Asthma Flashcards
asthma
bronchospasm, thickened mucous, edema
How is activation of the beta-2 receptor involved
causes formation of cAMP
cAMP leads to smooth muscle relaxation & decreased immune response.
What causes constriction of the smooth muscle in bronchioles?
leukotrienes
What drugs can cause bronchoconstriction?
beta blockers OLOLs, NSAIDS like aspirin & sulfides.
How do bronchodilators work to treat asthma
increase cAMP to cause smooth muscle dilation
Beta-2 receptor agonists
Treat asthma
1: Epinephrine
- lack of specificity (activates everything–>increase in BP), epi pen.
2: isoproterenol
- more specific, short half life
Selective Beta-2 agonists vs. non-selective
longer half life
more selective
inhaled–immediately reaches target & can use lower dose
fewer side effects
Selective beta-2 agonists
albuterol, terbutaline, pirbuterol, levalbuterol
SE of all beta-agonists
tremor, tachycardia & palpitations.
Cholinergic blockers
treat asthma (mostly COPD) "trop"=analogs of atropine inhibit muscarinic receptors given as an aerosol ipratropium bromide & tiotropium
PDE inhibitors
treat chronic asthma
Theophylline–methylxanthine like caffeine
inhibits cAMP PDE
Anti-Inflammatory Agents
not bronchodilators given by inhalation, not systemically absorbed 1: mast cell inhibitors 2: glucocorticoids 3: anti IgE Ab 4: leukotriene inhibitors
Mast Cell inhibitors
inhibit Cl channels and decrease Ca uptake
cromolyn sodium
nedocromil
glucocorticoids
DOC prophylaxis to prevent asthma attack
first pass metabolism
many are inhaled
Bind intracellular receptors–leads to altered DNA transcription
SE: inhibit immune response–mouth infections like thrush, dysphonia
SONIDE & SONE
Beclomethasone, budesonide, fluticasone, mometasone, ciclesonide
Prednisone & dexmethasone –not inhaled
Anti-IgE Ab
omalizumab
monoclonal Ab, injection
blocks immunoglobulin receptor
