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PHARMACOLOGY pt.2 - Coggle Diagram
PHARMACOLOGY pt.2
Inhaled corticosteroids(Anti.Inf.controller)
bind glucorticoid receptors>change gene expression>
anti-inflammatory
response
discontinue=deterioration of control
Cornerstone
Target:site of inflammation
Side effects: Oropharyngeal candida & hoarseness
≠ CURE FOR ASTHMA
Example>
Beclomethasone
Leukotriane modifier(Anti-inflam. controller)
Less effective<Lacting B2 agonists when addded to corticosteroids
Not all pts. respond
≠Monotherapy(add to glucocorticoids)
≠improvement after 4 wks>Withdraw
Few side effects
Useful=>>added on therapy(corticosteroid+L.A B2 agonists)>when symptomatic/L.A B2 agonists intolerance
Example:
Montelukast
SHORT-ACTING B2 AGONISTS(reliever)
↑ of use=deterioration of control
For sole therapy>>mild intermittent
Relieves
branchospasm(MDI with Spacer/Nebuliser)
Chronic intermittent=used as needed
S.E:Oral beta agonists>>slow onset >↑systemic risk
Example:
Salbutamol
Long acting B2 AGONISTS(Sustained controller
≠ anti-inflammatory effect
≠Monotherapy(add to glucocorticoids)
Bind B2 receptors>stimulate Adenylyl Cyclase>↑ CAMP>Bronchodilation(
S.E=tremors & palpitations
Inhaled
Example:
Salmeterol
Anticholinergics(reliever)
Inhibit bronchoconstriction
Onset:30 min
Less effective reliever
SE:Addictive with B2 agonists
Ipratropium bromide
Oral corticosteroids(Anti.Infl. controller)
Severe/poorly controlled asthma
Risk side effects: Suppress HPA axis adrenal atrophy & inadequate stress response.>HPT,Cushing's syndrome
Short course after exacerbations
Example:
Prednisone