Respiratory Flashcards
Name the two categories of asthma drug
Relievers and preventers
Name 3 classes of asthma reliever
B2-adrenoreceptor agonist
Methyl Xanthines
Anti-muscarinics
Name 4 examples of B2-agonists
Short acting (Salbutamol, Rimiterol) Long acting (Salmeterol, Formoterol)
How do B2-agonists work?
Cause bronchodilation and decreased mucus secretion (sympathetic innervation)
adenylyl cyclase->cAMP, less Ca2+
Inhibition of mediator release from mast cells+monocytes
What are the side effects of B2 adrenoreceptor agonists?
Down regulation of receptors,
hypokalemia (cAMP fuels Na+/K+ pump)
skeletal muscle tremor, restlessness, cardiac arrhythmia (rare), tachycardia, palpitations, nervous tension
How does Salmeterol work?
Binds to an exosite via a flexible tail so repeatedly stimulates B2 adrenoreceptor
Useful for nocturnal asthma
How does Formoterol work?
Dissolves in plasma membrane and diffuses out to stimulate the receptor (slowly released) s long acting B2 agonist
What is Rimiterol?
Short acting B2-agonsit for treatment of asthma
How do methyl xanthines work?
Inhibits breakdown of cAMP by phosphodiesterases so bronchodilation and inhibition of mast cell activation occurs
Name 2 Methyl Xanthines and their administration
Theophyline- slow release oral (narrow therapeutic index)
Aminophyline (IV)
Side effects of Theophyline?
Nausea, insomnia, dysrhythmia, convulsions, headache (similar to caffeine)
What is Aminophyline?
An IV Methyl Xanthine to relieve asthma sufferers
How do anti muscarinics work?
Block ACh at M1&M3 muscarinic receptors so block parasympathetic action of bronchoconstriction and mucus hypersecretion
What are the problems with antimuscarinics for asthma?
Low efficacy- used with other drugs
Only side effect= dry mouth
Give 3 examples of anti-muscarinics
Ipratropium, Oxitropium, Tiotropium (aTROPIne like)
Name 4 classes of asthma preventer drugs
Corticosteroids, Cromones, Anti-Leukotrienes, Anti-IgE
What corticosteroids are inhaled daily in moderate asthma?
Beclomethasone, Budesonide, Fluticasone
What oral corticosteroid is given in severe asthma?
Prednisolone
In status asthmaticus, what corticosteroid is given and how?
IV Hydrocortisone
Name 2 Cromones and their side effects
Sodium Cromoglycate Nedocromil Sodium (inhaled as dry powder so coughing and transient bronchospasm)
How do Cromones work?
Prevents degranulation of mast cells so protects against immediate bronchoconstriction induced by allergens
Inhibits Bcell switching to IgE production and inhibits eosinophil accumulation in lungs
How do Anti-Leukotrienes work?
Antagonsit of Cys-Leukotriene receptors on smooth muscle and eosinophils
Inhibits bronchoconstriction induced by Cys-LT & LTC4
Reduces eosinophilia and mucus secretion
Side effects of anti-leukotrienes?
GI upset and headache (minimal)
Name 3 Anti-Leukotrienes
Montelukast, Zafirlukast and Zileuton
Name the Anti-IgE drug
OMALIZUMAB (Xolair)
How do anti-IgE drugs work?
Antibody against IgE so binds to IgE in plasma and prevents mast cell degranulation
The complex is then excreted
What is Omalizumab?
Anti IgE drug for treatment of asthma
