Asthma

Question 1

Name 5 classes of asthma medication

Answer 1

Salbutamol
Fluticasone
Mometasone
Budesonide
Montelukast

Question 2

What is the primary mechanism of action of salbutamol?

Answer 2

Agonist at the B2 receptor on the airway of the smooth muscle cells.
Activation reduced Ca2+ entry and this prevents smooth muscle contraction

Question 3

What is the mechanism of action of Fluticasone?

Answer 3

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

Question 4

What is the primary mechanism of action of Mometasone?

Answer 4

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

Question 5

What is the primary mechanism of action of Budesonide?

Answer 5

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

Question 6

What is the primary mechanism of action of Montelukast?

Answer 6

Antagonism of CysLT1 leukotrine receptor on eosinophils, mast cells and airways smooth muscle cells decreases eosinophils migration, bronco constriction and inflammation induced oedema

Question 7

What is the main drug target of salbutamol?

Answer 7

B2 adrenergic receptors

Question 8

What is the main drug target of Fluticasone?

Answer 8

Glucocorticoid receptor

Question 9

What is the main drug target of Mometasone?

Answer 9

Glucorticoid receptor

Question 10

What is the main drug target of Budenoside?

Answer 10

Glucocorticoid receptor

Question 11

What is the main drug target of Montelukast?

Answer 11

CysT1 receptor leukotrine receptor

Question 12

What are the main side effects of Salbutamol?

Answer 12

Palpitations/ Agitation/ Tachycardia/ Arrythmias/ Hypokalaemia ( at higher doses)

Question 13

What are the main side effects of Fluticasone?

Answer 13

Local: Sore throat, hoarse voice, opportunistic oral infections

Systemic: Growth retardation in children, Hyperglycaemia, Decreased bone mineral density, IMmunosuppresion, Effects on mood

Question 14

What are the main side effects of Mometasone?

Answer 14

Local: Sore throat, Hoarse voice, opportunistic oral infection,

Systemic: Hyperglycaemia, Growth retardation in children, Immunosuppresion, Decreased bone mineral density, effect on mood

Question 15

What are the main side effects of Budesonide?

Answer 15

Local: Opportunistic oral infctions,hoarse voice

Systemic: Growth retardation in children, Decreased bone mineral density, Hyperglycaemia, Immunosuppresion, Effect on mood

Question 16

What are the main side effects of Montelukast?

Answer 16

Mild: Diarrhoea, Fever, Headaches, Nausea or vomiting

Severe: Mood changes, Anaphylaxis

Question 17

Extra information on Salbutamol

Answer 17

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

Question 18

Extra information on Fluticasone

Answer 18

Oral bioavailability (<1 %) - inhaled route is predominantly through the pulmonary vasculature
Greater affinity for glucocorticosteroid receptor than cortisol

Question 19

Extra information on Mometasone

Answer 19

Oral bioavailability (<1 %) - inhaled route is predominantly through the pulmonary vasculature
Greater affinity for glucocorticosteroid receptor than cortisol

Question 20

Extra information of Budesonide

Answer 20

Oral bioavailability (>10%) - has GI route

Question 21

Extra information on Montelukast

Answer 21

For prophylaxis of exercise induced bronchoconstriction, be admistered 2hrs before initating exercise

Question 22

What are the areas of loss in asthma treatment inhalation

Answer 22

1. Exhalation
2. Absorption from lungs
3. Mucocilliary clearance
4. Swallowed - GI tract
5. Absorbed in mucous membrane of oral cavity and pharynx