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Respiratory Pharmacology > Asthma Pharmacology > Flashcards

Asthma Pharmacology Flashcards

1
Q

What do Relievers do and give examples?

A

Act as Bronchodilators

SABAs, LABAs and CysLT1 receptor antagonists

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2
Q

What are preventers and give examples?

A

Act as anti-inflammatory agents that reduce airway inflammation.

Glucocorticoids, Cromoglicate and humanised monoclonal IgE antibodies

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3
Q

Give a named SABA

A

Salbutamol (aka Albuterol or terbutaline)

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4
Q

What do SABAs do?

A

Increase mucous clearance and decrease mediator release from last cells and monocytes.

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5
Q

Side effects of SABAs?

A

Fine Tremor
Tachycardia
Cardiac Dysrhythmia
Hypokalaemia

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6
Q

Give examples of LABAs

A

Salmeterol

Formoterol

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7
Q

When are LABAs useful?

A

In treating nocturnal asthma

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8
Q

How should LABAs be prescribed?

A

Should always be co-administered with a glucocorticoid

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9
Q

Give examples of CysLT1 Receptor Antagonists

A

Montelukast

Zafirlukast

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10
Q

When are CysLT1s effective?

A

Against allergen and exercise induced brinchospasm

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11
Q

How are CysLT1s administered?

A

Through the oral route

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12
Q

Side effects of CysLT1s?

A

Headache
GI upset
Generally well tolerated

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13
Q

Examples of Methylxanthines

A

Theophylline

Aminophylline

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14
Q

What do Methylxanthines do?

A

Combine bronchodilator and inflammatory actions
Inhibit mediator release from mast cells and increases mucous clearance
Increase diaphragmatic contractibility and reduces fatigue.
Theophylline activates HDAC which may potentiate anti-inflammatory action of glucocorticoids

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15
Q

How are Methylxanthines given?

A

Used in combination with a b2-adrenoreceptor agonist and glucocorticoids
Given through the oral route.

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16
Q

Side effects of Methylxanthines

A

Nausea, vomiting, abdominal discomfort and headache

17
Q

Problems of Methylxanthines

A

Numerous drug interactions involving CYP450s in particular with antibiotics that inhibit CYP450s

18
Q

Why are synthetic derivatives of cortisol used in the treatment of asthma?

A

The endogenous steroids posses glucocorticoid and mineralcorticoid actions. The latter is unwanted. So synthetic treatments are frequently used for anti-inflammatory effect.

19
Q

Examples of glucocorticoids.

A

Beclometasone
Budesonide
Fluticasone

20
Q

How are Glucocorticoids delivered?

A

Used prophylactic and given by inhalational route

21
Q

What do glucocorticoids do?

A

Increase the transcription of genes encoding for anti-inflammatory proteins and decrease the transcription of genes coding for inflammatory proteins.

22
Q

Name some glucocorticoid effects

A

Decrease the formation of Th2 cytokines and cause apoptosis
Prevent antibody production
Reduce number of mast cells and decrease Fce production
Prevent allergen induced influx into the lung and cause apoptosis

23
Q

How do glucocorticoids suppress the inflammatory component of asthma?

A

Prevent inflammation and resolve established inflammation

24
Q

Effectiveness short and long term of glucocorticoids?

A

In short term don’t alleviate early stage bronchospasm caused by allergens or exercise
But effective long term when used with LABAs

25
Q

Adverse side effects of glucocorticoids

A

Dysphonia and oropharyngeal carditis

26
Q

What are Cromones?

A

Second line drug used prophylactocally in treatment of allergic asthma- particularly in children.
‘Mast cell stabilisers’ suppress histamine release

27
Q

Specific cromate agent

A

Sodium cromoglicate

28
Q

Effectiveness of sodium cromoglicate?

A

More effective in children and young people.

Efficacy develops over several weeks.

29
Q

Example of monoclonal antibodies directed against IgE

A

Omalizumab

30
Q

How do IgE monoclonal antibodies work?

A

Prevent attachment to Fce receptors suppressing the mast cell response to allergens. Reduces the expression of Fce on many inflammatory cells.

31
Q

Problems with IgE monoclonal antibody treatment.

A

Expensive and requires IV administration

32
Q

Example of antibodies directed against IL-5

A

Mepolizumab

33
Q

When is IL-5 treatment used?

A

Asthma associated with severe eosinophilia

34
Q

Problems with IL-5 treatment

A

Expensive

Respiratory Pharmacology (1 decks)

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