PHAR232 - Pharmalogical tools in Asthma Flashcards
Allergic Asthma
Asthma hypersensitivity reaction - KNOW
KNOW ADENOSINE AND ASTHMA
Increased adenosine in lungs associated with asthma
KNOW, LEARN AND DRAW OUT
KNOW AND DRAW OUT
Mast cell degranulation - KNOW AND LEARN
Draw out
Main goal o asthma drug management is…
to find an adjunct treatments to combine with BETA AGONISTS to provide synergistic benefit and delay need for glucocorticoids
OPEN UP THE AIRWAYS
In asthma treatment do you want drugs to bronchodilate or constrict for ease of airflow?
dilate
2 key areas that we are focusing on with asthma medication interventions
Bronchoconstriction
Mast cell destabilisation
What are the 3 categories of drugs used to manage asthma?
- Symptom relievers (short-acting beta2 agonists - salbutamol e.g. ventalin)
- Symptom controllers (long-acting beta2 agonists - salmetrerol)
- Symptom controllers - methylxanthines (theophylline) preventative for physical activity (longer acting)
- Symptom preventers (inhaled corticosteroids)
_ NSAIDS
Are methylxanthines used by an enhaler?
no they are oral medications
MUST KNOW AND WRITE OUT - BETA2 RECEPTOR AGONIST MECHANISM OF ACTION
What do beta 2 receptors usually respond to?
Adrenaline (NE)
If you are a beta-2 agonist what are the drugs mimicking?
Adrenaline
Must know systemic side effects of Beta2 receptor agonists
= increases SNS
- Overuse of inhalers can cause issues
Does caffeine bronchodilate or bronchoconstrict?
bronchodilate
= Used as an old remedy for asthma
= related to the adenosine inhibition
Review diagram
MUST KNOW - METHYLXANTHINES AS BRONCHODILATORS - DRAW OUT
What do A1 adenosine receptors to if they are agonised?
Bronchoconstrict
What is a key mechanism of action for methylxanthines (MXs) e.g. theophylline and aminophylline?
Adenosine A1 receptor ANTAGONISTS
= bronchodilate
What 2 mechanisms of action do methylxanthines have as bronchodilators?
- Adenosine A1 receptor antagonists
- Block phosphodiesterase (PDE)
MUST KNOW - DRAW OUT MECHANISM OF ACTION - BLOCK PHOSPHODIESTERASE (PDE)
What do methylanthines mimic?
Caffiene
What side effects does methylxanthines have?
MUST KNOW
Acts like caffiene
Increases SNS
Because adosine Rs are everywhere
Methylxanthines target them all
DRAW THIS OUT - ADENOSINE RECEPTORS AS A TARGET IN ASTHMA
OVERVIEW OF A2B Adenosine receptor antagonists
MUST KNOW MECHANISM OF ACTION OF A2B ADENOSINE RECEPTORS AS DRUG TARGETS
- Avoids histamine and
proinflammatory mediatiors
= reduces bronchodilation
MUST KNOW THIS QUESTION - WRITE IT OUT AND KNOW
- WHY CHOOSE GS OR GQ ?
- Why choose GQ ? = increase in histamine in asthma
- Research wants to bypass A2B receptors
A1 adenosine receptors as drug targets in astha
KNOW AND DRAW OUT
Do methylxanthines have lots of side effects?
yes
Where in the body has lots of adenosine A1 receptors?
Brain, SA and SV node in the heart
MECHANISM OF ACTION OF A1 ADENOSINE RECEPTORS. KNOW AND DRAW OUT!!!!
- Review why it decreases CA++?? Type of receptor?
Other approaches to asthma
- targets bacterial ribosomes
- Can still effect human cells even if targeting bacterial ribosomes