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Pharmacology 2 > Asthma Drugs > Flashcards

Asthma Drugs Flashcards

0
Q

What are the 2 types of asthma?

A

Chronic and severe

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1
Q

What are the 2 first line drug treatments for asthma?

A

Glucocorticoids

B2 adrenergic receptor agonists

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2
Q

What is asthma characterised by?

A

Inflammation in the airways

Hyper reactivity of bronchioles resulting in broncho constriction and mucus secretion

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3
Q

What are the intrinsic triggers of an asthma attack?

A

Exercise, cold air, respiratory infection, atmospheric pollutants.

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4
Q

What are some allergic triggers of an asthma attack?

A

Pollen, dust mite proteins, hair, animals

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5
Q

Which cell does the allergic interact with?

A

B cells

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6
Q

What does the allergens reaction with a B cell trigger?

A

Cytokines

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7
Q

What are the two phases of an asthma attack?

A

Early phase: bronchospasm

Late phase: inflammation

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8
Q

What happens during the intermediate phase of an attack?

A

Bronchospasm - mast cells release: histamines, leukotrienes (LTC4 and LTD4) and prostaglandin D2.
Mast cells release inflammatory mediators: interleukins, macrophage inflammatory protein, tumour necrosis factor chemotoxins and chemokines to attract leukocytes to the area.

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9
Q

What happens during the late phase

A

Progressing inflammatory reaction, lymphocytes and eosinophils invade release cytokines, chemokine and toxic proteins.
Agents from inflammatory cells cause damage and loss of bronchial epithelium, smooth muscle cell hypertrophy and hyperplasia, hyper reactivity to irritant stimuli.

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10
Q

What are the two drug types in asthma?

A

Bronchodilators

Anti inflammatorys

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11
Q

What are the four main types of bronchodilator?

A

B2 adrenergic receptor agonists
Theophylline
Muscarinic receptor antagonists
Leukotriene receptor antagonists

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12
Q

How do b2 receptor agonists work?

A

Directly act on b2 receptors, stops cAMP from converting inactive PKA to activated PKA. cause smooth muscle relaxation.

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13
Q

What are the secondary actions of B2 receptor agonists?

A

Inhibit mediator release from mast cells and monocytes.

May act on cilia to increase mucus clearance.

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14
Q

Name 2 short acting b2 receptor agonists?

A

Salbutamol and terbutaline

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15
Q

When is the max effect of salbutamol and terbutaline and how long do they last?

A

Max effect within 30 mins last 4-6 hours.

16
Q

Name a longer acting b2 receptor agonist

A

Salmeterol

17
Q

How long does salmeterol last?

A

12 hours

18
Q

How should you administer B2 agonists and why?

A

Inhaled

To target lung action and minimise systemic effects

19
Q

What is the most common unwanted effect from B2 agonists?

A

Tremor

20
Q

Theophylline is a similar molecule to what?

A

Caffeine

21
Q

How does theophylline work?

A

Mechanism unclear - phosphodiesterase inhibitor.

22
Q

What are some unwanted effects of theophylline?

A

Tremor, sleep disturbance, stimulate heart, vasodilation, anorexia, nausea, vomiting

23
Q

What type of drug is ipratropium?

A

Muscarinic receptor antagonist

24
Q

How do muscarinic antagonists work?

A

Block action of acetylcholine at muscarinic receptors causing bronchodilation, inhibit elevated mucus secretions, increase clearance of bronchial secretions.

25
Q

Give two examples of leukotriene receptor antagonists?

A

Montelucast

Zafirlukast

26
Q

How do leukotriene receptor agonists work?

A

Act at cysteinyl-leukotrkene receptors and prevent actions of LTC4 and LTD4 which are bronchial spasmogens and stimulate mucus secretion.

27
Q

Name 4 glucocorticoids?

A

Beclometasone diproprionate, budesonide, fluticasone propionate and prednisolone.

28
Q

How long does it take for the full effect of glucocorticoids to develop?

A

Several days

29
Q

What do glucocorticoids reduce the production of?

A

Cytokines, spasmogens and leukocyte chemotaxins. Reducing bronchospasm and activation of inflammatory cells.

30
Q

What is the mechanism of glucocorticoid action?

A

Enter cells, bind to receptors in cytoplasm, moves to nucleus and binds to DNA, alters gene transcription.

31
Q

How does cromoglicate work?

A

Upmost stabiliser - not main action. Reduces neuronal reflexes, inhibits release of T cytokines, effects inflammatory cells and mediators.

32
Q

Name a new biological agent?

A

Omalizumab

33
Q

What does omalizumab bind to?

A

IgE

Pharmacology 2 (14 decks)

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