asthma

Answer 1

Question: How do Beta2-Adrenergic Agonists (e.g., Salbutamol, Terbutaline, Salmeterol, Formoterol, Vilanterol) work in the treatment of asthma and COPD?
Answer:

Class: Beta2-Adrenergic Agonists (Short and Long Acting)

Mechanism:

Stimulate beta-2 receptors on smooth muscle cells in the bronchi.

Activation increases cAMP levels, leading to bronchodilation (relaxation of the bronchial muscles), which helps relieve symptoms like wheezing, shortness of breath, and tightness.

Use:

Relief therapy for mild asthma (treats symptoms but not the underlying condition).

First-line treatment for COPD.

Side Effects:

Tremor, tachycardia, hypokalemia (especially at high doses).

Caution in patients with hyperthyroidism, CVD, and arrhythmi

Answer 2

Question: How do Anticholinergics like Ipratropium Bromide, Umeclidinium, and Tiotropium work in treating asthma and COPD?
Answer:

Class: Anticholinergics (Short and Long Acting)

Mechanism:

Block the action of acetylcholine at muscarinic receptors in smooth muscle, glands, and CNS.

This leads to bronchodilation and reduced glandular secretion (dry mouth, reduced mucus production).

Use:

Adjunct to beta-2 agonists in treating asthma.

Maintenance therapy for COPD.

Side Effects:

Constipation, cough, dizziness, dry mouth, headache, nausea.

Caution in glaucoma, prostatic hyperplasia, and pregnancy.

Answer 3

Question: What are Inhaled Corticosteroids like Beclometasone, Fluticasone, and Budesonide used for?
Answer:

Class: Inhaled Corticosteroids

Mechanism:

Reduce airway inflammation and prophylaxis for asthma.

Asthma symptoms management when short-acting beta-2 agonists are used frequently or symptoms persist.

Use:

Asthma prophylaxis, especially for frequent symptoms (e.g., 3 times a week or more).

Side Effects:

Oral candidiasis, hoarse voice, dysphonia (difficulty speaking).

Long-term use increases risk of pneumonia and bone fractures.

Answer 4

Question: How do Theophylline and Aminophylline help with chronic asthma?
Answer:

Class: Methylxanthine

Mechanism:

PDE inhibition increases cAMP levels, leading to smooth muscle relaxation (bronchodilation).

Adenosine receptor antagonism reduces bronchoconstriction.

Mild anti-inflammatory effect in airways.

CNS stimulant effect to increase alertness and reduce fatigue.

Use:

Chronic asthma management.

Side Effects:

Nausea, vomiting, tremor, insomnia, tachycardia.

Smoking increases metabolism, requiring higher doses and regular serum monitoring.

Note: Plasma levels of theophylline should be between 10-20 mg/L.

Answer 5

Question: What is the role of Sodium Cromoglycate and Nedocromil Sodium in treating respiratory conditions?
Answer:

Class: Mast Cell Stabilizers

Mechanism:

Unclear, but believed to stabilize mast cells by reducing calcium influx and preventing the release of inflammatory mediators.

Use:

For allergic reactions like itchy eyes (allergic rhinitis, allergic conjunctivitis).

Useful in young patients (<20 years old) with significant allergic disease.

Side Effects:

Cough, dry mouth, headache.

Note: These drugs are no longer used in the UK due to limited effectiveness and availability.

Answer 6

Question: How do Leukotriene Receptor Antagonists like Montelukast and Zafirlukast help with asthma?
Answer:

Class: Leukotriene Receptor Antagonists (LTRA)

Mechanism:

Block leukotrienes from binding to CysLT1 receptors in smooth muscle and inflammatory cells.

Leukotrienes are inflammatory mediators that cause bronchoconstriction, mucus production, and increased vascular permeability during allergic reactions.

Use:

Asthma prophylaxis and symptomatic relief for seasonal allergic rhinitis in patients with asthma.

Side Effects:

GI disturbance, dry mouth, headache.

Caution in elderly, pregnancy, and Churg-Strauss syndrome.