Asthma Therapy

Question 1

name the Short acting β2 agonists (SABA)

(“ROL call”)

Answer 1

Albuterol
(Salbutamol)

Terbutaline
(“do not distrub”)

Pirbuterol

Question 2

Inhaled corticosteroids

Answer 2

Beclomethasone

Budesonide

Fluticasone

-corticosteroids treat asthma by blocking inflammation and and cellular infiltration

*can cause oral candidiasis (“snow cone tongue”)

• treat with topical clopiprazole

Question 3

leukotrienes receptor antagonists

Answer 3

-AA turn to Leukotrienes by LOX
leukotrienes increase vascular permeability ,
increase mucus secretion and cause bronchoconstriction
(“lacrosse team constrict stick bronchi”)
——————————————————————————-
-CysLT1 is the receptor of LTD4 - the most potent leukotriene bronchocontrictor

–“kast” suffix

Montelukast (“monte the broadkaster”)

Zafirlukast

• cause bronchodilation (“dilated scarf”)
• taken orally“(monte opening his mouth”)

• *Zileuton** (“God_zile”_ above LOX Coach_)_

direct LOX inhibitor (“lipoxygenase inhibitor”)

-hepatotoxic

inhibition of COX shifts AA towards LOX ⇒ exacerbate bronchoconstriction therefore Zileuton is useful to prevent that

Question 4

Long acting β2 agonists

(LABA)

Answer 4

Salmeterol
(“salute formation”)

**Formoterol

-**
Long duration of action since highly lipophilic
(“long tapering flag”)

Question 5

methylxanthines

(“xanthine energy drinks”)

Answer 5

Theophylline (“you’ll be flyin”)

-related to caffeine (“energy drink says caffeine”)

-are phosphodiesterase inhibitors
(“don’t phoster disinterest” sign on shop)

-Increase cAMP
(“camping world” store)

-Adminstered orally
(“drinker open mouth”)

-can cause CNS side effects including Nervousness and tremor (“shaking kid”)

-can cause tachycardia
(“shaking kid has elevated heart wrist watch”)

-metabolized by CYP450
(“Chrome bumper hitting xanthine drink”)

Question 6

inhibitors of Histamine release

Answer 6

-mast cell degranulation of histamine causes asthma
(“Bee hive”)

-after first exposure mast cells are coated with IgE→second antigen exposure binds Fc portion of IgE →mast cell degranulation and release of histamine
(“IgE Gun shooting bee hive and making hole”)
——————————————————————————–
Omalizumab (“limousine driver stopping IgE gun”)
-is anti-IgE monoclonal antibody against Fc portion of IgE preventing mast cell sensitization

Chromolyn Na+ (“lynn’s bee control”)

-inhibits mast cell degranulation
(“bee sedating smoke”)

Question 7

treatment of acute exacerbation of Asthma

Answer 7

-albuterol (SABA)

-iv corticosteroids

• beclomethasone
• budesonide
• fluticasone

​-Ipratropium bromide (antimuscarinic)

• intramuscular Epinephrine (anaphylactic)
• oxygen ( in notes)