Inhalers/asthma drugs

Question 1

Salbutamol/terbutaline

• Class
• MoA
• Indications
• Side effects
• Extra info

Answer 1

Class:
Short acting beta-agonist

MoA:
Beta 2 adrenergic agonist which blocks Ca2+ entry and therefore muscle contraction

Indications:
Acute asthma, hyperkalemia

Side effects:
Palpitations/tachycardia, hypokalaemia, tremors, lactic acidosis

Extra info:
Hypokalaemia exacerbated by corticosteroids and theophylline

Question 2

Fluticasone/Mometasone/Budesonide

*Class
* MoA
* Indications
* Side effects

Answer 2

Class:
Inhaled Corticosteroids

MoA:
Acts on glucocorticoid receptor to decrease inflammatory cells

Indications:
Asthma, COPD with asthmatic features

Side effects:
Headache, oral candidiasis, pneumonia (in patients with COPD), taste altered, voice alteration, paradoxical bronchospasm

Question 3

Montelukast

• Class
• MoA
• Side effects

Answer 3

Class:
Leukotriene receptor anatgonist

MoA:
Antagonism of CysLT1decreases eosinophil migration and bronchoconstriction

Side effects:
Gastrointestinal disturbance,** eosinophilic granulomatosis with polyangiitis**

Question 4

Ipratropium

• Class
• MoA
• Side effects

Answer 4

Class:
Short acting muscarinic antagonist

MoA:
Blocks the binding of acetylcholine in smooth muscle preventing bronchoconstriction/parasympathetic activity

Side effects:
Brain:** drowsiness, dizziness, confusion, hallucinations
Eyes: blurred vision, dry eyes
Mouth: dry mouth
Heart: tachycardia
Bowel: constipation
Bladder: urinary retention**
Skin: inability to sweat, overheating

Question 5

Theophylline

• Class
• MoA
• Side effects

Answer 5

Class:
Methylxanthines

MoA:
Non-specific inhibitor of phosphodiesterase resulting in an increase in cAMP and therefore bronchodilation

Side effects:

Diarrhoea, dizziness, headache