Bronchodilators: Leukotriene antagonists and methylxanthines
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Bronchodilators: Leukotriene antagonists and methylxanthines
Medicine and surgery
Allergy and immunology
Antihistamines for allergies
Glucocorticoids
Cardiology, cardiac surgery and vascular surgery
Coronary artery disease: Clinical (To be retired)
Heart failure: Clinical (To be retired)
Syncope: Clinical (To be retired)
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Hypercholesterolemia: Clinical (To be retired)
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Leg ulcers: Clinical (To be retired)
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
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Endocrinology and ENT (Otolaryngology)
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Hyperthyroidism medications
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Gastroenterology and general surgery
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Anticoagulants: Warfarin
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Protein synthesis inhibitors: Aminoglycosides
Antimetabolites: Sulfonamides and trimethoprim
Miscellaneous cell wall synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
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Nephrology and urology
Chronic kidney disease: Clinical (To be retired)
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ACE inhibitors, ARBs and direct renin inhibitors
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Neurology and neurosurgery
Stroke: Clinical (To be retired)
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Migraine medications
Pulmonology and thoracic surgery
Asthma: Clinical (To be retired)
Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)
Lung cancer: Clinical (To be retired)
Antihistamines for allergies
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Rheumatology and orthopedic surgery
Joint pain: Clinical (To be retired)
Rheumatoid arthritis: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Foot
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Glucocorticoids
Opioid agonists, mixed agonist-antagonists and partial agonists
Antigout medications
Non-biologic disease modifying anti-rheumatic drugs (DMARDs)
Osteoporosis medications
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Bronchodilators: Leukotriene antagonists and methylxanthines
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Transcript
Contributors
Anuj Paul
Ursula Florjanczyk, MScBMC
Sam Gillespie, BSc
Evan Debevec-McKenney
In obstructive lung diseases like asthma, individuals suffer from reversible narrowing of the airways, medications like bronchodilators are helpful in keeping the airways open.
Now, based on their mechanism of action, bronchodilators can be broadly divided into four main groups; β2-agonists, muscarinic antagonists, leukotrienes antagonist and methylxanthines.
In this video, we’ll focus on the leukotriene modifying agents and methylxanthines.
So, if we take a look at the lungs, you’ve got the trachea, which branches off into right and left bronchi, and then continues to branch into thousands of bronchioles.
In the bronchioles you’ve got the lumen, the mucosa, which includes the inner lining of epithelial cells, as well as the lamina propria which contains many cells like the type 2 helper T cells, B cells, and mast cells.
Surrounding the lamina propria, there is a layer of smooth muscles and submucosa.
The submucosal layer contains mucus-secreting glands and blood vessels.
Now, the molecular pathway that leads to asthma is actually pretty complex but it is often initiated by an environmental trigger.
Allergens from environmental triggers, like air pollutants or cigarette smoke, are picked up by dendritic cells which present them to a type 2 helper T cell or Th2 cell in the lamina propria. These cells then produce cytokines like IL-4 and IL-5 which causes the inflammatory response.
IL-4 is especially important because it leads to the production of IgE antibodies by B cells, and these antibodies bind to FcεR1 receptors on mast cells to activate them.
Sources
- "Katzung & Trevor's Pharmacology Examination and Board Review,12th Edition" McGraw-Hill Education / Medical (2018)
- "Rang and Dale's Pharmacology" Elsevier (2019)
- "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
- "Triple therapy (ICS/LABA/LAMA) in COPD: time for a reappraisal" International Journal of Chronic Obstructive Pulmonary Disease (2018)
- "Exacerbations of COPD" International Journal of Chronic Obstructive Pulmonary Disease (2016)
- "Medication Regimens for Managing Acute Asthma" Respiratory Care (2018)
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