Asthma

Question 1

Regular, high doses of corticosteroids results in what?

Answer 1

Adrenal supression.

Question 2

Name the two Xanthines.

Answer 2

Theophyline and aminophylline.

Question 3

The beta2 agonist acts in what chain of cellular events?

Answer 3

1. Binds to the metabotropic beta2 receptor.
2. The g-proteins act on adenylate cyclase
3. Increases cyclic AMP
4. Relaxation of smooth muscle

Question 4

Why do corticosteroids have broad effects?

Answer 4

Because it has both positive (increased transcription) and negative (decreased transcription) effects on genes.

Question 5

Asthmatic prophylacitcs act on inflammation or bronchoconstriction?

Answer 5

Inflammation.

Question 6

Tetrabutyline is a SABA or a LABA?

Answer 6

SABA

Question 7

Long term use of corticosteroids results in what?

Answer 7

Cushings
Hypokalaemia (Na+ retention and K+ loss)
Osteoporosis
Muscle wasting

Question 8

You have to be careful with xanthines, why?

Answer 8

Narrow therapeutic window (30-100 µmol/L)

At 110µmol/L it can produce GIT, CVS and CNS symptoms.

Question 9

How do leukotriene receptor antagonists work?

Answer 9

They antagonise leukotriene receptors, causing a block in the pathway that induce bronchoconstriction and the mediators that are released from mast cells and eosinophils.

Question 10

Relievers have only an effect on inflammation but none on bronchoconstriction. True or false?

Answer 10

False. Relievers only have an effect on bronchoconstriction, relieving it.

Question 11

SABA drugs are used for what?

Answer 11

First line of defence.

SABA stands for short acting beta2 agonists.

Question 12

Leukotriene receptor antagonists affect which stage of the asthma reaction?

Answer 12

Both!

Question 13

What do cromones do?

Answer 13

Produce a short and weak anti-inflammatory effect.

This is achieved by stabilising mast cells and preventing them from releasing mediators.

Question 14

Name the two LABA drugs.

Answer 14

Salmeterol

Eformoterol (a.k.a. formoterol)

Question 15

Corticosteroids are used to treat what part of the asthma reaction?

Answer 15

The late phase.

Question 16

B2 agonists reverse which phase of an asthma attack?

Answer 16

The acute phase.

Question 17

Name the two leukotriene receptor antagonists.

Answer 17

Montelukast and zafrilukast.

Question 18

What kind of receptors do corticosteroids have?

Answer 18

Cellular receptors that affect transcription.

Question 19

What are the current three big issues in asthma tratment?

Answer 19

Infection increases the need for medication.
Beta2 receptor desensitisation.
Corticosteroids are less effective in COPD.

Question 20

What are the two phases of an asthma attack?

Answer 20

1. Acute/immediate

2. Late

Question 21

The inflammation of an asthma attack occurs at which stage?

Answer 21

Late stage.

Question 22

Xanthines are used in conjuction with what other drug? Why?

Answer 22

Corticosteroids.

They induce (or contain) histone deacetylase, which reverses resistance to corticosteroids.

Question 23

Why do beta2 agonists cause hyperglycaemia?

Answer 23

They induce glycogenolysis.

Question 24

Why do asthmatics have airway instability?

Answer 24

Bronchospasm
Mucosal odema
Mucus hypersecretion