Respiratory Conditions Treatment Strategies Quiz

Treatment Strategies for COPD and Asthma

• In COPD, inflammation is largely corticosteroid-resistant, and there are currently no effective anti-inflammatory treatments.
• The most important therapeutic strategy in COPD is to induce persistent chronic bronchodilation, with LAMA or LABA being the first-line treatment.
• Classes of drugs for asthma and COPD include controllers (anti-inflammatory/immune modulators) such as corticosteroids, leukotriene pathway inhibitors, mast cell degranulation blockers, anti-IgE antibodies, IL-5, and PDE-4 inhibitors, as well as rescue agents (bronchodilators) like β2-adrenergic agonists, muscarinic antagonists, methylxanthines, and PDE-4 inhibitor (roflumilast).
• Inhaled corticosteroids (ICSs) are first-line therapy for chronic asthma but are much less effective in COPD due to corticosteroid resistance and the nature of inflammation.
• Glucocorticoids in asthma have various anti-inflammatory actions, including modulation of immune cell function, reduction in cytokine production, and inhibition of lysosomal enzymes and activity.
• Glucocorticoids decrease the concentration of lymphocytes, monocytes, eosinophils, and basophils, while increasing the concentration of neutrophils, erythrocytes, and platelets.
• Inhaled glucocorticoids like fluticasone, flunisolide, beclomethasone, and budesonide can be used as monotherapy in COPD but are usually combined with LABAs in asthma.
• Chronic treatment with long-acting β2 agonists can result in downregulation of β2 receptors, but corticosteroids sensitize the bronchial smooth muscle for β2 agonists by upregulating β2 adrenergic receptor density.
• Anticholinergics, particularly M3 muscarinic receptor antagonists, are particularly effective in COPD due to the problem of small airways, and have indications for COPD and asthma.
• LAMA, such as tiotropium, aclidinium, umeclidinium, and glycopyrrolate, and LABA/LAMA combinations can significantly improve lung function, dyspnea, symptoms, and health status, and reduce exacerbations in COPD.
• Indacaterol and glycopyrrolate combination (Utibron Neohaler) is a fixed LABA/LAMA combination indicated for COPD, not for asthma, and is effective in improving lung function and reducing exacerbations.
• LABAs are usually combined with ICS in asthma, whereas in COPD, LABA/LAMA combinations are preferred for improving lung function and reducing exacerbations.

Test your knowledge of treatment strategies for COPD and asthma with this quiz. Explore the different classes of drugs, therapeutic approaches, and the effectiveness of various medications in managing these respiratory conditions.