Pharmacology

Question 1

What are relievers? give an example

Answer 1

act as bronchodilators

e.g. Short acting B2 Adrenoceptor agonists (SABAS), long acting B2 Adrenoceptor agonists

(blue inhaler)

Question 2

What are controllers/preventors? give an example

Answer 2

act as anti-inflammatory agents that reduce airway inflammation

e.g. Glucocorticoids, Cromoglicate, Humanized monoclonal IgE antibodies

(brown inhaler)

Question 3

Humanized monoclonal IgE antibodies

Answer 3

prevents

Question 4

How is mild asthma treated

Answer 4

1. a short acting B2 adrenoceptor agonist
2. if it is needed more than once a day. add a regular glucocorticoid
3. if control is inadequate, add a long acting B2 adrenoceptor agonist
4. if this is still badly controlled. increase dose of ICS, add another drug

Question 5

compare the pharmokinetics of aerosol and oral therapy

Answer 5

Aerosol = slow absorption from lung surface and rapid systemic clearance

Oral = good absorption and slow clearance

Question 6

what do B2 adrenoceptor agonists do

Answer 6

they act as physiological antagonists of all spasmogens

they cause relaxation by the phosphorylation of MLCK and myosin phosphatase

Question 7

state 2 main mechanisms to cause relaxation

Answer 7

1. activate beta adrenoreceptor

2. inhibit phosphodiesterase

Question 8

name the two types of B2 adrenoreceptor agonists

Answer 8

short-acting SABA e.g. salbutamol

long-acting LABA e.g.

Question 9

describe short acting agents (SABAs)

Answer 9

• first line treatments
• relievers taken as needed
• usually administered by inhalation
• increase mucus clearance and decrease mediator release from mast cells and monocytes

Question 10

what are the benefits of inhalation

Answer 10

lessens systemic efects

Question 11

why would SABAs be administrated by IV?

Answer 11

in emergencies e.g. treatment of life threatening athsma attack

Question 12

why would SABAs be administrated orally?

Answer 12

for children

Question 13

how quickly does it take for SABAs to take effect?

Answer 13

takes 5 mins for them to relax, max effect within 30 mins, persists for 3-5 hrs

Question 14

what are the effects of SABAs on the immune system?

Answer 14

• increase mucus clearance and decrease mediator release from mast cells and monocytes

Question 15

name adverse affects of SABAs

Answer 15

fine tremor - B agonist tremor

but tachycardia, cardiac dysrhythmia and hypokalemia can also occur

Question 16

Describe the differences between B-agonists and CysLT receptor antagonists

Answer 16

B-agonists are specific

Cyst’s act systemically

Question 17

Name two types of CysLT1 receptor antagonists

Answer 17

Montelukast

Zafirlukast

Question 18

Name a type of Slow acting B-agonist

Answer 18

Salbutamol

Question 19

Name two types of long-acting B-agonist

Answer 19

Salmenterol

Formoterol

Question 20

How are CysLt1’s administered

Answer 20

Orally

Question 21

Actions of Xanthines

Answer 21

• increase diaphragmatic contractility and reduce fatigue

- combine bronchodilator and anti-inflammatory actions

Question 22

Why are xanthines not often used?

Answer 22

They have a very narrow therapeutic window - the ideal dose is very close to a toxic level that can cause

• dysrhythmia
• seizures
• hypotension

they also interact with lots of enzymes involved with drug metabolism

Question 23

Name two types of Corticosteroids

Answer 23

Glucocorticoids

Mineralocorticoids

Question 24

what do mineralocorticoids do

Answer 24

they regulate the retention of salt and water by the kidney

Question 25

How can glucocorticoids be delivered to minimize adverse systemic effects?

Answer 25

they can be delivered by the inhalation route rather than the oral route

Question 26

what do glucocorticoids do

Answer 26

increase transcription of genes encoding anti-inflammatory proteins decrease transcription of genes encoding inflammatory proteins