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Pathophysiology > Asthma Drug > Flashcards

Asthma Drug Flashcards

1
Q

What are the short-acting beta-agonists used for asthma & COPD

A

salbutamol

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2
Q

What are the long-acting beta-agonists used for asthma & COPD?

A

Fomoterol (New drug for relive & control)

Salmeterol

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3
Q

Name the LABA for asthma

A

Fomoterol (New drug for relive & control)

Salmeterol

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4
Q

Name the SABA for asthma

A

salbutamol

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5
Q

Name the drug to use in Beta 2 - emergency asthma

A

Epinephrine

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6
Q

How beta agonists work?

A

They work on Gs protein receptors –> increase of AC –> increased cAMP –> bronchodilation

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7
Q

Name the SAMA ?

A

Ipratropium

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8
Q

Name the LAMA?

A

Tiotropium

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9
Q

Name the Methyxanthines drug

A

Theophylline

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10
Q

Name the list of corticosteroids

A

Budesonide

Ciclesonide

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11
Q

Name the Leukotriene inhibitors

A

Montelukast

Zileuton

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12
Q

What is Mast cell stabilisers

A

Cromoglicic acid

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13
Q

What is drug use for allergic asthma

A

Ig-E Omalizumab

(IL4 - Dupilumab) help allegic

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14
Q

What is drug use for eosinophilic asthma

A

IL5 - Reslizumab

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15
Q

What drug will reduce B2 adrenoceptor down regulation ?

A

LABA + ICS

Below 12 , use formoterol + budesonide

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16
Q

What will B2 adrenoceptor agonists do?

A
  • 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
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17
Q

How long does SABA take to activate ?

A

3-6H

18
Q

How long does LABA take to activate ?

A

12H

19
Q

How long does Epinephrine take to activate ?

A

1-3H

20
Q

What the adverse effect of B2 agonist/ adrenoceptor ? (SABA/LABA)

A
  • Tremor
  • Peripheral vasodilatation
  • Palpitations & Tachycardia
  • Hyperglycaemia/ Hypokalaemia
21
Q

Ipratropium (SAMA)

A

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)
22
Q

Theophylline

A

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

23
Q

Magnesium Sulphate (MgSO4)

A

For treatment of acute asthma which can use as IV or nebulized

No Adverse effect

24
Q

List the inhaled Corticosteroids (ICS)

A
  • Budesonide
  • Ciclesonide
  • Fluticasone (risk of adrenal suppression)
25
Q

What does the Glucocorticoid receptor Anti inflammatory drug help asthma patient

A
  • Reduce pro-inflammatory mediators

- Increase anti -inflammatory mediators

26
Q

How corticosteroid help asthma?

A

-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

27
Q

What the adverse effect of corticosteroid?

A
  • 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
28
Q

Leukotriene Pathway Inhibitors example

A
  • Monetlukast-Cysteinyl-Leukotriene (CysLT) receptor antagonist
  • Zileuton-5-lipoxygenase (5-LOX) inhibitor
29
Q

What the use of Leukotriene Pathway Inhibitors

A

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
30
Q

Montelukast

A
  • 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

31
Q

Cromoglicic acid Uses

A

Uses:
Control of asthma, allergic rhinitis, vernal keratoconjunctivitis

Side Effects:
•Throat and nasal irritation, mouth dryness, cough
•Unpleasant/Bitter taste

32
Q

Omalizumab (Monoclonal)

A
  • Anti bodies for allegic asthma (Anti IgE)
  • SC route 4 weeks

Adverse effect
- Risk of heart attack , ischaemic and heart block

33
Q

Reslizumab

A
  • eosinophilic asthma
  • IL5
  • IV every 4 weeks

Adverse Effect
Oropharyngeal pain

34
Q

Ideal combine drug for asthma

A

Formoterol (LABA) + Budesonide (ICS)

Salmeterol (LABA) + Fluticasone (ICS)

35
Q

Name all bronchodilators that reverse Airway constriction

A

B2
Salbutamol (SABA) Relivers
Formoterol (LABA) Relivers + controller
Salmeterol (LABA) Controller

SAMA - Ipratropium
Throphylline (Methylxanthine)

Leukotriene Modifiers : Montelukast (weak bronchodialators)

36
Q

Name all Anti inflammatory that prevent recurring attack

A
  • Corticosteriod - Budesonide , Fluticasone , Ciclesonide
  • Leukotriene Modifiers - Monelukast , Zileuton
  • Mast cell stabilisation- Cromoglicic acid
  • Monoclonal antibodies - Omalizumab, Reslizumab
37
Q

What to prescribe for mild intermittent asthma/breathing issues?

A

SABA - Short-acting beta2-agonist

38
Q

What to prescribe for mild persistent asthma/breathing issues?

A

SAB2-agonist (SABA) & low dose of ICS

39
Q

What to prescribe for moderate persistent asthma/breathing issues?

A

SAB2-agonist (SABA), low dose ICS, & LABA

40
Q

What to prescribe for severe persistent asthma/breathing issues?

A

SAB2-agonist (SABA), high dose ICS, & LABA

41
Q

What to prescribe for very severe persistent asthma/breathing issues?

A

SAB2-agonist (SABA), high dose ICS, LABA, & OCS-Oral Corticosteroids

Pathophysiology (4 decks)

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