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18 Cards in this Set
- Front
- Back
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What are the phases in asthma?
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Immediate- bronchoconstriction
late- inflammatory |
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Which drugs target immediate phase
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Mast cell stabiliser
Drugs against bronchospasm |
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What are mast cell stabiliser?
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Prevent release of histamines and other inflammatory mediators
thus preventing bronchoconstriction e.g sodium cromolyn appear to be against hyperresponsiveness |
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What are the drugs against bronchospasm?
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Beta 2 agonist
antimuscarinic xanthines |
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What are the types of Beta 2 agonist
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short (SABA) and long (LABA)
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What are the mechanism and example of SABA
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SABA binds to B-2 receptor a g protein coupled receptor,in turn, lead to production of cAMP lead to smooth muscle relaxation
Prolong SABA exposure leads to downregulation of B2 receptor,which causes SABA to lose its affinity thus downregulating the receptor Example Salbutamol |
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What are the mechanism and example of LABA
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Bind and release binding to b2 receptor
No downregulation Has no tolerance problem and longer half life compared to SABA Example Salmeterol |
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What are the action of antimuscarinic and its example?
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Block M3 mediated bronchoconstriction and reduce mucus secretion
Example ipratropium bromide |
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What are the action of xanthines and its example?
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Phosphodiesterase inhibitor
Has bronchodilation and antiinflammatory properties Example theophylline, aminophylline Side effect: increase heart rate and contractility, CNS stimulation (like caffeine's effect!) |
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Which drugs target Late phase
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glucocorticoids
leukotriene antagonist mast cell stabiliser |
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What is the mechanism of action and example of glucocorticoids
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Suppress inflammatory response
by induce lipocortin syntheses which inhibits phospholipase A2 (reduce inflammatory mediators production) examples beclomethasone inhalation Prednisolone short term Hydrocortisone iv |
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What is the mechanism of action and example of leukotriene antagonist?
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Montelukast
Zafirlukast *5-lipooxygenase inhibitor (e.g. zileutton) inhibit development of leukotriene |
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How many steps are there for managing asthma? (according to BTS)
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5 steps
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Step 1?
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SABA prn
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Step 2?
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SABA prn
Add inhaled steroid 200-400mcg/day |
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Step 3?
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Change SABA to LABA
Steroid as previous Assess asthma control with LABA: 1. ok- continue 2. No response to LABA, increase steroid dose <800mcg +/- leukotriene antagonist or xanthine |
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Step 4?
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Increase steroid dose up to 2000 mcg/day
Add xanthine or LT-antagonist |
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Step 5?
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Daily steroid
max 2000mcg/day Specialist |
