Internal Diseases – Part 1 (Rheumatology, Pulmonology, Phthisiatrics, Cardiology, Haematology) · MU Plovdiv
7. Bronchial asthma – management of asthma attacks, treatment of stable asthma
Inside: 15 sections · 4 labelled pictures · 2 tables · 29 flashcards · 14 min
Topic 12 of 68 in the MU Plovdiv syllabus for Internal Diseases – Part 1 (Rheumatology, Pulmonology, Phthisiatrics, Cardiology, Haematology) (Medicine, Year 4). The free AceMed note covers it in 15 sections, about 1,818 words (14 min of reading), with 29 flashcards.
In this note
- Essay 7- Bronchial asthma – management of asthma attacks, treatment of stable asthma
- Corticosteroids
- Selective B2 agonists
- Antimuscarinic drugs
- Methylxanthines
- Mast cell stabalizers
- Leukotriene modifiers
- Anti IgE drugs
- Treatment
- Asthma: epidemiology, pathogenesis, clinical features, diagnosis and differential diagnosis.
- Treatment of asthma.
- Introduction
- Key change (GINA since 2019)
- Stepwise treatment (GINA, adults, track 1 preferred)
- Rational prescribing points
Essay 7- Bronchial asthma – management of asthma attacks, treatment of stable asthma
- Pharmacological drugs used
Corticosteroids
- Pharmacokinetics
- Inhalation is preferred
- Can also be given parenterally
- Pharmacodynamics
- Stimulate synthesis of lipocortin which inhibits phospholipase A2
- Inhibit prostaglandins, leukotriens, etc
- (antiallergic, anti-inflammatory and immunosuppressant effects)
- In patients with bronchial asthma they:
- Suppress inflammatory response to Ag-Ab reaction
- Decrease mucosal oedema
- Reduce bronchial hyperreactivity
- Theraputic uses
- Control symptoms of bronchial asthma (“controllersˮ) & for asthmatic attacks
- ADR
- Local- oropharyngeal candiasis, dysphonia
- These are ADRs for inhaled corticosteroids!!
- Hyperglycemia
- Gastric ulcer
- Osteoporosis
- Retention of sodium and water
- Increased risk of infections (immunosupression)
- Impaired wound healing
- Increased intraocular pressure
- Cataract
- Adrenal suppression
- Peripheral edema
- Hypertension
- Striae
- Drug interactions
- Potentiates the effects of β2adrenergic agonists
- Often used in combination
Selective B2 agonists
- Pharmacokinetics
- A- given via inhalation
- M- first pass metabolism in liver
- Pharmacodynamics
- Relax airway smooth muscles (bronchdilation)
- By binding to B2 receptors in the bronchi
- Theraputic uses
- Short-acting- relieve symptoms of asthmatic attack (“relieversˮ)
- Long-acting- to control symptoms of bronchial asthma between the attacks (“controllersˮ)
- ADR
- Tachycardia
- Hyperglycemia
- Finger tremor
- Hypokalemia
- Headache, agitation
- Tolerance
- Drug interactions
- With tricyclic antidepressants, MAO inhibitors and thyroid hormones - increased risk of ADRs.
- Beta blockers reduce the effect of β2 agonists.
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