Asthma Treatments Flashcards
During bronchospasm, bronchial muscles contract and mast cells release which spasmogens?
Histamine, leukotrienes and prostaglandins
How do bronchodilators work?
Relax the smooth muscle cells around the walls of bronchioles to dilate bronchioles to increase area of lumen.
What are the 4 types of bronchodilators?
B2 adrenergic receptor agonists
Theophylline
Muscarinic receptor antagonists
Leukotriene receptor antagonists
How do B2 adrenergic receptor agonists work to treat asthma?
Act directly on B2 adrenoceptors on bronchiole smooth muscle to relax muscle. Also inhibit mediator release from mast cells & monocytes and may act on cilia to increase mucus clearance.
What does the activation of B2 adrenoceptors do?
Cause a string of reactions leading to muscle relaxation
Name the 2 short acting B2 adrenergic receptor agonists used in asthma treatments
Salbutamol & terbutaline
Name the longer acting B2 adrenergic receptor agonists used in asthma treatments
Salmeterol
In the treatment of asthma, how are B2 adrenergic receptor agonists administered?
Inhalation
What are the side effects of B2 adrenergic receptor agonist?
Tremor & tolerance to B2 adrenergic receptor agonists
What does theophylline do?
Inhibits phosphodiesterase to build up cAMP and cause muscle relaxation to treat Asthma.
What are the side effects of theophylline?
Tremor, sleep disturbance, vasodilation, stimulates heart, anorexia, nausea and vomiting
What is the main muscarinic receptor antagonist, used in the treatment of asthma?
Ipratropium
How do muscarinic antagonist work in the treatment of asthma?
Relax the smooth muscle cells in the bronchioles to increase lumen area (vasodilation). This happens as the they block the action of endogenous acetylcholine at muscarinic receptors. They also inhibit mucous secretion in asthma and can increase the clearance of bronchial secretions.
Montelucast and zafirlukast are examples of…
Leukotriene receptor antagonists.
How do leukotriene antagonists work in the treatment of asthma?
Act on bronchiole smooth muscle cells by acting at cysteinyl-leukotriene receptors. Also prevent actions of bronchial spasmogens.
Side effects of leukotriene antagonists
Headache and GI disturbances
What are the main anti-inflammatory drugs used in the treatment of asthma?
Glucocorticoids
What are beclometasone, budesonide, fluticasone, prednisolone and hydrocortisone examples of?
Glucocorticoids
How do glucocorticoids work in the treatment of asthma?
By reducing the production of cytokines, spasmogens & chemotaxins to reduce bronchospasm and inflammation
What are the side effects of inhaled glucocorticoids?
Oral thrush, dysphonia
What does cromoglicate do?
Treat asthma by reducing bronchial hyper-reactivity
What are the side effects of cromoglicate
Irritation of the upper respiratory tract and hypersensitivity reactions.
What is omalizumab?
Give side effects
A biological agent used in the treatment of asthma. Given by injection every 2-3 weeks. Side effects of anaphylaxis and malignancies
What would be the best treatment for a mild asthmatic with rare attacks?
Inhaled b2 agonist when required
What would be the best treatment for a mild asthmatic with more frequent attacks?
A glucocorticoid for prophylaxis and inhaled b2 agonist when needed for acute attack.
What would be the best treatment for moderate to severe asthmatics?
A drug combination preferred, usually B2 agonist with glucocorticoid.
