Pharmacology tutorial 7 – Asthma drugs

What is salbutamol and when is it indicated?
Salbutamol is a fast-acting (5 mins) sympathomimetic to relieve symptoms of asthma.

What is the MOA of sodium cromoglycate and when might it be used as a treatment for asthma?
It is believed to be a mast cell stabiliser. Thought to prevent bronchoconstriction by inhibiting release of inflammatory mediators.
Used mainly for allergy and exercise induced asthma. Not a reliever. A preventer.
Safe in preg and BF.

A pregnant woman is ‘having trouble with her asthma’. It is keeping her awake at night. She doesn’t want to take her steroid inhaler as she is concerned about the risk of steroids on her baby. What would you say?
Corticosteroids anti inflammatory and immunosuppressant. Preventers of asthma symptoms. used in conjunction with relievers. The risks of these to the baby outweigh the risks of uncontrolled asthma to the baby (Risks include preeclampsia, PIH, preterm birth, congenital anomalies, IUGR and lowbirth weight)

A woman is in labour. Her asthma is fairly well controlled throughout her pregnancy as she has continued to need to use both her steroid and Beta 2 agonists inhalers. As her labour progressess she is feeling SOB. You know her beta 2 agonist inhaler may slow her labour. What is the MOA for this? What do you say regarding her use of her inhaler? Should she or should she not?
Beta 2 adrenoreceptor agonists are sympathomimetics that act on receptors in bronchial smooth muscle. Activation of these receptors causes relaxation therefore bronchodilation. For it to slow labour she would have to take a higher dose. The inhaler will be acting on her lungs due to its local effects. It is more important for her to be able to breathe in labour!!!

A woman in early pregnancy tells you she has been taking a new asthma drug called luco-trying-something. They are very good and her asthma has never been better. How do leukotrienes treat asthma? Is it okay for her to continue taking them?
Leukotrienes act by reducing the effects of bronchoconstriction, mucosal oedema, increased mucus secretion and inflammatory cell infiltrate that cause asthma. They do this by preventing synthesis of leukotrienes and blocking the receptors for leukotrienes.
Avoid in pregnancy and insufficient data for BF.

Egs of some corticosteroids
Beclomethasone, budesonide, fluticasone.

Asthma chronic inflammatory disorder of the airway leading to recurrent but reversible episodes of airway limitations and hyperresponsiveness, wheezing, breathlessness, and coughing Asthma pathophysiology: early IgE binds to receptors on most cells with allergen exposure causing degranulation and release of …

beta 2 adrenergic bronchodilators (front door bronchodilators) – short acting beta 2 agonists SABA rescue/ quick relief medications indicated for treatment of acute episodes of bronchospasm -albuterol (ventolin or Proventil) = dose 2.5 mg in 3 ml NS Q1-Q6 hours …

What is Viral Rhinitis and what are its symptoms? The Common Cold – virus invades mucosa of upper respiratory tract sneezing, coughing, sore throat, runny nose, congestion What is Allergic Rhinitis and how is it different than Viral Rhinitis? Airborne …

Asthma This is a reversible obstructive airway disease process which causes an increased irritability of the tracheal bronchial tree. 3 components of Asthma These include: Airway obstruction (intermittent), Airway hyper-responsiveness, and inflammation. It is an immunologic allergic reaction. WE WILL …

What components of the sympathetic nervous system are innervated by cholinergic fibers? adrenal medulla and sweat glands ACh acts are 2 types of receptors: nicotinic and muscarinic. What types of receptors are these? nicotinic ACh receptors are Na+/K+ channels muscarinic …

alpha 1- found where? – vascular smooth muscle in skin and gut alpha 1- effect? – activates vasoconstriction – during flight or fight want reduced blood flow to skin and gut – End result: VASOCONSTRICTION at skin and gut WE …

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