pharmacology of asthma Flashcards
what are the four main pharmacological therapies for asthma
bronchodialators, inhaled corticosteroids, leukotriene receptor antagonists, monoclonal antibodies targeting eosinophillic inflammation
what are the main goals of asthma treatment
to reduce impairment to life, minimise risks e.g exacerbations
what is the difference between a reliever and controller in asthma treatment
reliver short term e.g broncho dialoator, controller long term e.g ics
outline how you treat asthma using stepwise management
- consider low dose controller. SABA
- low dose ics and saba
- low dose ICS/LABA, SABA or formoterol
- med or high dose ICS LABA and SABA/formeterol
- Refer for add on treatment anti ige e.g tiotropium, SABA/ics formetrol and low dose ocs of ics
how would you manage a patient with infrequent asthma symptoms of short duration, no risk factors for exacerbations and no night waking due to asthma
SABA
name some selective beta adrenoreceptor agonists
sahort term salbutamol, long acting formoterol, salmeterol, vitanterol. can be given iv
name anticholinergic/muscarinic antagonists
Inhaled
– Short-acting: Ipratropium
– Long-acting: Tiotropium, Umeclidinium
how long does salbutamol act for
Overall duration of action of salbutamol is 4-6 hours. takes 3-5 mins to kick in when inhaled
how do anticholinergic muscarinic antagonists work
Block effects of ACh released from cholinergic parasympathetic nerve
fibres to smooth muscle & mucus glands
– Prevents airway smooth muscle contraction
– Prevents mucus hypersecretion
• Less effective than β-2 adrenoceptor agonists
how does tiotropium work
long lasting, Tiotropium attenuates IL-13-induced goblet cell metaplasia and
potentially reduced mucus hypersecretion
what does ics therapy do for asthma patient outcomes
reduces symptoms, increase lung function, improves quality of life, reduces exacerbation risk.
how does ics work act on the body
Corticosteroids suppress Th2 / ‘Type 2’ airways inflammation
– reduce the infiltration and activation of eosinophils, Th2 cells, and
other inflammatory cells
what does having elevated blood eosinophil levels mean for asthma patients
more exacerbations and lower asthma control
What is fluticasone furoate
long acting ics fast association and slow disassociation. long duration of action and retained so can be used once daily. in severe asthma
what does ocs stand for
oral corticosteroids