Leukotriene drugs

Question 1

Which drug inhibits leukotriene synthesis?

Answer 1

Zileuton

Question 2

How does zileuton inhibit leukotriene synthesis?

Answer 2

Inhibits 5-lipoxygenase–which blocks arachidonic conversion to leukotrienes

Question 3

What metabolizes zileuton?

Answer 3

CYP enzymes in the liver… then it is excreted in urine

Question 4

What is a major toxicity?

Answer 4

Neuropsychiatric–including suicidal ideation

Question 5

Patients with what kind of diseases shouldn’t be given zileuton?

Answer 5

Liver diseases

Question 6

Does zileuton help with all phases of asthma?

Answer 6

No… does nothing for acute bronchoconstrictor response or delayed inflammatory response to inhaled antigen/irritant

Question 7

What kind of drugs are zafirlukast and montelukast?

Answer 7

Leukotriene-Receptor Antagonists

Question 8

Which leukotrienes do the -lukast drugs specifically inhibit? By binding to which receptor?

Answer 8

LTD4 and LTE4

CysLT1 receptor

Question 9

Where are -lukast drugs metabolized? Excreted?

Answer 9

Liver (CYP enzymes)…reduced in 5-11 and >65yo’s

Feces…poop…crap…shit

Question 10

Do -lukast drugs help with all phases of asthma?

Answer 10

Yes…to the best of my knowledge…acute, leukotriene, and delayed

Question 11

Do -lukast drugs have the same neuropsychiatric side effect?

Answer 11

Yes

Question 12

Which type of leukotriene drug is the preferred drug for long-term asthma control?

Answer 12

Receptor agonists (-lukasts)

Question 13

Are -lukasts drugs the best asthma drugs?

Answer 13

No…corticosteroids are usually better