Pulmonary Drugs Flashcards
Biochemical mechanism of beta2 agonists?
Activate adequate cyclamen–> increased cAMP
Short acting and long acting muscarinic antagonists?
Short acting: ipratropium
Long acting: tiotropium
Steroids by various routes?
Inhaled: beclomethasone, fluticasone, budesonide
Oral: prednisone
IV: methylprednisolone, hydrocortisone
Mechanism of steroids?
Inhibit synthesis of cytokines
Reduce expression of many interleukin, IFN-gamma, TNF-alpha, GM-CSF
INACTIVATION OF NF-KB
- transcription factor
- induces production of TNF-alpha
Describe the arachidonic acid pathway
Phospholipids are converted to arachidonic acid by phospholipase-A2
Lipooxygenase can turn arachidonic acid into leukotrienes
Cyclooxygenase can turn arachidonic acid into prostaglandins and thromboxanes
How do leukotriene receptor antagonists work?
They prevent leukotrienes binding to leukotriene receptors
Name some leukotriene receptor antagonists
Montelukast
All the -kast
Use of leukotriene receptor antagonists?
Useful in aspirin sensitive asthma since blockage of COX cause increased production of leukotrienes
How do 5-lipooxygenase inhibitors work?
The prevent the formation of leukotrienes by lipooxygenase
Name a 5-lipooxygenase inhibitor
Zileuton
Explain the mechanism of omazulimab
It is a monoclonal antibody
It inhibits IgE binding to IgE receptor on mast cells and basophils (since it is similar to an immunoglobulin)
Explain cromolyn, route and mechanism
Inhaler/nebuliser
Inhibits mast cell degranulation
Blocks release of histamine, leukotrienes
Name some methyxanthines
Theophylline
Aminophilline
How do methyxanthines work?
Antagonising adenosine receptors which reduces bronchoconstriction
Inhibiting phosphodiesterase which reduces breakdown of cAMP
Issues with theophylline?
Many drug drug interactions due to being metabolised by P450
