Week 3 Asthma ✅

Question 1

Which mediators cause asthma?

Answer 1

IL-4 and IL-5

Question 2

What does IL-4 activate?

Answer 2

IgE - which activates muscles

Question 3

What does IL-5 activate?

Answer 3

Eosinophils

Question 4

What are the two main drug aims in asthma?

Answer 4

Bronchodilation and reduce inflammation

Question 5

What are the 6 steps in asthma management?

Answer 5

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

Question 6

What is an example of a SABA?

Answer 6

Salbutamol

Question 7

How does SABA/salbutamol work?

Answer 7

Activation of adenylyl cyclase
ATP converts to cAMP
cAMP inctivates myosin light chain kinase and decreases intracellular calcium
Bronchodilation

Question 8

What are the side effects of SABA?

Answer 8

Tolerance
Tachycardia
Hypokalaemia
Tremor

Question 9

What is an example of a regular preventer?

Answer 9

Beclometasone or Fluticasone

Question 10

What does Beclometasone do?

Answer 10

Inhibits inflammation and suppresses immunity

Question 11

What are the side effects of Beclometasone?

Answer 11

Oral candidasis
Adrenal suppression

Question 12

What is the benefit of Fluticasone over Beclometasone?

Answer 12

It is metabolised on FPM to avoid systemic suppression

Question 13

What is an example of a leukotriene antagonist?

Answer 13

Montelukast

Question 14

How does Montelukast work?

Answer 14

Acts at cell membrane, leukotriene slow releasing substance of anaphylaxis

Question 15

What effect does Montelukast have?

Answer 15

Reduced airflow obstruction, bronchoconstriction, inflammatory cell infiltration and mucus secretion/accumulation

Question 16

What is an adverse effect of Montelukast?

Answer 16

Diarrhoea, GI pain, nausea, vomiting, fever, headache

Question 17

What is an example of LABA?

Answer 17

Salmeterol or Formeterol

Question 18

What is important about using LABAs?

Answer 18

Needs to be used with corticosteroids - MART! Maintenance and reliever therapy

Question 19

What is important about Theophylline?

Answer 19

Requires drug monitoring - narrow therapeutic window

Question 20

What type of drug is Theophylline?

Answer 20

Adenosine receptor antagonist

Question 21

What is the side effects of Theophylline?

Answer 21

Causes convulsions/arrhythmia

Question 22

How does Theophylline work?

Answer 22

Inhibits phosphodiesterase - increases cAMP

Question 23

What is an example of a LAMA?

Answer 23

Ipratropium
Atropine
Tiotropium

Question 24

What is an example of a corticosteroid used to treat asthma?

Answer 24

Prednisolone

Question 25

What happens if corticosteroids are given long term?

Answer 25

Can inhibit production of cortisol

Question 26

What happens if you stop long term steroids suddenly?

Answer 26

Addisonian crisis

Question 27

What are the side effects of corticosteroids?

Answer 27

Moon face
Skin thinning
Muscle wasting
Increased abdominal fat
H2O
Osteoporosis
Increased susceptibility to infection

Question 28

What conditions can oral corticosteroids cause?

Answer 28

Diabetes
Hypertension
Mood swings

Question 29

What is an example of monoclonal antibody used to treat asthma?

Answer 29

Mepolizumab

Question 30

What does Mepolizumab inhibit?

Answer 30

IL-5

Question 31

What are examples of H1 antihistamines?

Answer 31

Cetirizine
Loratdine
Fexofenadine