Asthma Drugs Flashcards
List all of the common Asthma drugs
Inhaled corticosteroids (ICS) Beta 2 agonists Leukotriene receptor antagonist Long-acting muscarinic antagonist Theophylline
List the step-wise treatment pathway for Asthma
- Regular preventer - low dose ICS
- Add on therapy - inhaled LABA
- Additional controller therapies - increase ICS to medium dose ICS, or add leukotriene receptor antagonist
- Specialist care
List the following for: Inhaled corticosteroids (ICS)
- Use
- Example drugs
- Drug class
- Mechanism of action
- Adverse effects
- Warnings / contraindications
Asthma preventer (when reliever not sufficient) Reduces symptoms, exacerbations and prevents death
Beclomethasone
Budesonide
Fluticasone
Inhaled corticosteroids (ICS)
Anti-inflammatory properties
- Activates cytoplasmic receptors (goes into nucleus to modify transcription)
- Reduce mucosal inflammation, widens airway and reduces mucous
Local immunosuppressive action
- Candidiasis
- Hoarse voice
- Pneumonia – possible in COPD in higher doses
List the following for: Beta 2 agonists
- Use
- Example drugs
- Drug class
- Mechanism of action
- Adverse effects
- Warnings / contraindications
- Important drug reactions
SABA – Symptom relief as required
LABA – Add on therapy to SABA and ICS
SABA: Salbutamol Terbutaline LABA: Salmeterol Formoterol
Beta2 agonists
- Major action at bronchial smooth muscle – prevent bronchoconstriction before exercise
- Increase mucous clearance by action of cilia
Adrenergic effects:
- Tachycardia
- Palpitations
- Anxiety and tremor
- Increased glycogenolysis
- Increased renin production
- LABA only prescribed alongside ICS
- CVD
- Beta blockers (caution)
List the following for: Leukotriene receptor antagonist
- Use
- Example drugs
- Drug class
- Mechanism of action
- Adverse effects
Alternative to LABA (as add on therapy)
Montelukast
Leukotriene receptor antagonist
- Block CysLT1 at CYSLTR1 – prevents binding of leukotrienes (released by mast cells)
- Prevents some bronchoconstriction
- Reduces mucous
- Reduces oedema
- Headache
- GI disturbance
- Dry mouth
- Hyperactivity
List the following for: Long-acting muscarinic antagonist
- Use
- Example drugs
- Drug class
- Mechanism of action
- Adverse effects
Severe asthma and COPD
Tiotropium
Long-acting muscarinic antagonist
- Block vagal mediated contraction of airway smooth muscle
Infrequent – anticholinergic effects
- Dry mouth
- Urinary retention
- Dry eyes
List the following for: Theophylline
- Use
- Drug class
- Mechanism of action
- Warnings / contraindications
- Important drug reactions
For chronically poorly controlled asthma
Adenosine receptor antagonist
- Adenosine receptor antagonist
- Reduce bronchoconstriction
- Very narrow therapeutic index – plasma concentration monitoring required
- CYP450 inhibitors
