Pharmacology of Asthma Flashcards

1
Q

what is the MOA of salbutamol?

A

agonist for B2 receptor on airway smooth muscle cells
reduces Ca2+ entry
prevents smooth muscle contraction

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2
Q

what is the drug target for salbutamol?

A

beta-2 adrenergic receptor on smooth muscle cells

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3
Q

what are the main side effects for salbutamol?

A

palpitations
tachycardia
arrhythmias
hypokalaemia at high doses

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4
Q

what class of drug is salbutamol?

A

SABA - short acting beta agonist

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5
Q

what is the MOA of fluticasone?

A

multiple actions on diff cells via glucocorticoid receptor
directly decreases inflammatory cells e.g eosinophils, monocytes, mast cells, macrophages, DCs
reduces cytokine release from these cells

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6
Q

what is the drug target for fluticasone?

A

glucocorticoid receptor

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7
Q

what are the local side effects for fluticasone?

A

sore throat
hoarse voice
opportunistic oral infections

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8
Q

what are the systemic side effects of fluticasone?

A
growth retardation in children
hyperglycaemia
decreased bone mineral density
immunosuppression
effects on mood
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9
Q

what is the MOA for mometasone?

A

multiple actions on diff cells
directly decreases inflammatory cells e.g eosinophils, monocytes, mast cells, macrophages, DCs
reduces cytokine release from these cells

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10
Q

what is the MOA for budesonide?

A

multiple actions on diff cells
directly decreases inflammatory cells e.g eosinophils, monocytes, mast cells, macrophages, DCs
reduces cytokine release from these cells

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11
Q

what is the drug target for mometasone?

A

glucocorticoid receptor

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12
Q

what is the drug target for budesonide?

A

glucocorticoid receptor

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13
Q

which drug out of fluticasone, mometasone and budesonide is less potent?

A

budesonide

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14
Q

what is the MOA of montelukast?

A

CysLT1 leukotriene receptor antagonist on eosinophils, mast cells and airway smooth muscle cells
causes decreased eosinophil migration, broncho-constriction and inflammation induced oedema

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15
Q

what is the drug target of montelukast?

A

CysLT1 leukotriene receptor

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16
Q

what are the main side effects of montelukast?

A
diarrhoea
fever
headaches
nausea/vomiting
mood changes
anaphylaxis
17
Q

how should montelukast be administered?

A

at least 2 hours before exercising as prophylaxis for exercise induced bronchoconstriction

18
Q

what is prescribed first for management

A

salbutamol - SABA

19
Q

what is prescribed if salbutamol is not keeping things under control

A

low dose inhaled corticosteroids

20
Q

what is prescribed if asthma not controlled by SABA and ICS

A

SABA
low dose ICS
plus montelukast or long acting beta agonist

21
Q

last resort of asthma management

A

oral steroids