4b- Other Resp Anti-Inflammatories

Question 1

What are the 4 categories of other anti-inflammatory agents?

Answer 1

1. Leukotriene Receptor Antagonists (LTRAs)
2. Anti-IgEs
3. Anti-Interleukins
4. Phosphodiesterase 4 Inhibitors (PDE4)

Question 2

What are Leukotrienes and how is arachidonic acid converted to leukotrienes?

Answer 2

• Chem mediators of inflammation
• Converted via lipoxygenase pathway

Question 3

How do Leukotrienes contribute? (4)

Recall: They are WORSE versions of histamines

Answer 3

1. Attract other inflammatory cells to an area
2. Cause bronchoconstriction
3. Increase airway sensitivity
4. Increase vascular permeability

Question 4

LTRA Drugs

What 2 drugs fall under this category?

Answer 4

1. Accolate (Zafirlukast)
2. Singulair (Montelukast)

Competitive Antagonists for leukotriene Receptors

Question 5

Accolate + SIngulair

What form do they come in? Who can they be used for?

Answer 5

• Form = Tablet
• Used for yound kids w/ asthma, when ICS not enough alone to treat it.

Question 6

IgE

What are IgEs?

Answer 6

Antibodies prod by B cells, after being presented with antigens

Question 7

How do IgEs work?

Answer 7

They attach to mast cells and wait around for antigens to show up.
- Once they show up, release inflammatory mediators

Question 8

Anti-IgE Drug

What drug falls under this category?

Answer 8

Xolair (Omalizumab)

Question 9

Xolair (Omalizumab)

How does it work? How often is it given?

Answer 9

• Targets someone’s IgE antibodies (binds to free ones, before they attach to mast cells)
• Given –> Subcutaneously injected Q2-4weeks

Q=every

Question 10

Interleuins

What are they?

Answer 10

A cytokine (signal protein) that helps control inflammation in the body.
- Ex: Interleukin 5

Question 11

How does Interleukin 5 affect eosinophils?

Answer 11

1. Recruite more
2. ↑their production
3. ↑Their survival time

Question 12

Anti-Interleukin Agents

How do anti-interleukin agents work?

Answer 12

1. Bind to IL-5 as it goes throughout the body, creating differently shaped complex.
2. Bind to IL-5 receptors directly, occupying receptor site.

Question 13

Anti-Interleukin Drugs

What 2 drugs bind to FREE CIRCULATING IL5s?

N+C

Answer 13

1. Nucula (Mepolizumab)
2. Cinqair (Reslizumab)

Question 13

Anti-Interleukin Drugs

What drug binds to IL5 RECEPTORS DIRECTLY?

Answer 13

Faserna (Benralizumab)

Question 14

what do PDE-4s do?

Answer 14

Promote release of pro-inflammatory mediators

Question 15

PDE4 Inhibitors

What drug falls under this category? What does it do?

Answer 15

• Drug –> Duxas (Roflumilast)
• Blocks PDE-4 to decrease pro-inflammatory mediator release

Question 16

What form are they given in? What are its 2 negative side effects?

Answer 16

• Tablet form (once daily)
• Side effects –> Severe diarrhea + Suicidal thoughts