treatment and monitoring of asthma Flashcards
short acting B2 agonists
eg salbutamol
stimulation of B2-receptors on airway smooth muscle
adverse effects
-fine tremor, nervous tension, headache,tachycardia
-HYPOkalaemia at high doses
methylxanthines
eg theophylline -inhibits phosphodiesterase -additive effect when used in conjunction with small does of B2 agonists -given orally or by very slow I/v infusion -hepatically metabolised adverse effects -nausea,headache,insomia -toxic effects above 25mg/L
antimuscarinics
eg ipratropium
-block muscarinic receptors
-administered by inhalation (maximal effect occurs 30-60 mins after use,duration of action 3-6 hours)
adverse effects
-dry mouth,constipation,diarrhoea,cough ,headache
preventers
corticosteroids
leukotriene receptor antagonists
cromones
corticosteroids
eg beclometasone
-reduce bronchial inflammatory reactions eg oedema
-metered inhalation
-must be used regularly
fewer systemic effects, but
-hoarse voice,reflex cough, oral candidiasis
corticosteroids oral therapy
prednisolone -acute attacks -chronic asthma -taken as single dose in morning hydrocortisone I/v injection in emergency treatment of severe acute asthma
leukotriene-receptor antagonists
- block effects of cysteine leukotrienes in airways
- effective in late phase response
- well tolerated
cromones
eg sodium cromoglicate
-mechanism of action is unclear
-prophylactic drug-of NO VALUE in acute attacks
-must be withdrawn gradually over 1 week
adverse effects may be prohibitive
long acting B2 agonists
eg salmeterol
- for use with regularly inhaled corticosteroid
- role in long-term control of chronic asthma
- NOT typically used for relief of an asthma attack
monoclonal antibodies
eg omalizumab
- recombinant humanised monoclonal antibody
- selectively binds to IgE forming a complex
