Anti Asthma Drugs

Question 1

Anti asthma drugs types?

Answer 1

Long Term Management

Acute Relief

Question 2

Long Term Management Asthma drugs?

Answer 2

1. Corticosteroids
2. Leukotriene Pathway Inhibitor
3. Mast Cell Stabilizer
4. Anti-IgE Antibody

Question 3

Corticosteroids drugs?

Answer 3

– Fluticasone (most potent)

– Ciclesonide (long acting)

Question 4

Corticosteroids mechanism of action?

Answer 4

• Intracellular signalling molecule downregulating the expression of genes involved in the inflammatory response (↓ immune cell activation, ↓ leukocyte recruitment

• Increased expression of β2 receptors facilitating β2
adrenergist action (synergistic)

Question 5

Corticosteroids Side Effects & Contraindications?

Answer 5

• Local immunosuppression – candidiasis, dysphonia
• Systemic effects – more prone to infection
• Adrenal suppression, osteoporosis

Question 6

Leukotriene Pathway Inhibitor drugs?

Answer 6

Montelukast, Zafirlukast

• Limited use after advent of COX-2
inhibitors

Question 7

Leukotriene Pathway Inhibitor mechanism of action?

Answer 7

• Decreased leukotriene production esp in NSAID induced asthma where substrates are shunted to lipooxygenase and leukotriene pathway

Question 8

Leukotriene Pathway Inhibitor Side Effects & Contraindications?

Answer 8

Minimal

Question 9

Mast Cell Stabilizer drugs?

Answer 9

Cromolyn

Question 10

Mast Cell Stabilizer mechanism of action?

Answer 10

Downregulate mass cell activity and degranulation

by preventing IgE mediated activation

Question 11

Mast Cell Stabilizer Side Effects & Contraindications?

Answer 11

• Throat irritation and dryness

* Coughing

Question 12

Anti-IgE Antibody drugs?

Answer 12

Omalizumab

Question 13

Anti-IgE Antibody mechanism of action?

Answer 13

Reduce IgE levels in the body

Question 14

Anti-IgE Antibody Side Effects & Contraindications?

Answer 14

• Allergic reaction

* Expensive

Question 15

Acute Relief drugs?

Answer 15

1. β2 Adrenergist
2. Methylxanthine
3. Anti-muscarinics

Question 16

β2 Adrenergist drugs?

Answer 16

Salbutamol (Bronchiole smooth muscle relaxation, 3-6 hr)

Salmeterol (Maintenance/prevention, 12 hr)

Indacaterol (COPD only, 24 hr)

Question 17

β2 Adrenergist mechanism of action?

Answer 17

Direct agonism of β2 receptors in the airways leading to bronchodilation by
↑cAMP, ↑ [Ca2+], ↓MLCK activity,
↑K conductance

Question 18

β2 Adrenergist Side Effects & Contraindications?

Answer 18

• Fine muscular tremors and cramps
• Palpitations and tachycardia
• Hypokalemia, Hyperglycemia

Question 19

Methylxanthine drugs?

Answer 19

• Theophylline (similar structure to caffeine)

Question 20

Methylxanthine mechanism of action?

Answer 20

• Inhibits phosphodiesterase leading to decreased cAMP breakdown that facilitates bronchodilation

Question 21

Methylxanthine Side Effects & Contraindications?

Answer 21

• GIT disturbances: Vomiting, diarrhoea, dyspepsia
• CNS disturbances: nervousness
• CVS disturbances: arrhythmia

Question 22

Anti-muscarinics drugs?

Answer 22

• Ipatropium bromide, Tiotropium bromide

Question 23

Anti-muscarinics mechanism of action?

Answer 23

• Inhibits M3 muscarinic receptors preventing bronchoconstriction and mucus secretion

Question 24

Anti-muscarinics Side Effects & Contraindications?

Answer 24

• Dry mouth, unpleasant taste

* Urinary retention