Asthma Drugs

Question 1

Albuterol

Answer 1

Beta agonist

relaxes bronchial smooth muscle (beta 2); use during acute exacerbation

Question 2

Salmeterol, formoterol

Answer 2

Beta agonist

long-acting agents for prophylaxis. Adverse effects are tremor and arrhythmia

Question 3

Theophylline

Answer 3

methylxanthines

likely causes bronchodilation by inhibiting phosphdiesterase, thereby decreasing cAMP hydrolysis. Usage is limited because of narrow therapeutic index (cardiotoxicity, neurotoxicity); metabolized by P-450. Blocks actions of adenosine

Question 4

Ipratropium

Answer 4

muscarinic antagonists

competitive block of muscarinic receptors, preventing bronchoconstriction. Also used for COPD, as is tiotropium, a long acting muscarinic antagonist

Question 5

Beclomethasone, fluticasone

Answer 5

corticosteroids

inhibit the synthesis of virtually all cytokines. Inactivate NFkB, the transcription factor that induces the production of TNFalpha, among other inflammatory agents. 1st line therapy for chronic asthma

Question 6

Montelukast, zafirlukast

Answer 6

antileukotrienes

block leukotriene receptors. Especially good for aspirin-induced asthma

Question 7

Zileuton

Answer 7

5-lipoxygenase pathway inhibitor. Blocks conversion of arachidonic acid to leukotrienes

Question 8

Omalizumab

Answer 8

Monoclonal anti-IgE antibody. Binds mostly unbound serum IgE. Used in allergic asthma resistant to inhaled steroids and long-acting Beta2 agonists