beta2 agonists
FALSE: beta2 agonists are more effective
TRUE or FALSE: beta2 agonists and zafirlukast ca be used additively together to treat asthma.
TRUE
What are the adverse effects in using montelukast/zafirlukast to treat asthma?
headache and GI disturbances (generally well tolerated)
Are montelukast and zafirlukast usually given to patients via inhalation, oral route, or injection?
oral route (in combination with inhaled corticosteroid)
Which enzyme does zafirlukast inhibit? Inhibiting this enzyme may increase effects of which drug?
inhibit CYP3A4 –> increase effects of WARFARIN
What anti-inflammatory agents are used to treat asthma? Name the 6 drugs that call under this category of anti-inflammatory agents.
glucocorticoids:
- beclometasone
- budenoside
- fluticasone
- mometasone
- ciclesonide
- prednisolone
Which glucocorticoid is reserved for patients with the severest disease?
prednisolone
Are glucocorticoids usually given to patients via inhalation, oral route, or injection?
inhalation
What are the 2 mechanisms of glucocorticoid gene expression control? Explain both.
basic transactivation: ligand binds to GR dimer –> upregulate transcription
basic transrepression: ligand binds to GR dimer –> binds a nGRE –> turns off transcription
Describe the glucocorticoid mechanism of action in asthma.
- reduce transcription of IL2 gene
- inhibit Th cell proliferation
- reduce formation of Th2 cytokines and activation of eosinophils
- reduce Il5/IL3 –> inhibit allergen-induced influx of eosinophils into the lung
- reduce production of IgE and expression of IgE receptors
What are the adverse effects of taking inhaled glucocorticoids to treat asthma?
oropharyngeal candidiasis (thrush)
dysphonia (croaky voice)
adrenal suppression (with beclometasone and budenoside)
