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28 Cards in this Set
- Front
- Back
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What happens when an asthmatic inhales an antigen? |
histamine, prosaglandins, leukotienes and cytokines are released This causes broncho constriction, oedema, mucus secretion and inflammation |
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what drugs are used in the treatment of asthma? |
Bronchodilators and antinflammatory agents |
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What drugs are used as bronchodilators? |
Beta 2 agonists and muscarinic antagonists |
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What are some examples of anti-inflamatory agents? |
Glucocorticosteriods Xanthies Cromones Leukotriene antagonists Anti IgE |
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Current drugs used for treatment of symptoms? |
Short acting beta 2 agonists (SABA) Long acting beta 2 agonists (LABA) Thephylline |
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What are some examples of SABA and LABA drugs? |
SABA= salbutamol, terbutalin enad fenoteral LABA= salmeterol, formoterol and indacaterol |
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Mechanism of action of beta agonists |
1)binds to receptor which activates adenyl cyclase to create cAMP from ATP 2) cAMP causes PKA to phosphorylate MICK which causes relaxation of smooth muscle of airways 3) cAMP is converted to AMP by phosphodiesterase (PDE) |
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Beta 2 agonists summary |
Causes smooth muscle relaxation and mast cell degranulation Administered via inhaled route Side effects= tremor, increased HR and hypokalemia |
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What do muscarinic antagonists do? |
Prevents smooth muscle contraction and mucus secretion induced by activation of PNS |
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Examples of muscarinic antagonists |
ipratropium bromide titotropium bromide |
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What are muscarinic anragonists mainly used to treat? |
COPD |
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Side effects of muscarinic antagonists |
dry mouth, urinary retention, constipation and acute angle glaucoma |
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What is the current anti inflamatory therapy? |
glucocorticosteriods |
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Examples of glucocorticosteriods and method of administration |
theophylline (oral) Leukotriene receptor antagonists (oral) Anti-IgE: Omalizumab (subcutanous) Cromones: Sodium cromoglycate (inhaled) |
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How do glucocorticosteriods work in asthma? |
1) enters cytosol via plasma mem and binds to heat shock protein 90 (HSP90) 2) HSP90 transports steriod into nucleus and binds to gene where it either activates or inhibits transcription which causes: -inhibits leukotriene and cytokine synthesis/release -inhibit recruit of inflammatory cells -antioedema -increased beta 2 adrenoreceptor function |
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Role of inhaled corticosteroids in asthma therapy |
Prevents infiltration adn activation of inflammatory cells Reduces mucosal oedema improves airflow and hence lung function decreases airway hyper-responsiveness reduces symptoms reduce frequency and severity of exacerbations improve quality of life |
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side effects of inhaled glucocorticosteriods |
oral candidasis hoarseness, cough and voice problems |
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Side effects of oral or prolonged high dose of glucocorticosteroids |
growth retardation suppression of hypothalmic pituatory axis osteoperosis, water retention, diabeties hypertension, weight gain and occular hypertension |
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What does leukotriene cause? |
bronchoconstriction oedema cellular infiltration mucus production |
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Example of leukotriene antagonist |
moteolukast |
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Use of leukotriene antagonist |
greatest benefit in severe asthma once per day useful for aspirin sensitive and exercise inuced asthma |
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Side effects of leukotriene antagonists |
headache and GI disturbance |
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What do xanthines do? |
Inhibit PDE so cAMP is not broken down |
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Examples of xanthines |
theophyline and aminophyline |
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side effects of xanthines |
nausea vommitting arrythmias hypokalemia |
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Examples of cromones |
sodium cromoglicate nedocrimil sodium |
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What do cromones do? |
stabilize mast cells reduce inflammatory cell activation and recruitment less effective than glucocorticosteriods |
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Use of Omalizumbs |
binds to free IgE only used in moderate to severe asthma where glucocorticosteriods dont work must be given as subcutaneous injection |
