Asthma Flashcards
Name a SABA
what is its mechanism of action
- Salbutamol
- Short acting β2-adrenoceptor agonists (SABA)
What different types of inhalers can you get ?
What are the adverse effects fo SABA ?
When would you add a inhaled corticosteroid on top of a SABA?
If the use of the beta-2 adrenoceptor agonist inhaler is required more than twice a week or with worsening night time symptoms a second inhaler containing a corticosteroid maybe required.
What colour are the inhaled corticosteroid inhalers ?
Brown
Name 3 Inhaled corticosteroids
How are inhaled corticosteroids effective ?
Corticosteroids have 2 major properties, they are inhibit inflammation and suppress the immune system. It is important to remember that corticosteroids have no bronchodilator activity and will not provide relief in an acute asthma attack.
What are the issues with Inhaled corticosteroids ?
After a
1- SABA
2- Inhaled corticosteroid
what should be added ?
There are two options:
1- LABA - Long acting β2-adrenoceptor agonist (inhaled)
OR
2- Leukotriene Receptor Antagonist (Oral)
If the patients symptoms remained uncontrolled on SABA and corticosteroid inhalers, add-in therapy maybe required with an oral leukotriene antagonist or a third inhaler containing a long acting beta-2 adrenoceptor agonist or LABA agent.
Name a the leukotriene receptor antagonist
How is this taken
what receptor does it interact with
What step is this added in the asthma ladder
Montelukast
Orally
the cysteinyl leukotrienes termed Cys LT-1 antagonism of which inhibits lung inflammation in asthmatics reducing airflow obstruction, bronchoconstriction, cell infiltration and mucous secretion all properties of which are of benefit to the asthmatic.
Step 3
What are the adverse effects of Montelukast – A Leukotriene Receptor Antagonist
Name a LABA
What step is this added?
What other medicatio MUST this be used with.
- Formoterol
- Salmeterol
3
MUST be used with inhaled corticosteroid - when used alone increases the number of asthma deaths.
Explain what a Maintenance and Reliever Therapy (MART) is.
Name one of these types of inhalers
Combination inhalers containing both a corticosteroid and a LABA agent are also available. This combination of maintenance and reliever therapy is termed MART, maintenance and reliever therapy. The example shown here is for beclometasone 100μg plus formoterol 6μg (100/6) delivered in dry powder form , the commercial name of which is Fostair.
Fostair
What is step 4 of the asthma ladder ?
There is two
1- Theophylline (oral )
2- Long-acting muscarinic cholinoceptor antagonist (inhalation) (LAMA)
Theophylline
- what step on asthma ladder is this ?
- What is the injectible version ?
- What do health care proffesionals need to do with this medication.
- What are adverse effects of this medication ?
- 4
- Aminophylline
- monitor drug
- Convulsions/arrythmias.
Name a LAMA
What does LAMA stand for?
What step is this on the ladder?
How does this work ?
Triotropium
Long-acting muscarinic receptor antagonist (LAMA)
4
Bronchiolar smooth muscle is also controlled by the parasympathetic nervous system. Typically, bronchial stiffness occurs due to acetycholine acting on the muscarinic receptors during relaxation. LAMA blocks this.
What is step 6 of asthma plan
name some of these drugs
how does it work ?
Monoclonal antibodies against Interleukin 5 (IL-5)
mepolizumab and reslizumab,
which bind to and neutralise IL-5 directly, which reduces the production and attraction of eosinophils to the airway.
