Respiratory Pharmacology Flashcards
What are the aims for asthma control?
Minimal symptoms during day + night Minimal need for reliever medication No exacerbations No limitation of physical activity Peak flow >80% predicted
What is the stepwise management for asthma in adults?
Low dose ICS
SABA + low dose ICS
LABA + low dose ICS
Increase ICS dose OR add LTRA
What is the stepwise management for asthma in children?
Very low dose ICS
SABA + very low dose ICS
Very low dose ICS + (>5) LABA/LTRA OR (<5) LTRA
Low dose ICS + LABA/LTRA
What are the commonly used SABAs?
Salbutamol
Terbutaline
What is the mechanism of SABAs?
Cause bronchodilation by agonising B2 receptors in the lungs
What are examples of LABAs?
Salmeterol
Formoterol
What are the side effects of B agonists?
Tachycardia
Palpitations
Tremor
What are examples of ICSs?
Beclomethasone
Budesonide
Fluticasone
What is the mechanism of ICSs?
Prevent IL-1 + IL-6 production by macrophages
Reduce inflammation
What are the side effects of ICSs?
Dry mouth
Nausea (if swallowed)
Headache
Oral candidiasis
What should you check before you add a new drug?
Re-check compliance
Check inhaler technique
Eliminate trigger factors
What are examples of LTRAs?
Montelukast
Zafirlukast
What is the mechanism of LTRAs?
Block effect of cysteinyl leukotrienes in the airways at CysLT1 receptor
Prevents LTC4 release by mast cells and eosinophils
Prevents
- Bronchoconstriction
- Mucus secretion
- Mucosal oedema
- Inflammatory cell recruitment
What are the side effects of LTRAs?
Angioedema Dry mouth Anaphylaxis Arthralgia Fever GI disturbances Nightmares
What are the drugs can be used for asthma?
Methylxanthines LAMAs (long acting anticholinergics)