Drugs used in the treatment of asthma - anti-inflammatory agents

Question 1

Where are the steroid hormones synthesised?

Answer 1

Adrenal cortex

Question 2

What are the two major classes of steroids?

Answer 2

glucocorticoids and mineralcorticoids

Question 3

Glucocorticoids - what do they do?

Answer 3

decrease inflammatory response
decrease immunological response
and other things

Question 4

mineralcorticoids do what?

Answer 4

mainly aldersterone and they regulate the retention of salt and water by the kidney

Question 5

What effect do glucocorticoids have on gene transcription?

Answer 5

increase the gene transcription of genes encoding anti inflammatory proteins and decrease the gene transcription encoding inflammatory proteins

Question 6

What do glucocorticoids do to prevent inflammation?

Answer 6

prevent production of IgE
decrease formation of Th2 cytokines and cause apoptosis
prevent allergen-induced influx into lung and cause apoptosis (eosinophils)
Recede number of cells and decrease Fce expression in mast cells

Question 7

How do glucocorticoids effect inflammatory cells?

Answer 7

eosinophils - reduce number by apoptosis
t-lymphocytes - decrease cytokines
mast cells - decrease numbers
macrophages - decrease cytokines
dendritic cells - decrease numbers

Question 8

how do glucocorticoids effect structural cells?

Answer 8

epithelial cells - decrease cytokine mediators
endothelial cells - decrease leak
in airway smooth muscle cells - increase beta 2 receptors and decrease cytokines
in mucus gland - decrease mucus secretion

Question 9

What are the common side effects of glucocorticoids?

Answer 9

dysphonia (hoarse and weak voice)
oropharyngeal candidiasis (thrush)

Question 10

What are cromolins?

Answer 10

mast cell stabilisers - sodium cromoglicate

more effective in children and young adults than older patients