Pharmacology of Asthma

Question 1

Isoproterenol

Type
Action
Adverse Effect
Delivery

Answer 1

Nonspecific beta agonist

Relaxes bronchial smooth muscle (B2). Major adverse effect is tachycardia due to B1 stimulation

We give this through IV

Question 2

Albuterol

Type
Action
Delivery

Answer 2

Specific B2 agonist

Relaxes bronchial smooth muscle B2. Use during acute asthma exacerbation.

Give via MDI or nebulizer

Question 3

Salmeterol

Type
Action
Adverse Effect
Delivery

Answer 3

Specific B2 agonist

Long acting agent for prophylaxis. Adverse effects are tremor and arrhythmia

MDI or nebulizer

Question 4

Theophylline

Type
Action
Adverse Effect
Delivery

Answer 4

Methylxanthine

Causes bronchodilation by inhibiting phosphodiesterase, thereby decreasing cAMP hydrolysis. Usage is limited because of narrow therapeutic index (abd pain, vomiting, seizures)

PO

Question 5

Ipratropium

Type
Action
Delivery

Answer 5

Muscarinic antagonists

Competitive block of muscarinic receptors, preventing bronchoconstriction

MDI or nebulizer

Question 6

Fluticasone, Beclomethasone, Prednisone

Type
Action
Adverse Effects
Delivery

Answer 6

Corticosteroids

Inhibit the synthesis of virtually all cytokines inactivates nf-kB which is the transcription factor that induces the production of TNF-a among other inflammatory agents. These can cause oral candidiasis, use mouthwash.

This is a first-line therapy for chronic asthma

MDI, nasal spray, or PO

Question 7

Cromolyn, nedocromil

Type
Action
Delivery

Answer 7

Mast cell stabilizers

Prevent release of mediators from mast cells. Effective only for the prophylaxis of asthma. Not effective during an acute asthma attack.

MDI or nebulizer

Question 8

Zileuton

Type
Action
Delivery

Answer 8

Antileukotriene

5-lipoxygenase inhibitor. Blocks conversion of arachidonic acid to leukotrienes

PO

Question 9

Zafirlukast, Montelukast

Type
Action
Delivery

Answer 9

Antileukotriene

Block CysLT1 leukotriene receptors. Especially good for aspirin-induced asthma

PO