Treatment for Obstructive disease Flashcards
Omalizumab
Binds to the IgE and prevents it from binding to the receptor. So it will reduce the inflammation and allergic response in the body.
Monoclonal antibody
NSAIDS
Inhibits the pathway of Cox
Zileuton
Inhibits the enzyme 5-lipoxygenase
preventing the synthesis of Leukotrienes
Short in duration of action and hepatotoxicity.
“Lukast”
Montelukast
Zafirlukast
Leukotriene receptor antagonists (LTRAs). Acts on Cyst-LT receptors
Which reduces the inflammatory response and bronchoconstriction
Used as a prophylactic agent.
Short acting Sympathomimetics
bronchodilator
Salbutamol, Albuterol, Terbutaline, Orciprenaline
Terbutaline is the only one that is Subcutaneous injection.
Long acting Sympathomimetics
bronchodilator
Salmetrol, Formoterol , indacaterol and Vilanterol
LOS -rol EXCEPT ALBUTEROL
Should NOT be use in the acute bronchospasm because they are slow in action.
High lipid solubility that interacts with corticosteroids to improve asthma.
Anti- cholinergic/ Muscarinic antagonist
Bronchodilator
Short acting: Ipratropium bromide
Long acting: tiotropium and Umeclidinium
Competitively inhibits the effect of acetylcholine at Muscarinic receptor 3 (M3).
Blocks only the vagal reflex- Bronchoconstriction and secretion.
Use for elderly
Use in triple therapy
They are the drug choice in bronchoconstriction caused by beta blockers.
Causes headaches, dizziness, nausea and dry mouth.
Methyl Xanthines
bronchodilator
“phylline”
Theophylline - Can cause hypotension which leads to reflex tachycardia.
Etophylline
Aminophylline
Non-selective Inhibition of Phophodiesterase to prevent the break down of cAMP.
Adenosine receptor antagonist- because adenosine stimulates the release of Ca for smooth muscle contraction.
Adverse effects can cause
1. Cardiac arrthymias
2. Seizures
3. Diuresis
Corticosteroids
Systemic: hydrocortisone, prednisolone
Inhaled: beclomethasone, budesonide, ciclesonide, flunisolide, mometasone and Tramcinolone
Most effective controller therapy
Reduces inflammation by inhibiting Phospholipase A2
No production of Arachidonic acid
Inhibition of the infiltration of asthmatic airway by lymphocytes, eosinophil and mast cell.
Upregulates expression of beta adrenergic receptor
Inactivate NF-kB
Mast cell stabilizers
Sodium chromoglycate
Nedocromil sodium
Have no effect on the airway smooth muscle tone. No bronchodilator action.
Inhibit the mast cell degranulation
Anti histamine
Cetirizine, loratadine, azelastine
Mechanism Of action of beta agonist
B agonist is gonna stimulate Beta 2 receptor in the smooth muscle of the lung.
Is a GPCR= stimulates adenyl cyclase - increases cAMP which inhibits Ca release in the smooth muscle and causes dilatation.
Adverse effects of Beta agonist
- Tolerance
- Skeletal muscle tremors
- Tachycardia and cardiac arrhythmias
- Hypokalemia
- Hyperglycemia- due to the release of glucagon. treated with insulin.
Adverse effect of corticosteroids
Oropharyngeal Candida
Hoarseness
cough
Dysphonia
Osteoporosis
adrenal supresssion
peptic ulcer
diabetes
cataracts
brushing psychosis
Recommend oral rinsing
Use of anti fungal like Nystatin
Anti IL-5 monoclonal therapy
Prevents the Eosinophils differentiation, maturation and activation.
Anti-IL-5 monoclonal antibodies work by binding to IL-5, thereby preventing it from interacting with its receptor on eosinophils.
For maintenance therapy
Mepolizumab, reslizumab- against IL-5
Benralizumab- Against IL-5 receptor alpha
Roflumilast
Selective phosphodiesterase 4 inhibitor
Used to decrease the effects on COPD patients.
