respiration medications 2

Question 1

Anti-inflammatory agents

Answer 1

Mast cell stabilisers

Corticosteriods

Question 2

Mast cell stabilisers

Answer 2

• Inhibit release of inflammatory
mediators from cells in the respiratory
tract
• Nedocromil sodium [Tilade]
• MDI
• Recombinant monoclonal antibody
that selectively binds to IgE (thought
to be responsible for degranulation of
mast cells releasing histamines,
leukotrines, cytokines and other
mediators)
• Omalizumab [Xolair]
• Injectable s/c

Question 3

Corticosteriods

Answer 3

• Inhibit inflammatory cells and prevent
release of inflammatory mediator
• Inhibit late bronchoconstrictor
response cause by allergen exposure
• Reduce mucus hyper-secretion

Question 4

Leukotriene Receptor Antagonists

Answer 4

• Specifically inhibit leukotrienes
LTC4, LTD4 and LTE4 that are
potent pro-asthmatic mediators
• Prevent bronchoconstriction
• Prevent smooth muscle
contraction of the bronchial
airways
• Decrease mucus secretion
• Prevent vascular permeability
• Decrease neutrophil and
leukocyte infiltration to the
lungs preventing inflammation
• Montelukast sodium (Singulair)

Question 5

Other medications used

for asthma

Answer 5

Mepolizumab (Nucala)

Question 6

Mepolizumab (Nucala)

Answer 6

• Monoclonal antibody that targets
interleukin 5 responsible for
growth, differentiation,
recruitment, activation and
survival of eosinophils
• Adjunct therapy for severe
refractory eosinophilic asthma
• s/c injection every 4 weeks

Question 7

Antitussives (cough

suppressants)

Answer 7

• Central or peripheral
action on the cough reflex
to suppress unproductive
coughs
• There are many OTC
preparations
• Codeine works well to
suppress cough but also
decreases mucociliary
clearance and secretions

Question 8

Expectorants

Answer 8

• Increase fluidity of
secretions
• Some expectorants are
thought to have an irritant
effect on the gastric
mucosa and reflex
stimulation of bronchial
goblet cells and
submucosal glands
• Limited evidence of
clinical benefit

Question 9

Mucolytics

Answer 9

• Break/alter the structure
of mucous by disrupting
the disulfide bonds and
breaking the mucous
chains to decrease
viscosity
• Ensure patients are well
hydrated (unless contraindicated) to facilitate
expectoration of mucous

Question 10

Antihistamines

Answer 10

• Histamine is the major mediator of inflammation,
anaphylaxis and gastric acid secretion. Mast cells are
found in large numbers in bronchial muscle

Question 11

There are 4 types of histamine receptors. H1 receptor

antagonists

Answer 11

are commonly referred to as

‘antihistamines’ and use to treat allergic disorders

Question 12

Antihistamine
General mechanism of action
General adverse effects

Answer 12

• Blocks the main action of histamine at H1 receptors
• Sedation, decreased motor skills and coordination,
fatigue, dizziness, insomnia (more common in first
generation antihistamine drugs)
• Dry eyes, nose and mouth, blurred vision, urinary
hesitancy/retention, constipation, tachycardia

Question 13

Antihistamines Examples

Answer 13

• Cetirizine, Loratadine, Dexchlorpheniramine,

Promethazine