Asthma Flashcards
Name 5 classes of asthma medication
Salbutamol
Fluticasone
Mometasone
Budesonide
Montelukast
What is the primary mechanism of action of salbutamol?
Agonist at the B2 receptor on the airway of the smooth muscle cells.
Activation reduced Ca2+ entry and this prevents smooth muscle contraction
What is the mechanism of action of Fluticasone?
Multiple actions on many different cell types:
Decreases inflammatory cells such as eosinophils, monocytes, mast cells, macrophages and dendritic cells
Reduced the number of cells and number of cytokines they produce
What is the primary mechanism of action of Mometasone?
Multiple actions on many different cell types:
Decreases inflammatory cells such as eosinophils, monocytes, mast cells, macrophages and dendritic cells
Reduced the number of cells and number of cytokines they produce
What is the primary mechanism of action of Budesonide?
Multiple actions on many different cell types:
Decreases inflammatory cells such as eosinophils, monocytes, mast cells, macrophages and dendritic cells
Reduced the number of cells and number of cytokines they produce
What is the primary mechanism of action of Montelukast?
Antagonism of CysLT1 leukotrine receptor on eosinophils, mast cells and airways smooth muscle cells decreases eosinophils migration, bronco constriction and inflammation induced oedema
What is the main drug target of salbutamol?
B2 adrenergic receptors
What is the main drug target of Fluticasone?
Glucocorticoid receptor
What is the main drug target of Mometasone?
Glucorticoid receptor
What is the main drug target of Budenoside?
Glucocorticoid receptor
What is the main drug target of Montelukast?
CysT1 receptor leukotrine receptor
What are the main side effects of Salbutamol?
Palpitations/ Agitation/ Tachycardia/ Arrythmias/ Hypokalaemia ( at higher doses)
What are the main side effects of Fluticasone?
Local: Sore throat, hoarse voice, opportunistic oral infections
Systemic: Growth retardation in children, Hyperglycaemia, Decreased bone mineral density, IMmunosuppresion, Effects on mood
What are the main side effects of Mometasone?
Local: Sore throat, Hoarse voice, opportunistic oral infection,
Systemic: Hyperglycaemia, Growth retardation in children, Immunosuppresion, Decreased bone mineral density, effect on mood
What are the main side effects of Budesonide?
Local: Opportunistic oral infctions,hoarse voice
Systemic: Growth retardation in children, Decreased bone mineral density, Hyperglycaemia, Immunosuppresion, Effect on mood
What are the main side effects of Montelukast?
Mild: Diarrhoea, Fever, Headaches, Nausea or vomiting
Severe: Mood changes, Anaphylaxis
Extra information on Salbutamol
Short acting beta agonist. It’s half life is 2.5 - 5 hrs
Beta 2 selectivity is not absolute - beta 1 effect can be seen
HYpokalemia can be exercabated by coadministration with corticosteroids
Extra information on Fluticasone
Oral bioavailability (<1 %) - inhaled route is predominantly through the pulmonary vasculature
Greater affinity for glucocorticosteroid receptor than cortisol
Extra information on Mometasone
Oral bioavailability (<1 %) - inhaled route is predominantly through the pulmonary vasculature
Greater affinity for glucocorticosteroid receptor than cortisol
Extra information of Budesonide
Oral bioavailability (>10%) - has GI route
Extra information on Montelukast
For prophylaxis of exercise induced bronchoconstriction, be admistered 2hrs before initating exercise
What are the areas of loss in asthma treatment inhalation
- Exhalation
- Absorption from lungs
- Mucocilliary clearance
- Swallowed - GI tract
- Absorbed in mucous membrane of oral cavity and pharynx
