Antiasthmatic.pdf

- Antiasthmatic ! ! Bronchodilators Anti-inflammatory agent S B2 agonists...

- Antiasthmatic ! ! Bronchodilators Anti-inflammatory agent S B2 agonists (sympathomimetic f ↓ antibodies ↓ ↳ Degranulation SABA LABA inhibitors (mass cell stabilizer) port) longdng& ↳ ↑ acting ↓ ↓ - no bronchodilation reliever preventer J mild B Methyl xanthines (strong & bronchodilator) Coffee ↳ 10 co anti-inflam M leukotriene ) bronchodilator + anti-inflammationC 1 M modifiers S ↳ Lipoxygenase Receptor ! inhibitor blockers Corticosteroids Aku muscarinic antagonists b ↳ Cari (block broncho constriction) Inhaled corticol oral Did steroid  > - Choice of drugs depends on severity Reliever (Acute asthma Controller (chronic asthma) · Short acting · Corticosteroid (ICS) inhaled B2-agonist (SABA) : ↳ Becomethasone In Fluticasone short acting Long acting Pe-agonist · · (LABA) anticholinergic (SAAC) : Inhaled = inhaled · Methylxanthine : IV (Aminophylline) Long acting anticholinergic (LAAC) Tiotropium inhaled = = · Corticosteroid : Oral (Hydrocortisone) IV (Prednisolone) · Leukotriene modifier = oral · Methylxanthine Theophylline Oral = :  I Bronchodilators Anti-inflammatory · B2 agonist (SABA) · Corticosteroid (ICS) - controller ↳ Salbutamol (inhaled ↳ Beclomethasone , Fluticasone · B2 agonist (LABA) · Systemic steroid ↳ Salmeterol (innaled La oral b IV Cemergency ( · Anticholinergic (SAAC) · mast cell stabilizer ↳ (inhaled ↳ inhaled Ipratropium ↳ inhibitor degranulation Anticholinergic (LAAC) ↳ · prevent mass cell collapse ↳ Tiotropium (innaled) Dual Mechanism · Methylxanthine · Leukotriene modifiers ↳ oral i IV (preventers (reliever ( boral (2nd line preventer ↳ Theophylline Coral zafirlucast (block receptors · ↳ Aminophylline (I · Zilenton (inhibit enzyme  Bronchodilators MOA ↳ Bind B2 receptor > active adenylyI cyclase - ↓ ~ activate protein kinase A = ↑ CAMP level inactivate myosin light chain kinase > - ↓ Smooth muscle cell contraction Side effect - (headache , peripheral vasodilation tremor , tachycardia - agonist SABA (Albuterol , Terbutaline) At stimulate B2-receptor of airway - · relaxation smooth muscle I ↑ airflow < 30 min · if uses - block adenosine Leukotriene modifiers land linearg-controller (prevent leukotriene - induced airway inflammation ( Crelax airways in mild asthma a ↳ x6t symptom lung · Zafirlukast · Zileuton ↳ inhibit ↳ inhibit CysLT, 5-lipoxygenase  Anti-inflammatory agents Inhaled corticosteroid IV Corticosteroid · Beclomethasone (Beclovent &) · Prednisolone · Budesonide (Pulmicort") o Fluticasone (Flixotide * ] Mast cell stabilizer · Cromolyn (Intal) Oral corticosteroid o Nedocromil (Hydrocort ) & · Hydrocortisone Leukotriene modifier Methyl xantine Zafircast (Accolate Theophylline · · · zilenton (zyflo( · Aminophylline Corticosteroid - most potent effective => no cytokine no histamine & inhibit allergen ↑ induced influx no histamine release I inhibit eosinophil 3 mediator no histamine , leukotriene ↳ inhibit most cell mediator ↳ inhibit As ↓ prostaglandin ↳ leukotrienes phospholipase > - other MoA b act on nuclear receptor /reduce gene expression ( pro inflammatory protein  Adverse effect of steroid · throat problem · Growth (children) reduction o oral thrush · ↓ resistance (infections] Osteoporosis impaired wound · healing · · eye problem : Glaucoma , Cataract o Hyperglycaemia o Cushing'sSyndrome Canti allergic Cromolyn sodrum/Sodium comoglycate · stabilize mast cell (inhibit cell degranulation ( · inhibit mediator release oprevent chemotaxis of eosinophills & Neutrophils (prevent local inflam) · no bronchodilation not absorbed orally · ↳ of prophylaxis asthma Side effect= irritation (throat) , dry mouth , fight chess nasal itching