18 Questions
What are the local side effects associated with inhaled corticosteroids?
Dysphonia, oropharyngeal candidiasis, cough
Which immune cells are glucocorticoid receptors ubiquitously expressed in?
T lymphocytes
What is the main advantage of using inhaled corticosteroids in asthma and COPD?
Target the inflammatory phase of airflow limitation
Which medication is an example of a cysteinyl leukotriene receptor antagonist used in asthma?
Montelukast
What is the effect of montelukast on FEV1 in patients with asthma?
Improves airflow in both early and late phases
How do anti-IgE therapies work in the treatment of asthma?
Block IgE receptors to reduce allergic response
What is the main characteristic of asthma patients who are suitable candidates for Omalizumab treatment?
High total serum IgE levels
Which of the following is a common trigger for severe asthma attacks?
House dust mites
What is the recommended initial treatment for severe asthma attacks that are unresponsive to bronchodilators?
Systemic corticosteroids
What is the significance of 'status asthmaticus' in severe asthma attacks?
It signifies an attack unresponsive to initial treatments
In the context of asthma management, what is the role of short-acting Beta agonists?
Providing symptomatic relief
Why are systemic corticosteroids considered life-saving in severe asthma attacks?
They help reduce airway inflammation and improve lung function
What was the historical treatment of asthma in the early 1900s?
Inhaled epinephrine
Which type of drugs focuses on mast cell stabilizers in the treatment of asthma?
Anti-IgE antibody therapy
What did the peaks of asthma mortality in England and Australia in 1966 highlight?
Excessive reliance on inhaled bronchodilators
What was the spirometry result for the 16-year-old girl with asthma mentioned in the text?
FEV1 60% of predicted
Which type of receptor is targeted by corticosteroids to produce their metabolic and immune effects?
Glucocorticoid receptor
What event in New Zealand in 1977 emphasized inadequate treatment due to excessive reliance on certain medications?
Excessive use of inhaled beta agonists and oral theophylline
Study Notes
Anti-Inflammatory Drugs in Asthma
- Corticosteroids, cysteinyl leukotriene receptor antagonists, mast cell stabilizers, and anti-IgE antibody therapy are used to treat asthma
Corticosteroids
- Act on glucocorticoid receptors in many cells, including innate immune cells, adaptive immune cells, and non-immune cells
- Inhaled corticosteroids provide immediate relief of acute asthmatic symptoms, acting via the mineralocorticoid receptor
- Systemic corticosteroids are used in severe cases, but have side effects such as adrenal suppression, growth suppression, and metabolic abnormalities
Historical Treatment of Asthma
- Early 1900s: inhaled epinephrine (unselective agonist)
- 1940s: inhaled isoprenaline (selective beta agonist)
- 1950s: oral corticosteroids
- 1960s: inhaled corticosteroids
- 1960s: inhaled salbutamol
- Peaks of asthma mortality in England, Australia, and New Zealand due to excessive reliance on inhaled bronchodilators and inadequate treatment
Case Study: 16-Year-Old Girl with Asthma
- Diagnosed with asthma at age 7, triggered by cold air and exercise
- Recurrent wheeze and dyspnoea when playing football, using lots of salbutamol
- Chest hyperinflated, prolonged phase of expiration
- FEV1 60% of predicted
Cysteinyl Leukotriene Receptor Antagonists
- Inhibit receptors expressed on respiratory epithelium and infiltrating leukocytes
- Improve airflow in both early and late phases
- Orally administered, well-tolerated, and slow-acting
- Example: Montelukast
Anti-IgE Therapy
- Used in moderate-to-severe persistent asthma, asthma symptoms inadequately controlled with inhaled glucocorticoids
- Total serum IgE level between 30-1500 international units/mL
- Allergic sensitization demonstrated by positive skin testing or in vitro testing for allergen-specific IgE
- Omalizumab, a recombinant humanized anti-IgE antibody, reduces serum IgE and may be useful in other IgE-mediated diseases
Therapeutic Approach to Asthma Patients
- Asthma action plan: "Relievers and Preventers"
- Severe asthma attacks: status asthmaticus, severe airflow limitation
- Systemic therapy necessary, hospital admission, oxygen, nebulized bronchodilators at high dose, IV corticosteroids
Explore the outline of a lecture on respiratory pharmacology by Professor LJ Egan, covering topics such as anti-inflammatory drugs in asthma, step-wise therapeutic approaches, historical treatments, and more.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
