Asthma

Question 1

Salbutamol

MOA

Answer 1

Dilate bronchial smooth muscle by direct action on ß2 adrenergic receptors and inhibits the release of inflammatory mediators by mast cells (mast cell stabilising agents).

Question 2

Salbutamol

S/E

Answer 2

• Tachycardia, AF/paroxysmal SVT (B1)
• Tremor (B2)
• Insomnia
• Muscle cramps
• Hypokalaemia due to intracellular shift
• Decreased BSL
Patient overuse leads to tolerance

Question 3

Inhaled corticosteroid example

Answer 3

Beclomethasone, Beudesnoide, Fluticasone

Budesonide

Question 4

ICS MOA

Answer 4

Glucocorticoids regulate gene transcription 🡪 reduced neutrophils and T-cell function and reduced COX-2 🡪 reduced airway inflammation and bronchial hyper-responsiveness

Question 5

Ipratropium Bromide (Atrovent)

MOA

Answer 5

Antagonises bronchial constriction caused by parasympathetic stimulation of M1 and M3 receptors when binding ACh.

Question 6

Ipratropium bromide

S/E

Answer 6

Tachycardia, nausea, vomiting, dry mouth, blurred vision

Question 7

Xanthines i.e. theopylline

MOA and S/E

Answer 7

MOA: Inhibition of phosphodiesterase 🡪 reduced intracellular hydrolysis of c-AMP 🡪 bronchodilation and pulmonary vasodilation +/- possibly inhibit the activation of inflammatory cells

S/E: CNS stimulation, cardiac stimulation, nausea, anorexia, diuresis (increased GFR)