Pharmacology of asthma

Question 1

What are the asthma medications?

Answer 1

-Salbutamol
-Fluticasone
-Mometasone
-Budesonide
-Montelukast

Question 2

What is the primary mechanism of action of salbutamol?

Answer 2

-Agonist at beta 2 receptor on airway smooth muscle cells
-Reduces Ca2+ entry preventing smooth muscle contraction

Question 3

What is the drug target of salbutamol?

Answer 3

Beta 2 adrenergic receptor in airway smooth muscle

Question 4

What are the main side effects of salbutamol?

Answer 4

-Palpitations/agitation
-Tachycardia/arrythmias
-Hypokalaemia (at higher doses)

Question 5

What type of drug is salbutamol?

Answer 5

Short acting beta agonist (SABA)

Question 6

How selective is salbutamol?

Answer 6

Not completely selective to beta 2 receptors so some cardiac (beta 1) effects can be seen

Question 7

What is the primary mechanism of action of fluticasone?

Answer 7

-Directly decreases inflammatory cells and the cytokine they produce

Question 8

What are examples of the inflammatory cells salbutamol reduces?

Answer 8

-Eosinophils
-Monocytes/macrophages
-Mast cells
-Dendritic cells

Question 9

What is the drug target for fluticasone?

Answer 9

Glucocorticoid receptor

Question 10

What are the main local side effects for fluticasone?

Answer 10

-Sore throat
-Hoarse voice
-Opportunistic oral infections

Question 11

What are some systemic side effects of fluticasone?

Answer 11

-Growth retardation in children
-Hyperglycaemia
-Decreased bone mineral density
-Immunosuppression
-Effects on mood

Question 12

Can fluticasone and mometasone replace cortisol in glucocorticoid receptors?

Answer 12

Yes as fluticasone has a greater affinity for glucocorticoid receptors than cortisol

Question 13

What is the primary mechanism of action of mometasone?

Answer 13

-Directly decreases inflammatory cells and the cytokine they produce

Question 14

What are examples of the inflammatory cells mometasone reduces?

Answer 14

-Eosinophils
-Monocytes/macrophages
-Mast cells
-Dendritic cells

Question 15

What is the drug target for mometasone?

Answer 15

Glucocorticoid receptor

Question 16

What are the main local side effects of mometasone?

Answer 16

-Sore throat
-Hoarse voice
-Opportunistic oral infections

Question 17

What are the main systemic side effects of mometasone?

Answer 17

-Growth retardation in children
-Hyperglycaemia
-Decreased bone mineral density
-Immunosuppression
-Effects on mood

Question 18

What is the primary mechanism of action of budesonide?

Answer 18

-Directly decreases inflammatory cells and the cytokine they produce

Question 19

What are examples of the inflammatory cells budesonide reduces?

Answer 19

-Eosinophils
-Monocytes/macrophages
-Mast cells
-Dendritic cells

Question 20

What is the drug target of budesonide?

Answer 20

Glucocorticoid receptors

Question 21

What are the main local side effects of budesonide?

Answer 21

-Hoarse voice
-Opportunistic oral infections

Question 22

What are the main systemic side effects?

Answer 22

-Growth retardation of children
-Hyperglycaemia
-Decreased bone mineral density
-Immunosuppression
-Effects on mood

Question 23

What is the primary mechanism of action of montelukast?

Answer 23

-Antagonism of CysLT1 leukotriene receptor on eosinophils, mast cells and airway smooth muscle cells
-Decreases esoinophil migration, bronchoconstriction and inflammation induced oedema

Question 24

What is the drug target of montelukast?

Answer 24

CysLT1 leukotriene receptor

Question 25

What are the mild side effects of montelukast?

Answer 25

-Diarrhoea
-Fever
-Headaches
-Nausea or vomiting

Question 26

What are the serious side effects of montelukast?

Answer 26

-Mood changes
-Anaphylaxis