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Pharmacology > Asthma > Flashcards

Asthma Flashcards

1
Q

What is used in Step 1 of asthma treatment?

A

Short acting B2 agonists eg. Salbutamol

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2
Q

For what purpose is Salbutamol used?

A

As a reliever

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3
Q

How do B2 agonists work?

A

Ligand binds Gs which increases cAMP
Downstream activation of pKa
Leads to relaxation and inhibition of agonist-induced contraction

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4
Q

What are ADRs of B2 agonists?

A

Tachycardia
Palpitations
Tremors

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5
Q

What is Step 2 of Asthma treatment?

A

Regular preventer therapy

Inhaled corticosteroids

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6
Q

How do Inhaled Corticosteroids work?

A

Reduce the eosinophilic TH2 driven inflammation of airways
Bind to GR alpha protein
Complex binds to DNA and activates infiltration of anti-inflammatory molecules

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7
Q

What makes up the concentration of ICS in the systemic circulation?

A

Absorption from lungs + Active drug from the gut

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8
Q

What does Add on therapy involve?

A

Long Acting B2 Agonists with ICS
Leukotriene Receptor Antagonists
Methylxanthines
Long acting anticholinergics

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9
Q

What is the use of LABAs?

A

Reduce Exacerbations

Improve lung function

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10
Q

How do Leukotriene Receptor Antagonists work?

A

LTC4 is released by mast cells and eosinophils and can induce
Bronchoconstriction, mucus secretion, mucosal oedema, promotion of inflammatory cells
So antagonists block these things

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11
Q

What are the ADRs of Leukotriene Receptor Antagonists?

A

Angioedema
Dry mouth
Arthralgia

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12
Q

How do methylxanthines work?

A

Antagonise adenosine receptors

This inhibits phosphodiesterase which increases cAMP

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13
Q

What are the ADRs of Methylxanthines?

A

Nausea
Headache
Reflux

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14
Q

What is an example of a Long Acting Cholinergic?

A

Tiotropium Bromide

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15
Q

When is Tiotropium Bromide used?

A

COPD

Severe Asthma

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16
Q

What are the ADRs of Tiotropium Bromide?

A

Dry mouth
Urinary retention
Glaucoma

17
Q

What is Step 5 of Asthma treatment?

A

Oral IgE

Anti-Steroids

18
Q

What is the criteria for Acute Severe Asthma?

A 
Any one of:
Unable to complete sentences
Pulse over 110 bpm
Resp over 25/min
Peak flow of 33-50% of best/predicted
19
Q

What is the Partial pressure of CO2 in near fatal asthma?

A

Over 6kPa

20
Q

How do you treat acute, severe Asthma?

A 
High flow oxygen 
Nebuliser salbutamol
Oral prednisolone 
Nebuliser Tiotropium Bromide
IV Aminophylline if no improvement
21
Q

What does TH2 driven inflammation do in Asthma?

A

Mucosal oedema
Bronchoconstriction
Mucus plugging
Airway remodelling

22
Q

When do you start step 2?

A

When p is using B2 agonists more than 3 times a week
Symptoms present more than 3 times a week
Waking from sleep more than once a week
Any Exacerbations requiring oral steroids in the last 2 years

Pharmacology (17 decks)

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