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Anti-Asthma Drugs (Anti inflammatory (Controller) (Inhaled corticosteroids…
Anti-Asthma Drugs
Anti inflammatory (Controller)
Leukotriene receptor antagonist
Zileutone (not used due to hepatotoxicity)
Inhibit 5-LOX
Montelukast (Oral)
Inhibit LTD4
Used in Aspirin‐Induced Asthma
Anti-IgE antibody
Omalizumab (dont need to memorise)
Binds to free IgE, decreasing cell bound IgE
Decrease expression of FcεRI receptors due to free IgE in patients is depleted by omalizumab
Anti-IL-5 mAB
Mepolizumab (dont need to memorise)
Inhaled corticosteroids
1st Line Prophylactic Asthma Therapy
Beclomethasone, flunisolide,
fluticasone
(only need to memorise this), budesonide, triamcinolone, ciclesonide
For Nocturnal Asthma (High Frequency of Asthma Attack At Night
Increase beta 2 receptors
Na Cromoglycate
Used in children to avoid steroid use
Inhibit mast cell degranulation induced by IgE‐mediated FcERI cross‐linking
Bronchodilators (Reliever)
beta-2 agonists
Long acting beta-2 agonist (LABA)
Salmeterol
, formoterol, bambuterol (12hr)
Ultra-long acting beta-2 agonists (for COPD)
Indacaterol
(24hr)
Indacaterol is used for maintenance therapy and it down regulates beta 2 receptors. In case of acute attack, use with corticosteroid to upregulate beta 2 receptors for salbutamol to act on
Short acting beta-2 agonist (SABA)
Salbutamol
, terbutaline, fenoterol (3-6hr)
Non selective (1-3hrs)
Theophylline
Anti-muscarinics (SAMA and LAMA)
SAMA: Ipratropium bromide
LAMA: Tiotropium bromide
Asthma and COPD