Week 3 Asthma ✅ Flashcards
Which mediators cause asthma?
IL-4 and IL-5
What does IL-4 activate?
IgE - which activates muscles
What does IL-5 activate?
Eosinophils
What are the two main drug aims in asthma?
Bronchodilation and reduce inflammation
What are the 6 steps in asthma management?
1) Short acting B2 agonist (SABA)
2) Regular preventer - low dose corticosteroid inhaler
3) Add-in therapy
Leukotriene antagonist or
Long acting B2 agonist (LABA)
4) Additional controller therapy
Theophylline or
Long acting muscarinic antagonist (LAMA)
5) Continuous corticosteroid
6) Monoclonal antibodies
What is an example of a SABA?
Salbutamol
How does SABA/salbutamol work?
Activation of adenylyl cyclase
ATP converts to cAMP
cAMP inctivates myosin light chain kinase and decreases intracellular calcium
Bronchodilation
What are the side effects of SABA?
Tolerance
Tachycardia
Hypokalaemia
Tremor
What is an example of a regular preventer?
Beclometasone or Fluticasone
What does Beclometasone do?
Inhibits inflammation and suppresses immunity
What are the side effects of Beclometasone?
Oral candidasis
Adrenal suppression
What is the benefit of Fluticasone over Beclometasone?
It is metabolised on FPM to avoid systemic suppression
What is an example of a leukotriene antagonist?
Montelukast
How does Montelukast work?
Acts at cell membrane, leukotriene slow releasing substance of anaphylaxis
What effect does Montelukast have?
Reduced airflow obstruction, bronchoconstriction, inflammatory cell infiltration and mucus secretion/accumulation
What is an adverse effect of Montelukast?
Diarrhoea, GI pain, nausea, vomiting, fever, headache
What is an example of LABA?
Salmeterol or Formeterol
What is important about using LABAs?
Needs to be used with corticosteroids - MART! Maintenance and reliever therapy
What is important about Theophylline?
Requires drug monitoring - narrow therapeutic window
What type of drug is Theophylline?
Adenosine receptor antagonist
What is the side effects of Theophylline?
Causes convulsions/arrhythmia
How does Theophylline work?
Inhibits phosphodiesterase - increases cAMP
What is an example of a LAMA?
Ipratropium
Atropine
Tiotropium
What is an example of a corticosteroid used to treat asthma?
Prednisolone
What happens if corticosteroids are given long term?
Can inhibit production of cortisol
What happens if you stop long term steroids suddenly?
Addisonian crisis
What are the side effects of corticosteroids?
Moon face
Skin thinning
Muscle wasting
Increased abdominal fat
H2O
Osteoporosis
Increased susceptibility to infection
What conditions can oral corticosteroids cause?
Diabetes
Hypertension
Mood swings
What is an example of monoclonal antibody used to treat asthma?
Mepolizumab
What does Mepolizumab inhibit?
IL-5
What are examples of H1 antihistamines?
Cetirizine
Loratdine
Fexofenadine
