Asthma Drugs Flashcards
In asthma peoples airways are more…
Sensitive than normal
Asthma is associated with…
Airway hyperresponsiveness
Reversible airflow limitaton
Bronchial inflammation
Asthma symptoms…
Wheezing attacks
Shortness of breath
Cough
(Can be worse at night)
Asthma triggers…
Exposure to allergen Emotion Cold air Exercise Diet Pollutants Drugs
2 drugs that shouldn’t be given to asthmatics…
B Blockers
Aspirin
Name the reliever (bronchodilators) drugs…
Salbutomol (ventolin)
Salmeterol
Ipratropium
Theophylline
The B2 agonist drugs =
Salbutomol & salmeterol
Which drug blocks mucus secretion?
Ipratropium (use alongside B2 agonists)
Which reliever drug is used in severe cases?
Theopylline
What are relievers mechanism of action?
Relax the smooth muscle and widen airways
Name the preventer drugs…
Beclometasone
Sodium cromoglicate
Montelukast
Which preventer is a steroid drug?
Beclometasone
When does the sensation phase occur?
With first exposure to an allergen (e.g. dust) which is when T cells are activated
What do T cells secrete?
Inflammatory mediators (interleukins) which activate B cells which become plasma cells
Plasma cells secrete…
Antibodies known as IgE which bind to receptors on mast cells
Eosinophils are…
WBC which contain histamine and other chemicals to kill viruses (they can damage airway)
. When re-exposed to allergen, the allergen binds to the IgEs on the surface of mast cells causing crosslinking to occur and this results in mast cells releasing histamine and other inflammatory mediators. This re-exposure prompts an early phase reaction, which occurs almost immediately, and a late phase reaction which may be more severe and occurs several hours (3-10 hours) later
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Preventers do not have…
Bronchodialtor activity
Preventer steroids can be taken…
Orally
Inhaled
IV
What do preventer drugs do?
They are anti-inflammatorys so stop the response to an allergen
B2 agonists act on…
B2 receptors on airway and smooth muscle
Salbutomol is similar to…
Adrenaline
How can B2 agonist be administered?
Inhaled
Orally
(Can be SHORT or LONG acting)
A short-acting beta2 agonist inhaled immediately before exertion reduces…
Exercise induced asthma…
Longer acting drugs are useful because…
They can be taken once or twice daily
Salbutomol duraton of action…
3-5 hours
Salmeterol duration of action…
12 hours
Name the short acting B2 agonists…
Salbutamol/ terbutaline
Name the long acting B2 agonists…
Salmeterol/ formoterol
B2 agonists are only used in patients taking…
Inhaled steroids
B2 agonist side effects…
Tremor (B2 receptors in skeletal muscle)
Increase HR (direct stimulation of SA nose)
Nervous tension
Headache
Hypokalaemia (stiumlation of sodium-potassium exchange pump)
Typical MDI requires…
Good co-ordination
What equpitment would act as a reservoir for the drug?
Spacer device
Breath-activated inhalers require…
No-cordination
When using an MDI what percentage of drug makes it to the intended target (lungs)?
10%
What happens to the remaining 90% of the drug when using MDI?
Eventually swallowed
Name the device that requires a short sharp intake of breath…
Accuhaler
A nebuliser is where the drug is breathed in through…
A mouthpiece or mask (most common in A&E for serious asthma attacks)
Beclometasone is administered as…
An oral inhaler or nasal spray
Budesonide gives relief in…
10 hours
Glucocorticoids bind to…
Steroid receptors (eventually bind to DNA to induce specific genes affecting protein production)
Glucocorticoids inhibit transcription of…
COX-2 gene (hence reduced inflammation due to lack of protein production)
Unwanted side effects of inhaled glucocorticoids…
Oral thrush
Dysphonia
Oral prednisolONE is used for…
Acute asthma attacks
Unwanted side effects of oral steroids…
Moon face etc…
Sudden widthdrawl of steroids may result in…
Acute adrenal insufficiency (Ads crisis)
