Corticosteroids, asthma and COPD Flashcards
What are the corticosteroids?
- Hydrocortisone
- Betamethasone
- Prednisone
- Dexamethasone
What are the relative lengths of effects of various corticosteroids?
Dexamethasone > Prednisone > Hydrocortisone
What are the clinical uses of corticosteroids?
- Addision’s disease
- Asthma
- Eczema
- Rheumatoid arthritis
- Cerebral oedema
What are the groups of drugs that treat asthma?
- Treatment of acute phase: Bronchodilators
- Treatment of late phase: Anti-inflammatories
- Prophylaxis: Anti-inflammatories
What are the bronchodilators used it treatment of asthma?
- β2-adrenoreceptor agonists
- Methylxanthines
- Muscarinic receptor antagonists
- CysLT receptor antagonists
What is the mechanism of action of β2-adrenoreceptor agonists in treatment of asthma?
- Induces relaxation of bronchial smooth muscle cells and bronchodilation
- Inhibits degranulation of mast cells
What are examples of β2-adrenoreceptor agonists used to treat asthma?
- Salbutamol (short-acting)
- Salmeterol (long-acting)
What is the mechanism of action of methylxanthines in treatment of asthma?
PDE inhibitor and increases intracellular [cAMP], causing same effects as β-adrenoreceptor agonists:
- Bronchodilation
- Inhibition of mast cell degranulation
What are examples of methylxanthines in treatment of asthma?
Theophylline (but mainly used prophylactically)
What is the mechanism of action of CysLT receptor antagonist in treatment of asthma?
Inhibition of CysLT1 and can induce bronchodilation
What are examples of CysLT receptor antagonists in treatment of asthma?
Zafirlukast
What is the mechanism of action of muscarinic receptor antagonists in treatment of asthma?
Inhibition of M3 receptors that promote bronchoconstriction, promoting bronchodilation
What are examples of muscarinc receptor antagonists in treatment of asthma?
Ipratropium
What are the anti-inflammatory agents used in treatment of asthma?
- Glucocorticoids
- CysT1 inhibitors
- 5-LO inhibitors
- Cromoglycate
- Omalizumab
What is the mechanism of action of glucocorticoids in treatment of asthma?
Anti-inflammtory effects used to counter inflammation during late phase
What are examples of glucocorticoids used in treatment of asthma?
Fluticasone
What is the mechanism of action of cromoglycate in treatment of asthma?
Stabilises mast cells and inhibits degranulation that causes inflammation
What are examples of cromoglycates used in treatment of asthma?
Sodium cromoglycate
What is the mechanism of action of anti-IgE antibodies in treatment of asthma?
Binds IgE and inhibits their binding to FcεR1 receptors, thus inhibiting mast cell degranulation and associated inflammatory response.
What are examples of anti-IgE antibodies used in treatment of asthma?
Omalizumab
What are examples of 5-lipoxygenase inhibitors used to treat asthma?
Zileuton
What are examples of cromoglycates used in treatment of asthma?
Sodium cromoglycate
What treatments are used to induce bronchodilation in COPD?
Long-lasting β-adrenoreceptor agonists (LABA) + Long-lasting muscarinic antagonist (LAMA)
What is an example example of a LABA?
Indacaterol
What is an example of a LAMA?
Glycopyronium
What is the mechanism of LABAs?
Promotion of β2-adrenoreceptor activity
What is the mechanism of LAMAs?
M3 receptor antagonist
What are the drugs used to reduce inflammation in COPD?
- Theophylline
- Roflumilast
What is the mechanism of action of theophylline in treating COPD?
- Non-selective PDE inhibitor
- Increased [cAMP] in neutrophils decreases chemotaxis and activation
What is the mechanism of action of roflumilast in treating COPD?
Specific PDE IV inhibitor that decreases activity of neutrophils, macrophages and T cells