Drugs used in asthma and COPD

Question 1

What is a reliever?

Answer 1

• Relief from symptoms
• Short term
• Less than 2 daytime symptoms a month, of short duration (e.g. few hours)
• More frequent symptoms indicate regular controller medication is required

Question 2

Describe the two types of bronchodilators.

Answer 2

Beta 2 agonists
• Short acting SABA, e.g. Salbutamol
• Binds to B2 receptors in airway smooth muscles cells. It causes the airway muscles and causes it relax

Anti-cholinergics
• M3 receptor antagonists e.g. atropine
• Acetylcholine normally causes bronchoconstriction. Thus, this binds to M3 receptors and prevents the release of Ach

Question 3

What are dental implications of SABA?

Answer 3

• Reduced saliva production (20-35%)
• Decreased pH
• Increased risk of caries
• Increased risk of gingivitis

Question 4

What is a controller?

Answer 4

• Used long-term
• Regular maintenance treatment
• Reduce airway inflammation
• Control symptoms

Question 5

What are the four types of controllers?

Answer 5

Inhaled Corticosteroids (ICS)

Cromones
(Cromogylcate and nedocromil)

Anti- Leukotriene

Long acting beta 2 agonists (LABA)

Question 6

Describe inhaled corticosteroids (ICS)

Answer 6

• Most consistently effective, long-term medication
• Inhibits cytokine production and thus inhibits inflammatory cell migration and activation
• Normally, cytokines causes vascular permeability/ adhesion and leaky endothelial
• Given orally in severe cases

Incorrect usage
• When a spacer is not used, 80% deposited in oropharynx
• Local immunosuppression
• Opportunistic infection
• Oral thrush

Question 7

Describe cromones

Answer 7

• Stabilises mast cells

* Interfere with chloride channel function in mast cells

Question 8

Describe anti-leukotriene

Answer 8

• Leukotriene’s contribute to bronchoconstriction, excess mucus and increased vascular permeability
• Interfere with pathway of leukotriene mediators released from mast cells

Question 9

Describe long acting beta 2 agonists

Answer 9

• E.g. Salmeterol
• Bind B2 airway smooth muscles, cAMP increase, causing bronchodilation
• Duration of 12 hours minimum
• Used in combination with ICS