Pharm Management
What is the difference between SABA and LABA?
SABA is a short-acting beta-agonist
LABA is a long-acting beta-agonist
What are the similarities and differences between the functions of LABA and LAMA?
LABA is a long-acting beta-agonist - this functions by causing bronchorelaxation
LAMA is a long-acting muscarinic-antagonist - this functions by reducing bronchoconstriction.
How does physical exercise contribute to asthma management?
For people with asthma, as in the general population, regular moderate physical activity has important health benefits including reduced CV risk and improved quality of life.
What is the difference between an asthma “preventor” and a “reliever”?
Preventers: Reduce the inflammation of the airways, this leads to fewer asthma attacks and less long-term damage. An example of this ICS.
Relievers: Opposes smooth muscle contraction, either by antagonising contraction or agonising relaxation. Examples of this are SABA, LABA, SAMA and LAMA.
What treatments are available to treat airway smooth muscle remodelling?
None!
Hence, it is really important to take ICS or biologics to reduce inflammation before airway remodelling occurs.
What is the role of pulmonary rehabilitation in management of severe asthma?
Studies have shown that pulmonary rehabilitation can have beneficial effects on individuals with asthma, improving symptoms, quality of life, and reducing exacerbations. It is particularly effective in severe asthma cases, where it can positively impact bronchial hyperresponsiveness, serum inflammation, quality of life, and asthma exacerbations
What are the adverse effects of taking high doses of ICS?
When high doses are taken it increases the systematic effects of the corticosteroids. Hence we get systematic side effects such as: Opportunistic infections, Cushing’s syndrome, Withdrawal effects
What are the adverse effects of taking a SABA?
Tachycardia
Muscle tremor
Receptor downregulation/desensitivity (can be caused by overuse (due to the short action…), infection or smoking)
Doesn't help with inflammation/remodelling (not a side effect but important in consider what medications someone should take)
Name a lifestyle/occupational change to make for asthma management/prevention
- reduce smoking
- avoidance of occupational exposure
- weight reduction
What biologics are currently available for asthma treatment? What is their effect?
The biologics available for asthma are all monoclonal antibodies targeted to specific molecules in the immune response to reduce inflammation (e.g. act the same as “preventers”)
The available biologics target:
IL-5
IL-5 Receptor
IgE
IL-4/IL-13 Receptor
Are ICS equally effective for all types of asthma and COPD? Why or why not?
No, ICS are most effective against eosinophil-mediated inflammation.
Hence ICS are most effective against T2 Type Asthma (eosinophil-mediated) but less effective against non-T2 type Asthma and COPD (neutrophil and macrophage-mediated)
Is pollution avoidance an effective way of controlling asthma, and why?
In general, when asthma is well-controlled, there is no need for patients to modify their lifestyle to avoid unfavourable outdoor conditions.