Asthma Flashcards
Fluticasone
PAMECICA
Glucocorticoid
Anti inflammatory
Given prophylactically
Reduce bronchial hyper reactivity
Inhibit PAF Inhibit allergen induced influx of inflammatory cell in the lung Inhibit activation of macrophages and Eosinophils Reduce cytokines Reduce IL3 Reduce COX2 and arachidonic acid
SE: oral hoarseness,
Systematic: adrenal suppression, altered bone metabolism
Growth suppression
Theophylline
Bronchodilator
Inhibit phosphodiesterase, increase cAMP, inhibit activation of inflammatory cells and produce bronchodilation
Drug interaction with cimetidine, erythromycin CNS stimulation: reduce fatigue Cardiac arrythmias Increase GFR GI symptom: nausea
Prednisolone
Oral glucocorticoid
Acute severe or deteriorating asthma
Combination
LABA + glucocorticoid
Fruticasone, salmeterol
Montelukast
Leukotriene receptor competitive antagonist
Leukotriene: potent bronchi constrictors ( amplify inflammatory process)
Prophylaxis
Block antigen and exercise induced asthma
Reduce need of steroids
For aspirin sensitive asthma
Zileutin
Leukotriene synthesis inhibitor
Inhibitor of 5-lipoxygenase
Block antigen, exercise and aspirin induced asthma
Sodium cromoglycate
Given by inhalation, nebuliser
Not as bronchodilator
Given prophylactically
Prevent allergen induced mediator release from mast cell
Effective in antigen, exercise and irritant induced asthma
Severe acute asthma
Post Mortem: thick mucus, shedding of epithelium, filled with inflammatory cells, eosinophils, SM hypertrophy
Treatment: salbutamol (nebuliser/ IV), prednisolone (orally), ipratropium( nebuliser)
Allergen immunotherapy
Treating IgE mediated disease with increasing dose of an allergen to decrease patient sensitivity to that allergen
Reduction in inflammation, bronchial hyper responsiveness
Mild swelling at the site of injection
Sneezing, bronchospasm and anaphylaxis with hypotension and collapse
Omalizumab
Anti-IgE
Monoclonal antibody
Not bronchodilator
IgE binds to its receptor on mast cells and basophils
Cytokines modulator
Glucocorticoid
Receptor antagonist
Blocking antibodies to cytokines or receptors
Peptide
Interact with T cell
Reduce responsiveness to allergen and asthmatic response
CatPAD
DNA vaccine
Strong immune response induced
Protecting animal from sensitisation to allergens
