Asthma Drug Flashcards
What are the short-acting beta-agonists used for asthma & COPD
salbutamol
What are the long-acting beta-agonists used for asthma & COPD?
Fomoterol (New drug for relive & control)
Salmeterol
Name the LABA for asthma
Fomoterol (New drug for relive & control)
Salmeterol
Name the SABA for asthma
salbutamol
Name the drug to use in Beta 2 - emergency asthma
Epinephrine
How beta agonists work?
They work on Gs protein receptors –> increase of AC –> increased cAMP –> bronchodilation
Name the SAMA ?
Ipratropium
Name the LAMA?
Tiotropium
Name the Methyxanthines drug
Theophylline
Name the list of corticosteroids
Budesonide
Ciclesonide
Name the Leukotriene inhibitors
Montelukast
Zileuton
What is Mast cell stabilisers
Cromoglicic acid
What is drug use for allergic asthma
Ig-E Omalizumab
(IL4 - Dupilumab) help allegic
What is drug use for eosinophilic asthma
IL5 - Reslizumab
What drug will reduce B2 adrenoceptor down regulation ?
LABA + ICS
Below 12 , use formoterol + budesonide
What will B2 adrenoceptor agonists do?
- Bronchodilation ( Airway smoothen muscle)
- Mast cell stabilisation( used to control inflammation in asthma and to prevent exercise-induced bronchospasm
- Increase mucociliary clearance
- decrease microvascular leakiness
How long does SABA take to activate ?
3-6H
How long does LABA take to activate ?
12H
How long does Epinephrine take to activate ?
1-3H
What the adverse effect of B2 agonist/ adrenoceptor ? (SABA/LABA)
- Tremor
- Peripheral vasodilatation
- Palpitations & Tachycardia
- Hyperglycaemia/ Hypokalaemia
Ipratropium (SAMA)
Mechanisms of Action:
•Inhibit M3receptor-mediated bronchoconstrictions
•Reverses vagal nerve–mediated bronchospasm & mucus secretion
Use and Efficacy
- Use with B2 agonist + ICS +
- Use when not tolerant of B2 agonist
Adverse Effects:
- Limited systemic side effect
- Dry mouth
- Urinary retention ( esp elder)
Theophylline
Use & Efficacy
- Lest strong than B2 agonist
- Can use IV
Adverse Effect
•Narrow therapeutic window (therapeutic range: 5-20 mg/L)
•Many drug-drug interactions: Caution for potential drug interactions
Gastro : abdominal discomfort, anorexia, Nausea, Vomit
CNS : Nervous, tremor, anxiety, insomnia, seizures
Cardio - Arrhythmias
Magnesium Sulphate (MgSO4)
For treatment of acute asthma which can use as IV or nebulized
No Adverse effect
List the inhaled Corticosteroids (ICS)
- Budesonide
- Ciclesonide
- Fluticasone (risk of adrenal suppression)
What does the Glucocorticoid receptor Anti inflammatory drug help asthma patient
- Reduce pro-inflammatory mediators
- Increase anti -inflammatory mediators
How corticosteroid help asthma?
-Reduce airway from hyper-responsiveness in 4-6weeks
- Reduce frequency of acute asthma exacerbation
- Prevent airway remodeling
- Reduce need of B2 agonist
- Reduce risk of death
It does not relax airway smooth muscle
Uses
- For nocturnal asthma
What the adverse effect of corticosteroid?
- Oropharyngeal candidiasis - yeast infection develops inside your mouth
- Dysphonia (disorders of the voice)
- Cough / throat irritation
- Adrenal suppression (e.g. fluticasone)
- Easy bruising (esp in elderly )
- Cataracts
- Osteoporosis
Leukotriene Pathway Inhibitors example
- Monetlukast-Cysteinyl-Leukotriene (CysLT) receptor antagonist
- Zileuton-5-lipoxygenase (5-LOX) inhibitor
What the use of Leukotriene Pathway Inhibitors
Uses:
It is use for chronic asthma
It is use for exercise induce asthma
Efficacy:
- less effective than glucocorticoids
- Reduce freq of asthma attack
- reduce inhaled steroid
- Reduce use B2 agonist
- Reduce peripheral blood eosinophil levels
Montelukast
- Cysteinyl-Leukotriene (CysLT)
Uses:
- Adjunct therapy for mild to moderate asthma
- Not used alone as relever to rescue asthma attach
Efficacy:
- Relax airways in mild asthma
- Effective in aspirin sensitive asthma
- Effective in exercise induces asthma
Cromoglicic acid Uses
Uses:
Control of asthma, allergic rhinitis, vernal keratoconjunctivitis
Side Effects:
•Throat and nasal irritation, mouth dryness, cough
•Unpleasant/Bitter taste
Omalizumab (Monoclonal)
- Anti bodies for allegic asthma (Anti IgE)
- SC route 4 weeks
Adverse effect
- Risk of heart attack , ischaemic and heart block
Reslizumab
- eosinophilic asthma
- IL5
- IV every 4 weeks
Adverse Effect
Oropharyngeal pain
Ideal combine drug for asthma
Formoterol (LABA) + Budesonide (ICS)
Salmeterol (LABA) + Fluticasone (ICS)
Name all bronchodilators that reverse Airway constriction
B2
Salbutamol (SABA) Relivers
Formoterol (LABA) Relivers + controller
Salmeterol (LABA) Controller
SAMA - Ipratropium
Throphylline (Methylxanthine)
Leukotriene Modifiers : Montelukast (weak bronchodialators)
Name all Anti inflammatory that prevent recurring attack
- Corticosteriod - Budesonide , Fluticasone , Ciclesonide
- Leukotriene Modifiers - Monelukast , Zileuton
- Mast cell stabilisation- Cromoglicic acid
- Monoclonal antibodies - Omalizumab, Reslizumab
What to prescribe for mild intermittent asthma/breathing issues?
SABA - Short-acting beta2-agonist
What to prescribe for mild persistent asthma/breathing issues?
SAB2-agonist (SABA) & low dose of ICS
What to prescribe for moderate persistent asthma/breathing issues?
SAB2-agonist (SABA), low dose ICS, & LABA
What to prescribe for severe persistent asthma/breathing issues?
SAB2-agonist (SABA), high dose ICS, & LABA
What to prescribe for very severe persistent asthma/breathing issues?
SAB2-agonist (SABA), high dose ICS, LABA, & OCS-Oral Corticosteroids
