Asthma

Question 1

What are the options for first line treatments for under 5s?

Answer 1

Symptoms that indicate maintenance therapy needed - ICS (inhaled corticosteroids) and SABA
Symptoms that don’t indicate maintenance therapy- SABA (Short acting beta agonist)

Question 2

What is the action mechanism of salbutamol?

Answer 2

Binds to B2 adrenoreceptor on bronchial smooth muscle and acts as an agonist
This decreases ca2+ entry decreasing smooth muscle contraction - RELAXES

Question 3

What are the side effects of salbutamol?

Answer 3

Palpitations
Fine tremor
Aggravation
Tachycardia
Hypokalaemia

Question 4

Why is an inhaled route preferred over an oral route? What are the stats? What can be used to improve this?

Answer 4

Orally a lot more is lost to tissue other than the lungs
Reduces side effects
20% gets inhaled into lungs (therapeutic)
Spacers used to increase amount of drug inhaled - eliminates issue with technique

Question 5

What is the action mechanism of budesonide, fluticasone and mometasone?

Answer 5

Binds to glucocorticoid receptor and decreases inflammatory cells such as eosinophils and mast cells, macrophages, dendritic cells.
Reduces no. Of cytokines. does this by affecting the nucleus of these cells and stop certain genes from being expressed eg the il-5 one

Question 6

What are the side effects of budesonide, fluticasone and mometasone

Answer 6

Hoarse voice
Yeast infection in mouth
Growth retardation in children
Hyperglycaemia
Osteoporosis

Question 7

What is the action mechanism of montelukast?

Answer 7

Antagonises CysLT1 leukotrine receptor on eosinophils, mast cells and airway smooth muscle = decreases eosinophil migration and smooth muscle contraction and inflammation

Question 8

What are the side effects of montelukast?

Answer 8

Diarrhoea
Fever
Headaches
Nausea
Anaphylaxis