Resp Drugs

Question 1

Examples of Bronchodilators (Relievers)

Answer 1

B2- adrenoceptors agonists

CysLT1 receptor antagonist

Question 2

Example of B2 adrenoceptors agonists

Answer 2

Short acting ( SABA)- salbutamol

Long acting (LABA)- salmetarol

Question 3

M.O.A of SABA (salbutamol)
Side effects of SABA

Answer 3

M.O.A:
Stimulate bronchial smooth muscle B2- adrenoceptors. ↑CAMP ↑PKA, Relaxation Act rapidly (max effect 30 mins)

Side effect:
Tremor, tachycardia, arrhythmias, hypokalaemia.
Lactic Acidosis

Question 4

Give M.O.A LABA (Salmetarol)

Answer 4

M.O.A:

Stimulate bronchial smooth muscle B - 2
adrenoceptors. ↑cAMP ↑PKA, Relaxation NOT for acute relief

Question 5

Why is LABA given as second line and not SABA

(Like name the difference)

Answer 5

LABA is more lipophilic than SABA

Question 6

Examples of CysLT1 receptors antagonist

Answer 6

Montelukast
Zafirlukast

Question 7

M.O.A and side effect of Montelukast

Answer 7

M.O.A:

Antagonise Cysteinyl leukotriene receptors. CysLTs (LTC4, LTD4 and LTE4) derived from inflammatory cells, contraction of ASM, Oedema, ↑mucus, ↑eosinophils. Relax ASM.

Side effect:
Headaches, abdo pain

Question 8

Examples of anti-inflammatory (controllers/ preventers)

Answer 8

Corticosteroids- (glucocorticoids)

Cromones

IgE antibodies

Question 9

Glucocorticoids

Give me example of oral and inhaled steroid

Answer 9

Prednisone-oral

Beclomethasone- inhaled

Question 10

Example of cromones (inhaled)

Answer 10

Sodium cromoglicate

Cromoglicate

Question 11

Example of IgE antibodies

(Anti- inflammatory anti-IgE monoclonal antibody)

Answer 11

Omalizumab (injection every 2-4 week, V. Expensive)

Question 12

M.O.A of sodium cromoglicate

Answer 12

Mast cell stabiliser (suppress histamine release).
Reduction of cytokines release

Question 13

M.O.A of Omlizumab

Answer 13

Inhibits binding to high affinity IgE receptor.
Mediator release from basophils and mast cells.

Question 14

Bronchodilators
(Competitive muscranic receptor antagonist )

Answer 14

ipatropium (SAMA)
tiotropium, Aclidinum (LAMA)

Question 15

M.O.A of Ipatropium

Answer 15

Ipratropium (non-selective blocker of M1, M2, M3 receptors. M3 muscarinic receptors mediate contraction of ASM.

Question 16

M.O.A of Tiotropium

Answer 16

Tiotropium selective for M3. Longer 1⁄2 life than ipratropium.

Question 17

Anti- inflammatory
(PDE4 inhibitor)

Answer 17

Rofumilast (oral)

Question 18

M.O.A of Rofumilast

Answer 18

Selective PDE4 inhibitor. PDE4 = expressed in neutrophils, T cells and macrophages.

Question 19

Mucolytics example

Answer 19

Oral Carbocisteine

Oral Erdosteine

Question 20

Prednisilone (oral steroid)

Answer 20

Low therapeutic ratio (good efficacy) Signal via nuclear receptors, bind to glucocorticoid response elements (GRE), gene transcription (↑anti-inflammatory, ↓inflammatory).
↓cytokines, prevent IgE antibody production, ↓mast cells, prevent allergen influx

Question 21

Beclomethasone (inhaled steroid)

Answer 21

Direct into lungs

Low therapeutic ratio (good efficacy) Signal via nuclear receptors, bind to glucocorticoid response elements (GRE), gene transcription (↑anti-inflammatory, ↓inflammatory).
↓cytokines, prevent IgE antibody production, ↓mast cells, prevent allergen influx