Asthma Drugs

Front 1

Anti-allergic drugs
Mechanism not known

Back 1

CHROMOGLYCATE (inhalation, inactive orally)
NEDOCROMIL (oral)
Prevent attacks, not useful in established asthma attack.

Hypotheses:
1) inhibition of release of mediators of inflammation from cells (e.g. mast cells, neutrophils, eosinophils)
2) inhibition of sensory nerve activity --> inhibition of reflexes that promotes bronchoconstriction and neurogenic inflammation

Hint 1

CHROMOGLYCATE
NEDOCROMIL

Front 2

Beta2 Receptor Agonists

Back 2

SALBUTAMOL
1) SMR in bronchi
2) Prevent release of mediators from mast cells

Hint 2

SALBUTAMOL

Front 3

Muscarinic antagonists

Back 3

IPRATROPIUM BROMIDE
Inhaled (oral use precluded from side effects), not absorbed into circulation

Good for types where bronchoconstriction predominates

Front 4

METHYLXANTHINES

Back 4

CAFFEINE, THEOBROMINE, THEOPHYLLINE

a) Intracellular Ca release
b) PDE-I
C) ADP-R antagonism
HOWEVER, not all three happen at plasma therapeutic concentration

1) bronchodilation
2) SMR in blood vessels
3) +ve chrono/inotropic
4) + GI secretions
5) CNS stimulation
6) weak diuresis
Unwanted effects: dysrhythmias, diarrhoea, tremor and wakefulness

AMINOPHYLLINE used both in asthma and in left ventricular failure with pulmonary oedema

Hint 4

Cellular vs pharmacological effects

Front 5

Anti-inflammatory

Back 5

GLUCORTICOIDS: BECLOMETHASONE

For sever asthma, but action is delayed (why?)

Hint 5

Why do you never give NSAIDs to asthma patients?

Front 6

H1-antagonists

Back 6

CETIRIZINE
Reduces ACUTE airway obstruction but only in part

Front 7

Biologics

Back 7

OMALIZUMAB (anti-IgE antibody)

Front 8

Leukotrienes

Back 8

Leukotrine antagonists/ 5-lypoxygenase inhibitors
ZILEUTON
ZAFIRLEUKAST
MONTELEUKAST