Morning Rounds · Asthma Pharmacology<\/title>\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Playfair+Display:ital,wght@0,400;0,600;0,700;1,400;1,600&family=Source+Serif+4:ital,wght@0,300;0,400;0,600;1,400&display=swap\" rel=\"stylesheet\">\n<style>\n#mrq02 *,#mrq02 *::before,#mrq02 *::after{box-sizing:border-box;margin:0;padding:0}\n#mrq02{--ter:#8B3D20;--ter-light:#B85A38;--ter-pale:#FDF0EB;--ter-dark:#6B2D14;--correct:#2D6B47;--correct-bg:#EAF6EF;--correct-border:#3A9960;--wrong:#B83232;--wrong-bg:#FDF0F0;--wrong-border:#E53935;--ink:#2C1810;--ink-mid:#5A3D30;--ink-soft:#9A7060;--line:#E8DDD8;--cream:#FAF6F2;--warm:#FFFDF9;font-family:'Source Serif 4',Georgia,serif;font-size:16px;color:var(--ink);background:var(--cream);line-height:1.7;padding:0 0 64px}\n#mrq02 .mr-header{background:var(--ter);color:#FFFDF9;padding:34px 24px 28px;text-align:center}\n#mrq02 .mr-eyebrow{font-size:0.68rem;letter-spacing:0.18em;text-transform:uppercase;font-weight:600;opacity:0.65;margin-bottom:10px}\n#mrq02 .mr-title{font-family:'Playfair Display',serif;font-size:1.75rem;font-weight:700;line-height:1.2;margin-bottom:4px}\n#mrq02 .mr-title em{font-style:italic;font-weight:400;opacity:0.88}\n#mrq02 .mr-subtitle{font-size:0.82rem;opacity:0.7;margin-top:8px;font-style:italic}\n#mrq02 .mr-chips{display:flex;justify-content:center;gap:10px;margin-top:18px;flex-wrap:wrap}\n#mrq02 .mr-chip{background:rgba(255,255,255,0.13);border:1px solid rgba(255,255,255,0.22);border-radius:20px;padding:4px 13px;font-size:0.73rem}\n#mrq02 .mr-sentinel{height:1px}\n#mrq02 .mr-progress{position:fixed;top:0;left:0;right:0;z-index:9999;background:var(--warm);border-bottom:1px solid var(--line);box-shadow:0 2px 12px rgba(44,24,16,0.08);padding:9px 16px;display:none}\n#mrq02 .mr-progress.visible{display:block}\n#mrq02 .mr-prog-inner{max-width:720px;margin:0 auto;display:flex;align-items:center;justify-content:center}\n#mrq02 .mr-pips{display:flex;align-items:center;justify-content:center}\n#mrq02 .mr-pip-wrap{display:flex;align-items:center}\n#mrq02 .mr-pip-line{width:28px;height:2px;background:var(--line);transition:background 0.35s}\n#mrq02 .mr-pip-line.done{background:var(--ter)}\n#mrq02 .mr-pip{width:28px;height:28px;border-radius:50%;border:2px solid var(--line);background:var(--warm);display:flex;align-items:center;justify-content:center;font-size:0.63rem;font-weight:700;color:var(--ink-soft);transition:all 0.3s;flex-shrink:0}\n#mrq02 .mr-pip.correct{background:var(--correct-border);border-color:var(--correct-border);color:#fff}\n#mrq02 .mr-pip.wrong{background:var(--wrong-border);border-color:var(--wrong-border);color:#fff}\n#mrq02 .mr-body{max-width:720px;margin:0 auto;padding:0 16px}\n#mrq02 .mr-case{background:var(--warm);border:1px solid var(--line);border-left:4px solid var(--ter);border-radius:10px;margin:28px 0;overflow:hidden;box-shadow:0 1px 6px rgba(44,24,16,0.05)}\n#mrq02 .mr-case-top{padding:16px 20px 14px;display:flex;gap:14px;align-items:flex-start}\n#mrq02 .mr-num{font-family:'Playfair Display',serif;font-size:2.2rem;font-weight:700;color:var(--ter);opacity:0.16;line-height:1;margin-top:-2px;flex-shrink:0}\n#mrq02 .mr-meta{flex:1}\n#mrq02 .mr-tag{font-size:0.61rem;font-weight:700;letter-spacing:0.14em;text-transform:uppercase;color:var(--ter);opacity:0.75;margin-bottom:5px}\n#mrq02 .mr-stem{font-size:0.94rem;color:var(--ink);line-height:1.72}\n#mrq02 .mr-stem strong{font-weight:600}\n#mrq02 .mr-stem em{font-style:italic}\n#mrq02 .mr-rule{height:1px;background:var(--line);margin:0 20px}\n#mrq02 .mr-opts{padding:12px 20px 16px;display:flex;flex-direction:column;gap:8px}\n#mrq02 .mr-opt{display:flex;align-items:flex-start;gap:11px;padding:10px 14px;border:1.5px solid var(--line);border-radius:8px;cursor:pointer;background:var(--warm);transition:border-color 0.15s,background 0.15s;-webkit-tap-highlight-color:transparent}\n#mrq02 .mr-opt:hover{border-color:var(--ter);background:var(--ter-pale)}\n#mrq02 .mr-opt.locked{cursor:default}\n#mrq02 .mr-opt.locked:hover{border-color:var(--line);background:var(--warm)}\n#mrq02 .mr-opt.correct{border-color:var(--correct-border);background:var(--correct-bg);cursor:default}\n#mrq02 .mr-opt.correct:hover{border-color:var(--correct-border);background:var(--correct-bg)}\n#mrq02 .mr-opt.wrong{border-color:var(--wrong-border);background:var(--wrong-bg);cursor:default}\n#mrq02 .mr-opt.wrong:hover{border-color:var(--wrong-border);background:var(--wrong-bg)}\n#mrq02 .mr-opt.dimmed{opacity:0.35;cursor:default}\n#mrq02 .mr-opt.dimmed:hover{border-color:var(--line);background:var(--warm)}\n#mrq02 .mr-ltr{flex-shrink:0;width:20px;height:20px;border-radius:50%;border:1.5px solid var(--line);display:flex;align-items:center;justify-content:center;font-size:0.62rem;font-weight:700;color:var(--ink-soft);margin-top:2px;transition:all 0.15s}\n#mrq02 .mr-opt.correct .mr-ltr{background:var(--correct-border);border-color:var(--correct-border);color:#fff}\n#mrq02 .mr-opt.wrong .mr-ltr{background:var(--wrong-border);border-color:var(--wrong-border);color:#fff}\n#mrq02 .mr-opt-text{font-size:0.9rem;color:var(--ink-mid);line-height:1.58}\n#mrq02 .mr-opt.correct .mr-opt-text{color:var(--correct);font-weight:600}\n#mrq02 .mr-opt.wrong .mr-opt-text{color:var(--wrong)}\n#mrq02 .mr-exp{display:none;border-top:1px solid #c8e0d8;background:linear-gradient(180deg,#edf7f4 0%,#f4faf8 100%);padding:13px 20px 15px}\n#mrq02 .mr-exp-lbl{font-size:0.61rem;font-weight:700;letter-spacing:0.12em;text-transform:uppercase;color:var(--correct);margin-bottom:6px}\n#mrq02 .mr-exp-text{font-size:0.86rem;color:#1c4a3a;line-height:1.68}\n#mrq02 .mr-exp-text strong{font-weight:600}\n#mrq02 .mr-exp-text em{font-style:italic}\n#mrq02 .mr-img-wrap{margin-top:14px;background:var(--warm);border:1px solid var(--line);border-radius:8px;padding:14px;text-align:center}\n#mrq02 .mr-img-wrap figcaption{font-size:0.73rem;color:var(--ink-soft);font-style:italic;margin-top:8px;line-height:1.4}\n#mrq02 .mr-submit-wrap{text-align:center;padding:28px 16px 8px}\n#mrq02 .mr-btn{background:var(--ter);color:#FFFDF9;border:none;border-radius:8px;padding:13px 44px;font-family:'Playfair Display',serif;font-size:1rem;font-weight:700;cursor:pointer;box-shadow:0 2px 8px rgba(139,61,32,0.28)}\n#mrq02 .mr-btn:hover{background:var(--ter-dark)}\n#mrq02 .mr-score{display:none;background:var(--warm);border:1px solid var(--line);border-top:4px solid var(--ter);border-radius:10px;margin:24px 0 0;box-shadow:0 2px 12px rgba(44,24,16,0.08);overflow:hidden}\n#mrq02 .mr-score-in{padding:28px 24px;text-align:center}\n#mrq02 .mr-score-ey{font-size:0.66rem;letter-spacing:0.14em;text-transform:uppercase;color:var(--ink-soft);margin-bottom:12px;font-weight:600}\n#mrq02 .mr-ring{width:98px;height:98px;border-radius:50%;background:conic-gradient(var(--ter) 0%, var(--line) 0%);display:flex;align-items:center;justify-content:center;margin:0 auto 16px;position:relative}\n#mrq02 .mr-ring::before{content:'';position:absolute;width:76px;height:76px;border-radius:50%;background:var(--warm)}\n#mrq02 .mr-ring-in{position:relative;display:flex;flex-direction:column;align-items:center;line-height:1.2}\n#mrq02 .mr-ring-pct{font-family:'Playfair Display',serif;font-size:1.3rem;font-weight:700;color:var(--ter)}\n#mrq02 .mr-ring-sub{font-size:0.54rem;color:var(--ink-soft);text-transform:uppercase;letter-spacing:0.06em}\n#mrq02 .mr-score-title{font-family:'Playfair Display',serif;font-size:1.15rem;font-weight:700;color:var(--ink);margin-bottom:4px}\n#mrq02 .mr-score-net{font-size:0.9rem;color:var(--ter);font-weight:600;margin-bottom:4px}\n#mrq02 .mr-verdict{font-size:0.83rem;color:var(--ink-soft);font-style:italic;margin-bottom:18px;padding:0 12px}\n#mrq02 .mr-bands{display:flex;justify-content:center;gap:10px;flex-wrap:wrap}\n#mrq02 .mr-band{padding:5px 13px;border-radius:16px;font-size:0.78rem;font-weight:600}\n#mrq02 .mr-band-c{background:var(--correct-bg);color:var(--correct)}\n#mrq02 .mr-band-w{background:var(--wrong-bg);color:var(--wrong)}\n#mrq02 .mr-band-s{background:var(--ter-pale);color:var(--ter)}\n#mrq02 .mr-retry{display:block;margin:18px auto 4px;background:transparent;border:2px solid var(--ter);color:var(--ter);border-radius:8px;padding:9px 28px;font-family:'Playfair Display',serif;font-size:0.92rem;font-weight:700;cursor:pointer}\n#mrq02 .mr-retry:hover{background:var(--ter);color:#FFFDF9}\n@media(max-width:480px){#mrq02 .mr-title{font-size:1.4rem}#mrq02 .mr-num{font-size:1.7rem}#mrq02 .mr-stem{font-size:0.9rem}#mrq02 .mr-opt-text{font-size:0.86rem}}\n<\/style>\n<\/head>\n<body>\n\n<div id=\"mrq02-img1\" style=\"display:none\">\n <figure class=\"mr-img-wrap\">\n <svg viewBox=\"0 0 560 220\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width:100%;max-width:560px;display:block;margin:0 auto\">\n <rect x=\"0\" y=\"0\" width=\"560\" height=\"220\" rx=\"10\" fill=\"#1a1a2e\"\/>\n <text x=\"280\" y=\"18\" text-anchor=\"middle\" fill=\"#aaaacc\" font-size=\"9.5\" font-family=\"Georgia,serif\" letter-spacing=\"1.5\">ASTHMA PHARMACOLOGY — SITES OF DRUG ACTION<\/text>\n <rect x=\"14\" y=\"28\" width=\"82\" height=\"34\" rx=\"5\" fill=\"#2a2a4a\" stroke=\"#4444aa\" stroke-width=\"1\"\/>\n <text x=\"55\" y=\"42\" text-anchor=\"middle\" fill=\"#8888dd\" font-size=\"8\" font-family=\"Georgia,serif\">Antigen<\/text>\n <text x=\"55\" y=\"54\" text-anchor=\"middle\" fill=\"#8888dd\" font-size=\"8\" font-family=\"Georgia,serif\">(allergen)<\/text>\n <rect x=\"130\" y=\"28\" width=\"90\" height=\"34\" rx=\"5\" fill=\"#2a2a4a\" stroke=\"#4444aa\" stroke-width=\"1\"\/>\n <text x=\"175\" y=\"42\" text-anchor=\"middle\" fill=\"#8888dd\" font-size=\"8\" font-family=\"Georgia,serif\">IgE on mast<\/text>\n <text x=\"175\" y=\"54\" text-anchor=\"middle\" fill=\"#8888dd\" font-size=\"8\" font-family=\"Georgia,serif\">cell surface<\/text>\n <rect x=\"260\" y=\"28\" width=\"90\" height=\"34\" rx=\"5\" fill=\"#2a2a4a\" stroke=\"#4444aa\" stroke-width=\"1\"\/>\n <text x=\"305\" y=\"42\" text-anchor=\"middle\" fill=\"#8888dd\" font-size=\"8\" font-family=\"Georgia,serif\">Mediator<\/text>\n <text x=\"305\" y=\"54\" text-anchor=\"middle\" fill=\"#8888dd\" font-size=\"8\" font-family=\"Georgia,serif\">release<\/text>\n <line x1=\"97\" y1=\"45\" x2=\"128\" y2=\"45\" stroke=\"#5555bb\" stroke-width=\"1.5\" marker-end=\"url(#arr)\"\/>\n <line x1=\"221\" y1=\"45\" x2=\"258\" y2=\"45\" stroke=\"#5555bb\" stroke-width=\"1.5\" marker-end=\"url(#arr)\"\/>\n <defs>\n <marker id=\"arr\" markerWidth=\"6\" markerHeight=\"6\" refX=\"5\" refY=\"3\" orient=\"auto\">\n <path d=\"M0,0 L0,6 L6,3 z\" fill=\"#5555bb\"\/>\n <\/marker>\n <marker id=\"arr2\" markerWidth=\"6\" markerHeight=\"6\" refX=\"5\" refY=\"3\" orient=\"auto\">\n <path d=\"M0,0 L0,6 L6,3 z\" fill=\"#cc4444\"\/>\n <\/marker>\n <marker id=\"arr3\" markerWidth=\"6\" markerHeight=\"6\" refX=\"5\" refY=\"3\" orient=\"auto\">\n <path d=\"M0,0 L0,6 L6,3 z\" fill=\"#44aa66\"\/>\n <\/marker>\n <\/defs>\n <line x1=\"305\" y1=\"63\" x2=\"305\" y2=\"82\" stroke=\"#5555bb\" stroke-width=\"1.5\" marker-end=\"url(#arr)\"\/>\n <line x1=\"305\" y1=\"63\" x2=\"420\" y2=\"82\" stroke=\"#5555bb\" stroke-width=\"1.5\" marker-end=\"url(#arr)\"\/>\n <rect x=\"245\" y=\"84\" width=\"118\" height=\"30\" rx=\"5\" fill=\"#1e3a28\" stroke=\"#3a9960\" stroke-width=\"1.2\"\/>\n <text x=\"304\" y=\"97\" text-anchor=\"middle\" fill=\"#6fcf97\" font-size=\"8\" font-family=\"Georgia,serif\">Early response<\/text>\n <text x=\"304\" y=\"108\" text-anchor=\"middle\" fill=\"#6fcf97\" font-size=\"8\" font-family=\"Georgia,serif\">Bronchoconstriction<\/text>\n <rect x=\"365\" y=\"84\" width=\"118\" height=\"30\" rx=\"5\" fill=\"#3a1e1e\" stroke=\"#cc4444\" stroke-width=\"1.2\"\/>\n <text x=\"424\" y=\"97\" text-anchor=\"middle\" fill=\"#f47c7c\" font-size=\"8\" font-family=\"Georgia,serif\">Late response<\/text>\n <text x=\"424\" y=\"108\" text-anchor=\"middle\" fill=\"#f47c7c\" font-size=\"8\" font-family=\"Georgia,serif\">Inflammation<\/text>\n <line x1=\"304\" y1=\"115\" x2=\"304\" y2=\"134\" stroke=\"#3a9960\" stroke-width=\"1.5\" marker-end=\"url(#arr3)\"\/>\n <line x1=\"424\" y1=\"115\" x2=\"424\" y2=\"134\" stroke=\"#cc4444\" stroke-width=\"1.5\" marker-end=\"url(#arr2)\"\/>\n <rect x=\"244\" y=\"136\" width=\"120\" height=\"22\" rx=\"4\" fill=\"#0d2b1e\" stroke=\"#2d6b47\" stroke-width=\"1\"\/>\n <text x=\"304\" y=\"151\" text-anchor=\"middle\" fill=\"#5ab87a\" font-size=\"7.5\" font-family=\"Georgia,serif\">Symptoms (wheeze, SOB)<\/text>\n <rect x=\"364\" y=\"136\" width=\"120\" height=\"22\" rx=\"4\" fill=\"#2b0d0d\" stroke=\"#8b2020\" stroke-width=\"1\"\/>\n <text x=\"424\" y=\"151\" text-anchor=\"middle\" fill=\"#d47070\" font-size=\"7.5\" font-family=\"Georgia,serif\">Hyperresponsiveness<\/text>\n <line x1=\"55\" y1=\"63\" x2=\"55\" y2=\"170\" stroke=\"#666688\" stroke-width=\"1\" stroke-dasharray=\"3,3\"\/>\n <text x=\"55\" y=\"180\" text-anchor=\"middle\" fill=\"#9999bb\" font-size=\"7.5\" font-family=\"Georgia,serif\">Avoidance<\/text>\n <line x1=\"175\" y1=\"63\" x2=\"175\" y2=\"170\" stroke=\"#666688\" stroke-width=\"1\" stroke-dasharray=\"3,3\"\/>\n <text x=\"175\" y=\"180\" text-anchor=\"middle\" fill=\"#cc9966\" font-size=\"7.5\" font-family=\"Georgia,serif\">Omalizumab<\/text>\n <text x=\"175\" y=\"190\" text-anchor=\"middle\" fill=\"#cc9966\" font-size=\"7\" font-family=\"Georgia,serif\">Chromones<\/text>\n <text x=\"304\" y=\"168\" text-anchor=\"middle\" fill=\"#88cc99\" font-size=\"7\" font-family=\"Georgia,serif\">β2-agonists<\/text>\n <text x=\"304\" y=\"178\" text-anchor=\"middle\" fill=\"#88cc99\" font-size=\"7\" font-family=\"Georgia,serif\">Theophylline<\/text>\n <text x=\"304\" y=\"188\" text-anchor=\"middle\" fill=\"#88cc99\" font-size=\"7\" font-family=\"Georgia,serif\">Muscarinic antagonists<\/text>\n <text x=\"424\" y=\"168\" text-anchor=\"middle\" fill=\"#dd8888\" font-size=\"7\" font-family=\"Georgia,serif\">Corticosteroids<\/text>\n <text x=\"424\" y=\"178\" text-anchor=\"middle\" fill=\"#dd8888\" font-size=\"7\" font-family=\"Georgia,serif\">Antileukotrienes<\/text>\n <text x=\"424\" y=\"188\" text-anchor=\"middle\" fill=\"#dd8888\" font-size=\"7\" font-family=\"Georgia,serif\">Anti-IL-5 \/ Anti-IL-4<\/text>\n <text x=\"280\" y=\"210\" text-anchor=\"middle\" fill=\"#666688\" font-size=\"7.5\" font-family=\"Georgia,serif\" font-style=\"italic\">Points of pharmacological intervention in asthma pathophysiology<\/text>\n <\/svg>\n <figcaption>Asthma drug action cascade. <strong>Left:<\/strong> omalizumab and chromones block at the IgE\/mast cell level. <strong>Centre:<\/strong> β2-agonists, theophylline, and muscarinic antagonists reverse the early bronchoconstriction response. <strong>Right:<\/strong> corticosteroids, antileukotrienes, and anti-IL-5\/IL-4 biologics suppress the late inflammatory response and airway hyperresponsiveness.<\/figcaption>\n <\/figure>\n<\/div>\n\n<div id=\"mrq02\">\n\n <div class=\"mr-header\">\n <div class=\"mr-eyebrow\">Morning Rounds · Daily Clinical Quiz<\/div>\n <div class=\"mr-title\">Asthma<br><em>Pharmacology<\/em><\/div>\n <div class=\"mr-subtitle\">Five cases · Read carefully · Trust your instinct<\/div>\n <div class=\"mr-chips\">\n <span class=\"mr-chip\">5 Cases<\/span>\n <span class=\"mr-chip\">+4 \/ −1 scoring<\/span>\n <span class=\"mr-chip\">Options reshuffled<\/span>\n <\/div>\n <\/div>\n\n <div class=\"mr-sentinel\" id=\"mrq02-sentinel\"><\/div>\n\n <div class=\"mr-progress\" id=\"mrq02-progress\">\n <div class=\"mr-prog-inner\">\n <div class=\"mr-pips\" id=\"mrq02-pips\"><\/div>\n <\/div>\n <\/div>\n\n <div class=\"mr-body\">\n <div id=\"mrq02-cases\"><\/div>\n <div class=\"mr-submit-wrap\">\n <button class=\"mr-btn\" id=\"mrq02-submit\">Submit for Debrief<\/button>\n <\/div>\n <div class=\"mr-score\" id=\"mrq02-score\">\n <div class=\"mr-score-in\">\n <div class=\"mr-score-ey\">Round Complete<\/div>\n <div class=\"mr-ring\" id=\"mrq02-ring\">\n <div class=\"mr-ring-in\">\n <span class=\"mr-ring-pct\" id=\"mrq02-pct\">0%<\/span>\n <span class=\"mr-ring-sub\">net<\/span>\n <\/div>\n <\/div>\n <div class=\"mr-score-title\">Your Debrief<\/div>\n <div class=\"mr-score-net\" id=\"mrq02-net\"><\/div>\n <div class=\"mr-verdict\" id=\"mrq02-verdict\"><\/div>\n <div class=\"mr-bands\">\n <span class=\"mr-band mr-band-c\" id=\"mrq02-ct-c\"><\/span>\n <span class=\"mr-band mr-band-w\" id=\"mrq02-ct-w\"><\/span>\n <span class=\"mr-band mr-band-s\" id=\"mrq02-ct-s\"><\/span>\n <\/div>\n <button class=\"mr-retry\" id=\"mrq02-retry\">↻ New Round<\/button>\n <\/div>\n <\/div>\n <\/div>\n\n<\/div>\n\n<script>\n(function () {\n 'use strict';\n var NS = 'mrq02', TOTAL = 5, MAX = 20;\n var LTRS = ['A','B','C','D'];\n\n var QS = [\n {\n id: 1,\n tag: 'β2-Agonists — Acute Use',\n stem: 'A <strong>22-year-old woman<\/strong> arrives in the emergency department with an acute asthma exacerbation. She is breathless at rest, SpO² 91% on room air, and has audible wheeze. Her regular medications include inhaled salmeterol\/fluticasone. Which statement best describes the correct immediate pharmacological approach?',\n correct: 'Inhaled albuterol (salbutamol) via MDI or nebuliser is first-line; onset is within 5 minutes',\n opts: [\n 'Inhaled albuterol (salbutamol) via MDI or nebuliser is first-line; onset is within 5 minutes',\n 'Oral salbutamol is preferred in the emergency setting as it avoids coordination difficulty with inhalers',\n 'Her regular salmeterol should be doubled in dose for immediate acute relief',\n 'Initiate intravenous terbutaline; inhaled routes are unreliable in severe exacerbations'\n ],\n exp: 'SABAs (albuterol\/salbutamol, levalbuterol) are the cornerstone of acute asthma management — inhaled onset within <strong>5 minutes<\/strong>, duration 4–6 hours. The <strong>oral form is not recommended for acute exacerbation<\/strong> due to slower onset and less effective bronchodilation. LABAs (salmeterol, formoterol) are <em>never<\/em> appropriate as monotherapy or for acute relief; they are maintenance agents used only in combination with inhaled corticosteroids. IV terbutaline is reserved for patients in extremis unresponsive to inhaled therapy.',\n imgId: null\n },\n {\n id: 2,\n tag: 'Inhaled Corticosteroids — Adverse Effects',\n stem: 'A <strong>38-year-old man<\/strong> with moderate persistent asthma has been well controlled on high-dose inhaled beclomethasone for 8 months. He presents complaining of hoarseness of voice for 6 weeks. On examination you notice white, curd-like plaques on his soft palate and posterior pharynx. Which statement correctly identifies both the mechanism of these two adverse effects and their prevention?',\n correct: 'Oropharyngeal deposition of ICS causes local immunosuppression (thrush) and direct mucosal irritation (dysphonia); both are reduced by large-volume spacer use and rinsing the oropharynx after each inhalation',\n opts: [\n 'Oropharyngeal deposition of ICS causes local immunosuppression (thrush) and direct mucosal irritation (dysphonia); both are reduced by large-volume spacer use and rinsing the oropharynx after each inhalation',\n 'These are systemic corticosteroid effects; switching to equivalent-dose oral prednisolone would eliminate them',\n 'The thrush reflects adrenal suppression from ICS; a short synacthen test is required before any change',\n 'Dysphonia is caused by β2 receptor stimulation from co-prescribed LABA; withholding salmeterol will resolve it'\n ],\n exp: 'Inhaled corticosteroids cause two characteristic local adverse effects: <strong>oropharyngeal candidiasis (thrush)<\/strong> from local immunosuppression from steroid deposition, and <strong>dysphonia<\/strong> from myopathy of the laryngeal muscles. Both result from drug deposition in the oropharynx. Prevention: a <strong>large-volume spacer<\/strong> reduces oropharyngeal impaction, and <strong>rinsing and gargling after each inhalation<\/strong> removes residual drug. Systemic effects (adrenal suppression, cataracts, growth deceleration) are much less common and are not the explanation here.',\n imgId: null\n },\n {\n id: 3,\n tag: 'Antileukotriene Agents — Indication',\n stem: 'A <strong>19-year-old competitive swimmer<\/strong> has mild persistent asthma triggered by exercise. He has concurrent perennial allergic rhinitis with nasal obstruction. He also reports that taking ibuprofen for muscle soreness reliably provokes bronchospasm within 30 minutes — consistent with aspirin-exacerbated respiratory disease (AERD). He asks whether a single <em>oral<\/em> agent could address all three of his problems. Which drug class fulfils this?',\n correct: 'Leukotriene receptor antagonists (e.g., montelukast)',\n opts: [\n 'Leukotriene receptor antagonists (e.g., montelukast)',\n 'Short-acting β2-agonists (e.g., albuterol)',\n 'Short-acting muscarinic antagonists (e.g., ipratropium)',\n 'Mast cell stabilisers (e.g., cromolyn)'\n ],\n exp: 'Antileukotriene agents have three specific indications that align precisely with this patient\\'s problems: <strong>(1) exercise-induced bronchospasm<\/strong>, <strong>(2) mild persistent asthma with comorbid allergic rhinitis<\/strong>, and <strong>(3) asthma with aspirin-exacerbated respiratory disease<\/strong> — where COX inhibition shunts arachidonic acid towards leukotriene synthesis; blocking leukotriene receptors interrupts this pathway. Montelukast also carries a <strong>neuropsychiatric caution<\/strong> (mood and behavioural changes) which warrants counselling. SABAs are relievers, not maintenance agents. Ipratropium and cromolyn do not address rhinitis or AERD.',\n imgId: 'mrq02-img1'\n },\n {\n id: 4,\n tag: 'Methylxanthines — Toxicity',\n stem: 'A <strong>62-year-old man<\/strong> with asthma poorly controlled on high-dose inhaled corticosteroids was started on oral theophylline 3 weeks ago as an add-on agent. He now presents with persistent nausea, a fine tremor of both hands, and had a single episode of palpitations last night. His serum theophylline level is 24 mg\/L (therapeutic range 5–15 mg\/L). Which statement correctly describes theophylline\\'s mechanism and the clinical significance of this level?',\n correct: 'Theophylline inhibits phosphodiesterase and blocks adenosine receptors; at supratherapeutic levels it can cause arrhythmias, seizures, and death',\n opts: [\n 'Theophylline inhibits phosphodiesterase and blocks adenosine receptors; at supratherapeutic levels it can cause arrhythmias, seizures, and death',\n 'Theophylline competitively blocks M3 muscarinic receptors; these symptoms represent atropine-like excess and are not life-threatening',\n 'Theophylline selectively inhibits 5-lipoxygenase; elevated levels primarily cause hepatotoxicity requiring urgent liver function testing',\n 'Theophylline is an anti-IgE monoclonal antibody; tremor indicates an injection site reaction and the serum level reflects antibody titre'\n ],\n exp: 'Theophylline has a <strong>narrow therapeutic index<\/strong>: inhibits phosphodiesterase (preventing cAMP degradation → smooth muscle relaxation) and blocks adenosine receptors (preventing bronchoconstriction and histamine release). At levels above 20 mg\/L, toxic features emerge in sequence: <strong>GI symptoms, tremor, headache<\/strong> (as here), then <strong>cardiac arrhythmias, hypotension, seizures, and death<\/strong> at higher levels. Serum levels must be monitored regularly. Caution in patients with seizure disorders, arrhythmias, hepatic impairment, peptic ulcer disease, and hyperthyroidism. This patient requires dose reduction and cardiac monitoring.',\n imgId: null\n },\n {\n id: 5,\n tag: 'Biologic Agents — Phenotype Selection',\n stem: 'A <strong>34-year-old woman<\/strong> has severe asthma uncontrolled despite high-dose inhaled corticosteroids plus a long-acting β2-agonist. She reports two exacerbations requiring oral prednisolone in the past year. Investigations: blood eosinophil count <strong>420 cells\/µL<\/strong>, total serum IgE <strong>14 IU\/mL<\/strong>, allergen skin prick testing <strong>negative<\/strong>. Which biologic agent is most appropriate, and which investigation result most decisively excludes omalizumab?',\n correct: 'Mepolizumab or benralizumab (anti-IL-5 pathway); omalizumab is excluded because IgE is below the required minimum of 30 IU\/mL and allergen testing is negative',\n opts: [\n 'Mepolizumab or benralizumab (anti-IL-5 pathway); omalizumab is excluded because IgE is below the required minimum of 30 IU\/mL and allergen testing is negative',\n 'Omalizumab (anti-IgE); her eosinophilia reflects a secondary phenomenon and the IgE level is within the acceptable therapeutic range',\n 'Dupilumab (anti-IL-4 receptor); this is first-line over anti-IL-5 agents in all eosinophilic asthma regardless of eosinophil count',\n 'No biologic is indicated; she requires assessment for vocal cord dysfunction as an alternative diagnosis'\n ],\n exp: '<strong>Omalizumab<\/strong> (anti-IgE) has two mandatory criteria: total IgE <strong>30–700 IU\/mL<\/strong> <em>and<\/em> a positive allergen skin test or specific IgE to a perennial allergen. This patient fails both thresholds — IgE of 14 IU\/mL is below the minimum and allergen testing is negative. <strong>Mepolizumab<\/strong> (anti-IL-5, age >12, eosinophils ≥150 cells\/µL) and <strong>benralizumab<\/strong> (anti-IL-5 receptor, age >12, eosinophils ≥150 cells\/µL) are both appropriate for her eosinophilic phenotype. Dupilumab is also an option (IL-4 receptor blockade, eosinophils ≥150) but anti-IL-5 agents are the more targeted first choice in pure eosinophilic disease without atopic comorbidity.',\n imgId: null\n }\n ];\n\n var answers = {}, answered = 0, shuffled = {}, done = false;\n\n function byId(id) { return document.getElementById(id); }\n function gid(s) { return byId(NS + '-' + s); }\n\n function shuffleArr(arr) {\n var a = arr.slice(), i, j, tmp;\n for (i = a.length - 1; i > 0; i--) {\n j = Math.floor(Math.random() * (i + 1));\n tmp = a[i]; a[i] = a[j]; a[j] = tmp;\n }\n return a;\n }\n\n function countVal(val) {\n var k, n = 0;\n for (k in answers) {\n if (answers.hasOwnProperty(k) && answers[k] === val) n++;\n }\n return n;\n }\n\n function buildPips() {\n var cont = gid('pips'), i, q, wl, wp, line, pip;\n cont.innerHTML = '';\n for (i = 0; i < QS.length; i++) {\n q = QS[i];\n if (i > 0) {\n wl = document.createElement('div'); wl.className = 'mr-pip-wrap';\n line = document.createElement('div'); line.className = 'mr-pip-line'; line.id = NS + '-pl' + q.id;\n wl.appendChild(line); cont.appendChild(wl);\n }\n wp = document.createElement('div'); wp.className = 'mr-pip-wrap';\n pip = document.createElement('div'); pip.className = 'mr-pip'; pip.id = NS + '-pip' + q.id;\n pip.textContent = String(q.id);\n wp.appendChild(pip); cont.appendChild(wp);\n }\n }\n\n function build() {\n var cont = gid('cases'), i, q, opts, card, top, nd, meta, tg, st, rule, od, expDiv, lbl, txt, imgDiv, imgSrc, j, oe, ls, ts;\n cont.innerHTML = '';\n answers = {}; answered = 0; shuffled = {}; done = false;\n gid('score').style.display = 'none';\n buildPips();\n\n for (i = 0; i < QS.length; i++) {\n q = QS[i]; opts = shuffleArr(q.opts); shuffled[q.id] = opts;\n\n card = document.createElement('div'); card.className = 'mr-case';\n top = document.createElement('div'); top.className = 'mr-case-top';\n nd = document.createElement('div'); nd.className = 'mr-num'; nd.textContent = q.id < 10 ? '0' + q.id : String(q.id);\n meta = document.createElement('div'); meta.className = 'mr-meta';\n tg = document.createElement('div'); tg.className = 'mr-tag'; tg.innerHTML = q.tag;\n st = document.createElement('div'); st.className = 'mr-stem'; st.innerHTML = q.stem;\n meta.appendChild(tg); meta.appendChild(st);\n top.appendChild(nd); top.appendChild(meta); card.appendChild(top);\n\n rule = document.createElement('div'); rule.className = 'mr-rule'; card.appendChild(rule);\n\n od = document.createElement('div'); od.className = 'mr-opts';\n for (j = 0; j < opts.length; j++) {\n oe = document.createElement('div'); oe.className = 'mr-opt';\n oe.id = NS + '-o' + q.id + '-' + j;\n oe.setAttribute('role','button'); oe.setAttribute('tabindex','0');\n ls = document.createElement('span'); ls.className = 'mr-ltr'; ls.textContent = LTRS[j];\n ts = document.createElement('span'); ts.className = 'mr-opt-text'; ts.innerHTML = opts[j];\n oe.appendChild(ls); oe.appendChild(ts); od.appendChild(oe);\n (function (qid, oi) { oe.addEventListener('click', function () { pick(qid, oi); }); }(q.id, j));\n }\n card.appendChild(od);\n\n expDiv = document.createElement('div'); expDiv.className = 'mr-exp'; expDiv.id = NS + '-exp' + q.id;\n lbl = document.createElement('div'); lbl.className = 'mr-exp-lbl'; lbl.textContent = 'Debrief';\n txt = document.createElement('div'); txt.className = 'mr-exp-text'; txt.innerHTML = q.exp;\n expDiv.appendChild(lbl); expDiv.appendChild(txt);\n\n if (q.imgId) {\n imgSrc = byId(q.imgId);\n if (imgSrc) { imgDiv = document.createElement('div'); imgDiv.innerHTML = imgSrc.innerHTML; expDiv.appendChild(imgDiv); }\n }\n\n card.appendChild(expDiv); cont.appendChild(card);\n }\n }\n\n function pick(qid, oi) {\n var q, opts, i, el, correct;\n if (answers[qid] !== undefined || done) return;\n q = null;\n for (i = 0; i < QS.length; i++) { if (QS[i].id === qid) { q = QS[i]; break; } }\n if (!q) return;\n opts = shuffled[qid]; correct = (opts[oi] === q.correct);\n answers[qid] = correct ? 'c' : 'w'; answered++;\n for (i = 0; i < opts.length; i++) {\n el = byId(NS + '-o' + qid + '-' + i);\n if (opts[i] === q.correct) { el.className = 'mr-opt correct locked'; }\n else if (i === oi) { el.className = 'mr-opt wrong locked'; }\n else { el.className = 'mr-opt dimmed locked'; }\n }\n byId(NS + '-exp' + qid).style.display = 'block';\n byId(NS + '-pip' + qid).className = 'mr-pip ' + (correct ? 'correct' : 'wrong');\n if (qid > 1) { var pl = gid('pl' + qid); if (pl) pl.className = 'mr-pip-line done'; }\n }\n\n function showScore() {\n var c, w, s, net, pct, disp, verdicts, vi, sc;\n if (done) return; done = true;\n c = countVal('c'); w = countVal('w'); s = TOTAL - answered;\n net = (c * 4) - w; pct = Math.max(0, Math.round((net \/ MAX) * 100)); disp = Math.min(100, Math.max(0, pct));\n gid('ring').style.background = 'conic-gradient(#8B3D20 ' + disp + '%, #E8DDD8 0%)';\n gid('pct').textContent = pct + '%'; gid('net').textContent = 'Net Score: ' + net + ' \/ ' + MAX;\n verdicts = [\n [5,'Perfect round. Exceptional clinical pharmacology.'],\n [4,'Strong \\u2014 one nuance to revisit.'],\n [3,'Solid base \\u2014 consolidate the finer distinctions.'],\n [2,'Halfway there \\u2014 review the missed cases carefully.'],\n [0,'These cases repay close reading. Come back tomorrow.']\n ];\n gid('verdict').textContent = verdicts[4][1];\n for (vi = 0; vi < verdicts.length; vi++) { if (c >= verdicts[vi][0]) { gid('verdict').textContent = verdicts[vi][1]; break; } }\n gid('ct-c').textContent = '\\u2705 ' + c + ' Correct';\n gid('ct-w').textContent = '\\u274C ' + w + ' Wrong';\n gid('ct-s').textContent = '\\u23ED ' + s + ' Skipped';\n sc = gid('score'); sc.style.display = 'block'; sc.scrollIntoView({behavior:'smooth',block:'center'});\n }\n\n function initObserver() {\n var sentinel = gid('sentinel'), bar = gid('progress');\n if (!sentinel || !bar || !window.IntersectionObserver) return;\n new IntersectionObserver(function (entries) {\n bar.className = entries[0].isIntersecting ? 'mr-progress' : 'mr-progress visible';\n }, {threshold:0}).observe(sentinel);\n }\n\n function init() {\n gid('submit').addEventListener('click', showScore);\n gid('retry').addEventListener('click', function () { build(); window.scrollTo(0,0); });\n initObserver(); build();\n }\n\n if (document.readyState === 'loading') { document.addEventListener('DOMContentLoaded', init); } else { init(); }\n}());\n<\/script>\n<\/body>\n<\/html>\n\n\n","protected":false},"excerpt":{"rendered":"<p>Morning Rounds · Asthma Pharmacology ASTHMA PHARMACOLOGY — SITES OF DRUG ACTION Antigen (allergen) IgE on mast cell surface Mediator release Early response Bronchoconstriction Late response Inflammation Symptoms (wheeze, SOB) Hyperresponsiveness Avoidance Omalizumab Chromones β2-agonists Theophylline Muscarinic antagonists Corticosteroids Antileukotrienes Anti-IL-5 \/ Anti-IL-4 Points of pharmacological intervention in asthma pathophysiology Asthma drug action cascade. Left:… <\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[24],"tags":[],"class_list":["post-36666","post","type-post","status-publish","format-standard","hentry","category-neet-pg"],"yoast_head":"\n<title>Asthma Pharmacology - atsixty<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Asthma Pharmacology - atsixty\" \/>\n<meta property=\"og:description\" content=\"Morning Rounds · Asthma Pharmacology ASTHMA PHARMACOLOGY — SITES OF DRUG ACTION Antigen (allergen) IgE on mast cell surface Mediator release Early response Bronchoconstriction Late response Inflammation Symptoms (wheeze, SOB) Hyperresponsiveness Avoidance Omalizumab Chromones β2-agonists Theophylline Muscarinic antagonists Corticosteroids Antileukotrienes Anti-IL-5 \/ Anti-IL-4 Points of pharmacological intervention in asthma pathophysiology Asthma drug action cascade. Left:… \" \/>\n<meta property=\"og:url\" content=\"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/\" \/>\n<meta property=\"og:site_name\" content=\"atsixty\" \/>\n<meta property=\"article:published_time\" content=\"2026-04-23T04:00:48+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-23T07:30:24+00:00\" \/>\n<meta name=\"author\" content=\"Avi\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Avi\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/\"},\"author\":{\"name\":\"Avi\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"headline\":\"Asthma Pharmacology\",\"datePublished\":\"2026-04-23T04:00:48+00:00\",\"dateModified\":\"2026-04-23T07:30:24+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/\"},\"wordCount\":126,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"articleSection\":[\"NEET PG\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/\",\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/\",\"name\":\"Asthma Pharmacology - atsixty\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\"},\"datePublished\":\"2026-04-23T04:00:48+00:00\",\"dateModified\":\"2026-04-23T07:30:24+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/atsixty.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Asthma Pharmacology\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\",\"url\":\"https:\\\/\\\/atsixty.com\\\/\",\"name\":\"At Sixty\",\"description\":\"The Option Taken\",\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/atsixty.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\",\"name\":\"Avi\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"url\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"contentUrl\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"width\":200,\"height\":200,\"caption\":\"Avi\"},\"logo\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\"},\"sameAs\":[\"https:\\\/\\\/atsixty.com\"],\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/author\\\/avinaux\\\/\"}]}<\/script>\n","yoast_head_json":{"title":"Asthma Pharmacology - atsixty","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/","og_locale":"en_US","og_type":"article","og_title":"Asthma Pharmacology - atsixty","og_description":"Morning Rounds · Asthma Pharmacology ASTHMA PHARMACOLOGY — SITES OF DRUG ACTION Antigen (allergen) IgE on mast cell surface Mediator release Early response Bronchoconstriction Late response Inflammation Symptoms (wheeze, SOB) Hyperresponsiveness Avoidance Omalizumab Chromones β2-agonists Theophylline Muscarinic antagonists Corticosteroids Antileukotrienes Anti-IL-5 \/ Anti-IL-4 Points of pharmacological intervention in asthma pathophysiology Asthma drug action cascade. Left:… ","og_url":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/","og_site_name":"atsixty","article_published_time":"2026-04-23T04:00:48+00:00","article_modified_time":"2026-04-23T07:30:24+00:00","author":"Avi","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Avi","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/#article","isPartOf":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/"},"author":{"name":"Avi","@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"headline":"Asthma Pharmacology","datePublished":"2026-04-23T04:00:48+00:00","dateModified":"2026-04-23T07:30:24+00:00","mainEntityOfPage":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/"},"wordCount":126,"commentCount":0,"publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"articleSection":["NEET PG"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/","url":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/","name":"Asthma Pharmacology - atsixty","isPartOf":{"@id":"https:\/\/atsixty.com\/#website"},"datePublished":"2026-04-23T04:00:48+00:00","dateModified":"2026-04-23T07:30:24+00:00","breadcrumb":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/atsixty.com\/"},{"@type":"ListItem","position":2,"name":"Asthma Pharmacology"}]},{"@type":"WebSite","@id":"https:\/\/atsixty.com\/#website","url":"https:\/\/atsixty.com\/","name":"At Sixty","description":"The Option Taken","publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/atsixty.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d","name":"Avi","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","url":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","contentUrl":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","width":200,"height":200,"caption":"Avi"},"logo":{"@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png"},"sameAs":["https:\/\/atsixty.com"],"url":"https:\/\/atsixty.com\/index.php\/author\/avinaux\/"}]}},"_links":{"self":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36666","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/comments?post=36666"}],"version-history":[{"count":2,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36666\/revisions"}],"predecessor-version":[{"id":36668,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36666\/revisions\/36668"}],"wp:attachment":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/media?parent=36666"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/categories?post=36666"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/tags?post=36666"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

{"id":36666,"date":"2026-04-23T09:30:48","date_gmt":"2026-04-23T04:00:48","guid":{"rendered":"https:\/\/atsixty.com\/?p=36666"},"modified":"2026-04-23T13:00:24","modified_gmt":"2026-04-23T07:30:24","slug":"asthma-pharmacology","status":"publish","type":"post","link":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/","title":{"rendered":"Asthma Pharmacology"},"content":{"rendered":"\n\n\n\n\n\n\n\nMorning Rounds · Asthma Pharmacology<\/title>\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Playfair+Display:ital,wght@0,400;0,600;0,700;1,400;1,600&family=Source+Serif+4:ital,wght@0,300;0,400;0,600;1,400&display=swap\" rel=\"stylesheet\">\n<style>\n#mrq02 *,#mrq02 *::before,#mrq02 *::after{box-sizing:border-box;margin:0;padding:0}\n#mrq02{--ter:#8B3D20;--ter-light:#B85A38;--ter-pale:#FDF0EB;--ter-dark:#6B2D14;--correct:#2D6B47;--correct-bg:#EAF6EF;--correct-border:#3A9960;--wrong:#B83232;--wrong-bg:#FDF0F0;--wrong-border:#E53935;--ink:#2C1810;--ink-mid:#5A3D30;--ink-soft:#9A7060;--line:#E8DDD8;--cream:#FAF6F2;--warm:#FFFDF9;font-family:'Source Serif 4',Georgia,serif;font-size:16px;color:var(--ink);background:var(--cream);line-height:1.7;padding:0 0 64px}\n#mrq02 .mr-header{background:var(--ter);color:#FFFDF9;padding:34px 24px 28px;text-align:center}\n#mrq02 .mr-eyebrow{font-size:0.68rem;letter-spacing:0.18em;text-transform:uppercase;font-weight:600;opacity:0.65;margin-bottom:10px}\n#mrq02 .mr-title{font-family:'Playfair Display',serif;font-size:1.75rem;font-weight:700;line-height:1.2;margin-bottom:4px}\n#mrq02 .mr-title em{font-style:italic;font-weight:400;opacity:0.88}\n#mrq02 .mr-subtitle{font-size:0.82rem;opacity:0.7;margin-top:8px;font-style:italic}\n#mrq02 .mr-chips{display:flex;justify-content:center;gap:10px;margin-top:18px;flex-wrap:wrap}\n#mrq02 .mr-chip{background:rgba(255,255,255,0.13);border:1px solid rgba(255,255,255,0.22);border-radius:20px;padding:4px 13px;font-size:0.73rem}\n#mrq02 .mr-sentinel{height:1px}\n#mrq02 .mr-progress{position:fixed;top:0;left:0;right:0;z-index:9999;background:var(--warm);border-bottom:1px solid var(--line);box-shadow:0 2px 12px rgba(44,24,16,0.08);padding:9px 16px;display:none}\n#mrq02 .mr-progress.visible{display:block}\n#mrq02 .mr-prog-inner{max-width:720px;margin:0 auto;display:flex;align-items:center;justify-content:center}\n#mrq02 .mr-pips{display:flex;align-items:center;justify-content:center}\n#mrq02 .mr-pip-wrap{display:flex;align-items:center}\n#mrq02 .mr-pip-line{width:28px;height:2px;background:var(--line);transition:background 0.35s}\n#mrq02 .mr-pip-line.done{background:var(--ter)}\n#mrq02 .mr-pip{width:28px;height:28px;border-radius:50%;border:2px solid var(--line);background:var(--warm);display:flex;align-items:center;justify-content:center;font-size:0.63rem;font-weight:700;color:var(--ink-soft);transition:all 0.3s;flex-shrink:0}\n#mrq02 .mr-pip.correct{background:var(--correct-border);border-color:var(--correct-border);color:#fff}\n#mrq02 .mr-pip.wrong{background:var(--wrong-border);border-color:var(--wrong-border);color:#fff}\n#mrq02 .mr-body{max-width:720px;margin:0 auto;padding:0 16px}\n#mrq02 .mr-case{background:var(--warm);border:1px solid var(--line);border-left:4px solid var(--ter);border-radius:10px;margin:28px 0;overflow:hidden;box-shadow:0 1px 6px rgba(44,24,16,0.05)}\n#mrq02 .mr-case-top{padding:16px 20px 14px;display:flex;gap:14px;align-items:flex-start}\n#mrq02 .mr-num{font-family:'Playfair Display',serif;font-size:2.2rem;font-weight:700;color:var(--ter);opacity:0.16;line-height:1;margin-top:-2px;flex-shrink:0}\n#mrq02 .mr-meta{flex:1}\n#mrq02 .mr-tag{font-size:0.61rem;font-weight:700;letter-spacing:0.14em;text-transform:uppercase;color:var(--ter);opacity:0.75;margin-bottom:5px}\n#mrq02 .mr-stem{font-size:0.94rem;color:var(--ink);line-height:1.72}\n#mrq02 .mr-stem strong{font-weight:600}\n#mrq02 .mr-stem em{font-style:italic}\n#mrq02 .mr-rule{height:1px;background:var(--line);margin:0 20px}\n#mrq02 .mr-opts{padding:12px 20px 16px;display:flex;flex-direction:column;gap:8px}\n#mrq02 .mr-opt{display:flex;align-items:flex-start;gap:11px;padding:10px 14px;border:1.5px solid var(--line);border-radius:8px;cursor:pointer;background:var(--warm);transition:border-color 0.15s,background 0.15s;-webkit-tap-highlight-color:transparent}\n#mrq02 .mr-opt:hover{border-color:var(--ter);background:var(--ter-pale)}\n#mrq02 .mr-opt.locked{cursor:default}\n#mrq02 .mr-opt.locked:hover{border-color:var(--line);background:var(--warm)}\n#mrq02 .mr-opt.correct{border-color:var(--correct-border);background:var(--correct-bg);cursor:default}\n#mrq02 .mr-opt.correct:hover{border-color:var(--correct-border);background:var(--correct-bg)}\n#mrq02 .mr-opt.wrong{border-color:var(--wrong-border);background:var(--wrong-bg);cursor:default}\n#mrq02 .mr-opt.wrong:hover{border-color:var(--wrong-border);background:var(--wrong-bg)}\n#mrq02 .mr-opt.dimmed{opacity:0.35;cursor:default}\n#mrq02 .mr-opt.dimmed:hover{border-color:var(--line);background:var(--warm)}\n#mrq02 .mr-ltr{flex-shrink:0;width:20px;height:20px;border-radius:50%;border:1.5px solid var(--line);display:flex;align-items:center;justify-content:center;font-size:0.62rem;font-weight:700;color:var(--ink-soft);margin-top:2px;transition:all 0.15s}\n#mrq02 .mr-opt.correct .mr-ltr{background:var(--correct-border);border-color:var(--correct-border);color:#fff}\n#mrq02 .mr-opt.wrong .mr-ltr{background:var(--wrong-border);border-color:var(--wrong-border);color:#fff}\n#mrq02 .mr-opt-text{font-size:0.9rem;color:var(--ink-mid);line-height:1.58}\n#mrq02 .mr-opt.correct .mr-opt-text{color:var(--correct);font-weight:600}\n#mrq02 .mr-opt.wrong .mr-opt-text{color:var(--wrong)}\n#mrq02 .mr-exp{display:none;border-top:1px solid #c8e0d8;background:linear-gradient(180deg,#edf7f4 0%,#f4faf8 100%);padding:13px 20px 15px}\n#mrq02 .mr-exp-lbl{font-size:0.61rem;font-weight:700;letter-spacing:0.12em;text-transform:uppercase;color:var(--correct);margin-bottom:6px}\n#mrq02 .mr-exp-text{font-size:0.86rem;color:#1c4a3a;line-height:1.68}\n#mrq02 .mr-exp-text strong{font-weight:600}\n#mrq02 .mr-exp-text em{font-style:italic}\n#mrq02 .mr-img-wrap{margin-top:14px;background:var(--warm);border:1px solid var(--line);border-radius:8px;padding:14px;text-align:center}\n#mrq02 .mr-img-wrap figcaption{font-size:0.73rem;color:var(--ink-soft);font-style:italic;margin-top:8px;line-height:1.4}\n#mrq02 .mr-submit-wrap{text-align:center;padding:28px 16px 8px}\n#mrq02 .mr-btn{background:var(--ter);color:#FFFDF9;border:none;border-radius:8px;padding:13px 44px;font-family:'Playfair Display',serif;font-size:1rem;font-weight:700;cursor:pointer;box-shadow:0 2px 8px rgba(139,61,32,0.28)}\n#mrq02 .mr-btn:hover{background:var(--ter-dark)}\n#mrq02 .mr-score{display:none;background:var(--warm);border:1px solid var(--line);border-top:4px solid var(--ter);border-radius:10px;margin:24px 0 0;box-shadow:0 2px 12px rgba(44,24,16,0.08);overflow:hidden}\n#mrq02 .mr-score-in{padding:28px 24px;text-align:center}\n#mrq02 .mr-score-ey{font-size:0.66rem;letter-spacing:0.14em;text-transform:uppercase;color:var(--ink-soft);margin-bottom:12px;font-weight:600}\n#mrq02 .mr-ring{width:98px;height:98px;border-radius:50%;background:conic-gradient(var(--ter) 0%, var(--line) 0%);display:flex;align-items:center;justify-content:center;margin:0 auto 16px;position:relative}\n#mrq02 .mr-ring::before{content:'';position:absolute;width:76px;height:76px;border-radius:50%;background:var(--warm)}\n#mrq02 .mr-ring-in{position:relative;display:flex;flex-direction:column;align-items:center;line-height:1.2}\n#mrq02 .mr-ring-pct{font-family:'Playfair Display',serif;font-size:1.3rem;font-weight:700;color:var(--ter)}\n#mrq02 .mr-ring-sub{font-size:0.54rem;color:var(--ink-soft);text-transform:uppercase;letter-spacing:0.06em}\n#mrq02 .mr-score-title{font-family:'Playfair Display',serif;font-size:1.15rem;font-weight:700;color:var(--ink);margin-bottom:4px}\n#mrq02 .mr-score-net{font-size:0.9rem;color:var(--ter);font-weight:600;margin-bottom:4px}\n#mrq02 .mr-verdict{font-size:0.83rem;color:var(--ink-soft);font-style:italic;margin-bottom:18px;padding:0 12px}\n#mrq02 .mr-bands{display:flex;justify-content:center;gap:10px;flex-wrap:wrap}\n#mrq02 .mr-band{padding:5px 13px;border-radius:16px;font-size:0.78rem;font-weight:600}\n#mrq02 .mr-band-c{background:var(--correct-bg);color:var(--correct)}\n#mrq02 .mr-band-w{background:var(--wrong-bg);color:var(--wrong)}\n#mrq02 .mr-band-s{background:var(--ter-pale);color:var(--ter)}\n#mrq02 .mr-retry{display:block;margin:18px auto 4px;background:transparent;border:2px solid var(--ter);color:var(--ter);border-radius:8px;padding:9px 28px;font-family:'Playfair Display',serif;font-size:0.92rem;font-weight:700;cursor:pointer}\n#mrq02 .mr-retry:hover{background:var(--ter);color:#FFFDF9}\n@media(max-width:480px){#mrq02 .mr-title{font-size:1.4rem}#mrq02 .mr-num{font-size:1.7rem}#mrq02 .mr-stem{font-size:0.9rem}#mrq02 .mr-opt-text{font-size:0.86rem}}\n<\/style>\n<\/head>\n<body>\n\n<div id=\"mrq02-img1\" style=\"display:none\">\n <figure class=\"mr-img-wrap\">\n <svg viewBox=\"0 0 560 220\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width:100%;max-width:560px;display:block;margin:0 auto\">\n <rect x=\"0\" y=\"0\" width=\"560\" height=\"220\" rx=\"10\" fill=\"#1a1a2e\"\/>\n <text x=\"280\" y=\"18\" text-anchor=\"middle\" fill=\"#aaaacc\" font-size=\"9.5\" font-family=\"Georgia,serif\" letter-spacing=\"1.5\">ASTHMA PHARMACOLOGY — SITES OF DRUG ACTION<\/text>\n <rect x=\"14\" y=\"28\" width=\"82\" height=\"34\" rx=\"5\" fill=\"#2a2a4a\" stroke=\"#4444aa\" stroke-width=\"1\"\/>\n <text x=\"55\" y=\"42\" text-anchor=\"middle\" fill=\"#8888dd\" font-size=\"8\" font-family=\"Georgia,serif\">Antigen<\/text>\n <text x=\"55\" y=\"54\" text-anchor=\"middle\" fill=\"#8888dd\" font-size=\"8\" font-family=\"Georgia,serif\">(allergen)<\/text>\n <rect x=\"130\" y=\"28\" width=\"90\" height=\"34\" rx=\"5\" fill=\"#2a2a4a\" stroke=\"#4444aa\" stroke-width=\"1\"\/>\n <text x=\"175\" y=\"42\" text-anchor=\"middle\" fill=\"#8888dd\" font-size=\"8\" font-family=\"Georgia,serif\">IgE on mast<\/text>\n <text x=\"175\" y=\"54\" text-anchor=\"middle\" fill=\"#8888dd\" font-size=\"8\" font-family=\"Georgia,serif\">cell surface<\/text>\n <rect x=\"260\" y=\"28\" width=\"90\" height=\"34\" rx=\"5\" fill=\"#2a2a4a\" stroke=\"#4444aa\" stroke-width=\"1\"\/>\n <text x=\"305\" y=\"42\" text-anchor=\"middle\" fill=\"#8888dd\" font-size=\"8\" font-family=\"Georgia,serif\">Mediator<\/text>\n <text x=\"305\" y=\"54\" text-anchor=\"middle\" fill=\"#8888dd\" font-size=\"8\" font-family=\"Georgia,serif\">release<\/text>\n <line x1=\"97\" y1=\"45\" x2=\"128\" y2=\"45\" stroke=\"#5555bb\" stroke-width=\"1.5\" marker-end=\"url(#arr)\"\/>\n <line x1=\"221\" y1=\"45\" x2=\"258\" y2=\"45\" stroke=\"#5555bb\" stroke-width=\"1.5\" marker-end=\"url(#arr)\"\/>\n <defs>\n <marker id=\"arr\" markerWidth=\"6\" markerHeight=\"6\" refX=\"5\" refY=\"3\" orient=\"auto\">\n <path d=\"M0,0 L0,6 L6,3 z\" fill=\"#5555bb\"\/>\n <\/marker>\n <marker id=\"arr2\" markerWidth=\"6\" markerHeight=\"6\" refX=\"5\" refY=\"3\" orient=\"auto\">\n <path d=\"M0,0 L0,6 L6,3 z\" fill=\"#cc4444\"\/>\n <\/marker>\n <marker id=\"arr3\" markerWidth=\"6\" markerHeight=\"6\" refX=\"5\" refY=\"3\" orient=\"auto\">\n <path d=\"M0,0 L0,6 L6,3 z\" fill=\"#44aa66\"\/>\n <\/marker>\n <\/defs>\n <line x1=\"305\" y1=\"63\" x2=\"305\" y2=\"82\" stroke=\"#5555bb\" stroke-width=\"1.5\" marker-end=\"url(#arr)\"\/>\n <line x1=\"305\" y1=\"63\" x2=\"420\" y2=\"82\" stroke=\"#5555bb\" stroke-width=\"1.5\" marker-end=\"url(#arr)\"\/>\n <rect x=\"245\" y=\"84\" width=\"118\" height=\"30\" rx=\"5\" fill=\"#1e3a28\" stroke=\"#3a9960\" stroke-width=\"1.2\"\/>\n <text x=\"304\" y=\"97\" text-anchor=\"middle\" fill=\"#6fcf97\" font-size=\"8\" font-family=\"Georgia,serif\">Early response<\/text>\n <text x=\"304\" y=\"108\" text-anchor=\"middle\" fill=\"#6fcf97\" font-size=\"8\" font-family=\"Georgia,serif\">Bronchoconstriction<\/text>\n <rect x=\"365\" y=\"84\" width=\"118\" height=\"30\" rx=\"5\" fill=\"#3a1e1e\" stroke=\"#cc4444\" stroke-width=\"1.2\"\/>\n <text x=\"424\" y=\"97\" text-anchor=\"middle\" fill=\"#f47c7c\" font-size=\"8\" font-family=\"Georgia,serif\">Late response<\/text>\n <text x=\"424\" y=\"108\" text-anchor=\"middle\" fill=\"#f47c7c\" font-size=\"8\" font-family=\"Georgia,serif\">Inflammation<\/text>\n <line x1=\"304\" y1=\"115\" x2=\"304\" y2=\"134\" stroke=\"#3a9960\" stroke-width=\"1.5\" marker-end=\"url(#arr3)\"\/>\n <line x1=\"424\" y1=\"115\" x2=\"424\" y2=\"134\" stroke=\"#cc4444\" stroke-width=\"1.5\" marker-end=\"url(#arr2)\"\/>\n <rect x=\"244\" y=\"136\" width=\"120\" height=\"22\" rx=\"4\" fill=\"#0d2b1e\" stroke=\"#2d6b47\" stroke-width=\"1\"\/>\n <text x=\"304\" y=\"151\" text-anchor=\"middle\" fill=\"#5ab87a\" font-size=\"7.5\" font-family=\"Georgia,serif\">Symptoms (wheeze, SOB)<\/text>\n <rect x=\"364\" y=\"136\" width=\"120\" height=\"22\" rx=\"4\" fill=\"#2b0d0d\" stroke=\"#8b2020\" stroke-width=\"1\"\/>\n <text x=\"424\" y=\"151\" text-anchor=\"middle\" fill=\"#d47070\" font-size=\"7.5\" font-family=\"Georgia,serif\">Hyperresponsiveness<\/text>\n <line x1=\"55\" y1=\"63\" x2=\"55\" y2=\"170\" stroke=\"#666688\" stroke-width=\"1\" stroke-dasharray=\"3,3\"\/>\n <text x=\"55\" y=\"180\" text-anchor=\"middle\" fill=\"#9999bb\" font-size=\"7.5\" font-family=\"Georgia,serif\">Avoidance<\/text>\n <line x1=\"175\" y1=\"63\" x2=\"175\" y2=\"170\" stroke=\"#666688\" stroke-width=\"1\" stroke-dasharray=\"3,3\"\/>\n <text x=\"175\" y=\"180\" text-anchor=\"middle\" fill=\"#cc9966\" font-size=\"7.5\" font-family=\"Georgia,serif\">Omalizumab<\/text>\n <text x=\"175\" y=\"190\" text-anchor=\"middle\" fill=\"#cc9966\" font-size=\"7\" font-family=\"Georgia,serif\">Chromones<\/text>\n <text x=\"304\" y=\"168\" text-anchor=\"middle\" fill=\"#88cc99\" font-size=\"7\" font-family=\"Georgia,serif\">β2-agonists<\/text>\n <text x=\"304\" y=\"178\" text-anchor=\"middle\" fill=\"#88cc99\" font-size=\"7\" font-family=\"Georgia,serif\">Theophylline<\/text>\n <text x=\"304\" y=\"188\" text-anchor=\"middle\" fill=\"#88cc99\" font-size=\"7\" font-family=\"Georgia,serif\">Muscarinic antagonists<\/text>\n <text x=\"424\" y=\"168\" text-anchor=\"middle\" fill=\"#dd8888\" font-size=\"7\" font-family=\"Georgia,serif\">Corticosteroids<\/text>\n <text x=\"424\" y=\"178\" text-anchor=\"middle\" fill=\"#dd8888\" font-size=\"7\" font-family=\"Georgia,serif\">Antileukotrienes<\/text>\n <text x=\"424\" y=\"188\" text-anchor=\"middle\" fill=\"#dd8888\" font-size=\"7\" font-family=\"Georgia,serif\">Anti-IL-5 \/ Anti-IL-4<\/text>\n <text x=\"280\" y=\"210\" text-anchor=\"middle\" fill=\"#666688\" font-size=\"7.5\" font-family=\"Georgia,serif\" font-style=\"italic\">Points of pharmacological intervention in asthma pathophysiology<\/text>\n <\/svg>\n <figcaption>Asthma drug action cascade. <strong>Left:<\/strong> omalizumab and chromones block at the IgE\/mast cell level. <strong>Centre:<\/strong> β2-agonists, theophylline, and muscarinic antagonists reverse the early bronchoconstriction response. <strong>Right:<\/strong> corticosteroids, antileukotrienes, and anti-IL-5\/IL-4 biologics suppress the late inflammatory response and airway hyperresponsiveness.<\/figcaption>\n <\/figure>\n<\/div>\n\n<div id=\"mrq02\">\n\n <div class=\"mr-header\">\n <div class=\"mr-eyebrow\">Morning Rounds · Daily Clinical Quiz<\/div>\n <div class=\"mr-title\">Asthma<br><em>Pharmacology<\/em><\/div>\n <div class=\"mr-subtitle\">Five cases · Read carefully · Trust your instinct<\/div>\n <div class=\"mr-chips\">\n <span class=\"mr-chip\">5 Cases<\/span>\n <span class=\"mr-chip\">+4 \/ −1 scoring<\/span>\n <span class=\"mr-chip\">Options reshuffled<\/span>\n <\/div>\n <\/div>\n\n <div class=\"mr-sentinel\" id=\"mrq02-sentinel\"><\/div>\n\n <div class=\"mr-progress\" id=\"mrq02-progress\">\n <div class=\"mr-prog-inner\">\n <div class=\"mr-pips\" id=\"mrq02-pips\"><\/div>\n <\/div>\n <\/div>\n\n <div class=\"mr-body\">\n <div id=\"mrq02-cases\"><\/div>\n <div class=\"mr-submit-wrap\">\n <button class=\"mr-btn\" id=\"mrq02-submit\">Submit for Debrief<\/button>\n <\/div>\n <div class=\"mr-score\" id=\"mrq02-score\">\n <div class=\"mr-score-in\">\n <div class=\"mr-score-ey\">Round Complete<\/div>\n <div class=\"mr-ring\" id=\"mrq02-ring\">\n <div class=\"mr-ring-in\">\n <span class=\"mr-ring-pct\" id=\"mrq02-pct\">0%<\/span>\n <span class=\"mr-ring-sub\">net<\/span>\n <\/div>\n <\/div>\n <div class=\"mr-score-title\">Your Debrief<\/div>\n <div class=\"mr-score-net\" id=\"mrq02-net\"><\/div>\n <div class=\"mr-verdict\" id=\"mrq02-verdict\"><\/div>\n <div class=\"mr-bands\">\n <span class=\"mr-band mr-band-c\" id=\"mrq02-ct-c\"><\/span>\n <span class=\"mr-band mr-band-w\" id=\"mrq02-ct-w\"><\/span>\n <span class=\"mr-band mr-band-s\" id=\"mrq02-ct-s\"><\/span>\n <\/div>\n <button class=\"mr-retry\" id=\"mrq02-retry\">↻ New Round<\/button>\n <\/div>\n <\/div>\n <\/div>\n\n<\/div>\n\n<script>\n(function () {\n 'use strict';\n var NS = 'mrq02', TOTAL = 5, MAX = 20;\n var LTRS = ['A','B','C','D'];\n\n var QS = [\n {\n id: 1,\n tag: 'β2-Agonists — Acute Use',\n stem: 'A <strong>22-year-old woman<\/strong> arrives in the emergency department with an acute asthma exacerbation. She is breathless at rest, SpO² 91% on room air, and has audible wheeze. Her regular medications include inhaled salmeterol\/fluticasone. Which statement best describes the correct immediate pharmacological approach?',\n correct: 'Inhaled albuterol (salbutamol) via MDI or nebuliser is first-line; onset is within 5 minutes',\n opts: [\n 'Inhaled albuterol (salbutamol) via MDI or nebuliser is first-line; onset is within 5 minutes',\n 'Oral salbutamol is preferred in the emergency setting as it avoids coordination difficulty with inhalers',\n 'Her regular salmeterol should be doubled in dose for immediate acute relief',\n 'Initiate intravenous terbutaline; inhaled routes are unreliable in severe exacerbations'\n ],\n exp: 'SABAs (albuterol\/salbutamol, levalbuterol) are the cornerstone of acute asthma management — inhaled onset within <strong>5 minutes<\/strong>, duration 4–6 hours. The <strong>oral form is not recommended for acute exacerbation<\/strong> due to slower onset and less effective bronchodilation. LABAs (salmeterol, formoterol) are <em>never<\/em> appropriate as monotherapy or for acute relief; they are maintenance agents used only in combination with inhaled corticosteroids. IV terbutaline is reserved for patients in extremis unresponsive to inhaled therapy.',\n imgId: null\n },\n {\n id: 2,\n tag: 'Inhaled Corticosteroids — Adverse Effects',\n stem: 'A <strong>38-year-old man<\/strong> with moderate persistent asthma has been well controlled on high-dose inhaled beclomethasone for 8 months. He presents complaining of hoarseness of voice for 6 weeks. On examination you notice white, curd-like plaques on his soft palate and posterior pharynx. Which statement correctly identifies both the mechanism of these two adverse effects and their prevention?',\n correct: 'Oropharyngeal deposition of ICS causes local immunosuppression (thrush) and direct mucosal irritation (dysphonia); both are reduced by large-volume spacer use and rinsing the oropharynx after each inhalation',\n opts: [\n 'Oropharyngeal deposition of ICS causes local immunosuppression (thrush) and direct mucosal irritation (dysphonia); both are reduced by large-volume spacer use and rinsing the oropharynx after each inhalation',\n 'These are systemic corticosteroid effects; switching to equivalent-dose oral prednisolone would eliminate them',\n 'The thrush reflects adrenal suppression from ICS; a short synacthen test is required before any change',\n 'Dysphonia is caused by β2 receptor stimulation from co-prescribed LABA; withholding salmeterol will resolve it'\n ],\n exp: 'Inhaled corticosteroids cause two characteristic local adverse effects: <strong>oropharyngeal candidiasis (thrush)<\/strong> from local immunosuppression from steroid deposition, and <strong>dysphonia<\/strong> from myopathy of the laryngeal muscles. Both result from drug deposition in the oropharynx. Prevention: a <strong>large-volume spacer<\/strong> reduces oropharyngeal impaction, and <strong>rinsing and gargling after each inhalation<\/strong> removes residual drug. Systemic effects (adrenal suppression, cataracts, growth deceleration) are much less common and are not the explanation here.',\n imgId: null\n },\n {\n id: 3,\n tag: 'Antileukotriene Agents — Indication',\n stem: 'A <strong>19-year-old competitive swimmer<\/strong> has mild persistent asthma triggered by exercise. He has concurrent perennial allergic rhinitis with nasal obstruction. He also reports that taking ibuprofen for muscle soreness reliably provokes bronchospasm within 30 minutes — consistent with aspirin-exacerbated respiratory disease (AERD). He asks whether a single <em>oral<\/em> agent could address all three of his problems. Which drug class fulfils this?',\n correct: 'Leukotriene receptor antagonists (e.g., montelukast)',\n opts: [\n 'Leukotriene receptor antagonists (e.g., montelukast)',\n 'Short-acting β2-agonists (e.g., albuterol)',\n 'Short-acting muscarinic antagonists (e.g., ipratropium)',\n 'Mast cell stabilisers (e.g., cromolyn)'\n ],\n exp: 'Antileukotriene agents have three specific indications that align precisely with this patient\\'s problems: <strong>(1) exercise-induced bronchospasm<\/strong>, <strong>(2) mild persistent asthma with comorbid allergic rhinitis<\/strong>, and <strong>(3) asthma with aspirin-exacerbated respiratory disease<\/strong> — where COX inhibition shunts arachidonic acid towards leukotriene synthesis; blocking leukotriene receptors interrupts this pathway. Montelukast also carries a <strong>neuropsychiatric caution<\/strong> (mood and behavioural changes) which warrants counselling. SABAs are relievers, not maintenance agents. Ipratropium and cromolyn do not address rhinitis or AERD.',\n imgId: 'mrq02-img1'\n },\n {\n id: 4,\n tag: 'Methylxanthines — Toxicity',\n stem: 'A <strong>62-year-old man<\/strong> with asthma poorly controlled on high-dose inhaled corticosteroids was started on oral theophylline 3 weeks ago as an add-on agent. He now presents with persistent nausea, a fine tremor of both hands, and had a single episode of palpitations last night. His serum theophylline level is 24 mg\/L (therapeutic range 5–15 mg\/L). Which statement correctly describes theophylline\\'s mechanism and the clinical significance of this level?',\n correct: 'Theophylline inhibits phosphodiesterase and blocks adenosine receptors; at supratherapeutic levels it can cause arrhythmias, seizures, and death',\n opts: [\n 'Theophylline inhibits phosphodiesterase and blocks adenosine receptors; at supratherapeutic levels it can cause arrhythmias, seizures, and death',\n 'Theophylline competitively blocks M3 muscarinic receptors; these symptoms represent atropine-like excess and are not life-threatening',\n 'Theophylline selectively inhibits 5-lipoxygenase; elevated levels primarily cause hepatotoxicity requiring urgent liver function testing',\n 'Theophylline is an anti-IgE monoclonal antibody; tremor indicates an injection site reaction and the serum level reflects antibody titre'\n ],\n exp: 'Theophylline has a <strong>narrow therapeutic index<\/strong>: inhibits phosphodiesterase (preventing cAMP degradation → smooth muscle relaxation) and blocks adenosine receptors (preventing bronchoconstriction and histamine release). At levels above 20 mg\/L, toxic features emerge in sequence: <strong>GI symptoms, tremor, headache<\/strong> (as here), then <strong>cardiac arrhythmias, hypotension, seizures, and death<\/strong> at higher levels. Serum levels must be monitored regularly. Caution in patients with seizure disorders, arrhythmias, hepatic impairment, peptic ulcer disease, and hyperthyroidism. This patient requires dose reduction and cardiac monitoring.',\n imgId: null\n },\n {\n id: 5,\n tag: 'Biologic Agents — Phenotype Selection',\n stem: 'A <strong>34-year-old woman<\/strong> has severe asthma uncontrolled despite high-dose inhaled corticosteroids plus a long-acting β2-agonist. She reports two exacerbations requiring oral prednisolone in the past year. Investigations: blood eosinophil count <strong>420 cells\/µL<\/strong>, total serum IgE <strong>14 IU\/mL<\/strong>, allergen skin prick testing <strong>negative<\/strong>. Which biologic agent is most appropriate, and which investigation result most decisively excludes omalizumab?',\n correct: 'Mepolizumab or benralizumab (anti-IL-5 pathway); omalizumab is excluded because IgE is below the required minimum of 30 IU\/mL and allergen testing is negative',\n opts: [\n 'Mepolizumab or benralizumab (anti-IL-5 pathway); omalizumab is excluded because IgE is below the required minimum of 30 IU\/mL and allergen testing is negative',\n 'Omalizumab (anti-IgE); her eosinophilia reflects a secondary phenomenon and the IgE level is within the acceptable therapeutic range',\n 'Dupilumab (anti-IL-4 receptor); this is first-line over anti-IL-5 agents in all eosinophilic asthma regardless of eosinophil count',\n 'No biologic is indicated; she requires assessment for vocal cord dysfunction as an alternative diagnosis'\n ],\n exp: '<strong>Omalizumab<\/strong> (anti-IgE) has two mandatory criteria: total IgE <strong>30–700 IU\/mL<\/strong> <em>and<\/em> a positive allergen skin test or specific IgE to a perennial allergen. This patient fails both thresholds — IgE of 14 IU\/mL is below the minimum and allergen testing is negative. <strong>Mepolizumab<\/strong> (anti-IL-5, age >12, eosinophils ≥150 cells\/µL) and <strong>benralizumab<\/strong> (anti-IL-5 receptor, age >12, eosinophils ≥150 cells\/µL) are both appropriate for her eosinophilic phenotype. Dupilumab is also an option (IL-4 receptor blockade, eosinophils ≥150) but anti-IL-5 agents are the more targeted first choice in pure eosinophilic disease without atopic comorbidity.',\n imgId: null\n }\n ];\n\n var answers = {}, answered = 0, shuffled = {}, done = false;\n\n function byId(id) { return document.getElementById(id); }\n function gid(s) { return byId(NS + '-' + s); }\n\n function shuffleArr(arr) {\n var a = arr.slice(), i, j, tmp;\n for (i = a.length - 1; i > 0; i--) {\n j = Math.floor(Math.random() * (i + 1));\n tmp = a[i]; a[i] = a[j]; a[j] = tmp;\n }\n return a;\n }\n\n function countVal(val) {\n var k, n = 0;\n for (k in answers) {\n if (answers.hasOwnProperty(k) && answers[k] === val) n++;\n }\n return n;\n }\n\n function buildPips() {\n var cont = gid('pips'), i, q, wl, wp, line, pip;\n cont.innerHTML = '';\n for (i = 0; i < QS.length; i++) {\n q = QS[i];\n if (i > 0) {\n wl = document.createElement('div'); wl.className = 'mr-pip-wrap';\n line = document.createElement('div'); line.className = 'mr-pip-line'; line.id = NS + '-pl' + q.id;\n wl.appendChild(line); cont.appendChild(wl);\n }\n wp = document.createElement('div'); wp.className = 'mr-pip-wrap';\n pip = document.createElement('div'); pip.className = 'mr-pip'; pip.id = NS + '-pip' + q.id;\n pip.textContent = String(q.id);\n wp.appendChild(pip); cont.appendChild(wp);\n }\n }\n\n function build() {\n var cont = gid('cases'), i, q, opts, card, top, nd, meta, tg, st, rule, od, expDiv, lbl, txt, imgDiv, imgSrc, j, oe, ls, ts;\n cont.innerHTML = '';\n answers = {}; answered = 0; shuffled = {}; done = false;\n gid('score').style.display = 'none';\n buildPips();\n\n for (i = 0; i < QS.length; i++) {\n q = QS[i]; opts = shuffleArr(q.opts); shuffled[q.id] = opts;\n\n card = document.createElement('div'); card.className = 'mr-case';\n top = document.createElement('div'); top.className = 'mr-case-top';\n nd = document.createElement('div'); nd.className = 'mr-num'; nd.textContent = q.id < 10 ? '0' + q.id : String(q.id);\n meta = document.createElement('div'); meta.className = 'mr-meta';\n tg = document.createElement('div'); tg.className = 'mr-tag'; tg.innerHTML = q.tag;\n st = document.createElement('div'); st.className = 'mr-stem'; st.innerHTML = q.stem;\n meta.appendChild(tg); meta.appendChild(st);\n top.appendChild(nd); top.appendChild(meta); card.appendChild(top);\n\n rule = document.createElement('div'); rule.className = 'mr-rule'; card.appendChild(rule);\n\n od = document.createElement('div'); od.className = 'mr-opts';\n for (j = 0; j < opts.length; j++) {\n oe = document.createElement('div'); oe.className = 'mr-opt';\n oe.id = NS + '-o' + q.id + '-' + j;\n oe.setAttribute('role','button'); oe.setAttribute('tabindex','0');\n ls = document.createElement('span'); ls.className = 'mr-ltr'; ls.textContent = LTRS[j];\n ts = document.createElement('span'); ts.className = 'mr-opt-text'; ts.innerHTML = opts[j];\n oe.appendChild(ls); oe.appendChild(ts); od.appendChild(oe);\n (function (qid, oi) { oe.addEventListener('click', function () { pick(qid, oi); }); }(q.id, j));\n }\n card.appendChild(od);\n\n expDiv = document.createElement('div'); expDiv.className = 'mr-exp'; expDiv.id = NS + '-exp' + q.id;\n lbl = document.createElement('div'); lbl.className = 'mr-exp-lbl'; lbl.textContent = 'Debrief';\n txt = document.createElement('div'); txt.className = 'mr-exp-text'; txt.innerHTML = q.exp;\n expDiv.appendChild(lbl); expDiv.appendChild(txt);\n\n if (q.imgId) {\n imgSrc = byId(q.imgId);\n if (imgSrc) { imgDiv = document.createElement('div'); imgDiv.innerHTML = imgSrc.innerHTML; expDiv.appendChild(imgDiv); }\n }\n\n card.appendChild(expDiv); cont.appendChild(card);\n }\n }\n\n function pick(qid, oi) {\n var q, opts, i, el, correct;\n if (answers[qid] !== undefined || done) return;\n q = null;\n for (i = 0; i < QS.length; i++) { if (QS[i].id === qid) { q = QS[i]; break; } }\n if (!q) return;\n opts = shuffled[qid]; correct = (opts[oi] === q.correct);\n answers[qid] = correct ? 'c' : 'w'; answered++;\n for (i = 0; i < opts.length; i++) {\n el = byId(NS + '-o' + qid + '-' + i);\n if (opts[i] === q.correct) { el.className = 'mr-opt correct locked'; }\n else if (i === oi) { el.className = 'mr-opt wrong locked'; }\n else { el.className = 'mr-opt dimmed locked'; }\n }\n byId(NS + '-exp' + qid).style.display = 'block';\n byId(NS + '-pip' + qid).className = 'mr-pip ' + (correct ? 'correct' : 'wrong');\n if (qid > 1) { var pl = gid('pl' + qid); if (pl) pl.className = 'mr-pip-line done'; }\n }\n\n function showScore() {\n var c, w, s, net, pct, disp, verdicts, vi, sc;\n if (done) return; done = true;\n c = countVal('c'); w = countVal('w'); s = TOTAL - answered;\n net = (c * 4) - w; pct = Math.max(0, Math.round((net \/ MAX) * 100)); disp = Math.min(100, Math.max(0, pct));\n gid('ring').style.background = 'conic-gradient(#8B3D20 ' + disp + '%, #E8DDD8 0%)';\n gid('pct').textContent = pct + '%'; gid('net').textContent = 'Net Score: ' + net + ' \/ ' + MAX;\n verdicts = [\n [5,'Perfect round. Exceptional clinical pharmacology.'],\n [4,'Strong \\u2014 one nuance to revisit.'],\n [3,'Solid base \\u2014 consolidate the finer distinctions.'],\n [2,'Halfway there \\u2014 review the missed cases carefully.'],\n [0,'These cases repay close reading. Come back tomorrow.']\n ];\n gid('verdict').textContent = verdicts[4][1];\n for (vi = 0; vi < verdicts.length; vi++) { if (c >= verdicts[vi][0]) { gid('verdict').textContent = verdicts[vi][1]; break; } }\n gid('ct-c').textContent = '\\u2705 ' + c + ' Correct';\n gid('ct-w').textContent = '\\u274C ' + w + ' Wrong';\n gid('ct-s').textContent = '\\u23ED ' + s + ' Skipped';\n sc = gid('score'); sc.style.display = 'block'; sc.scrollIntoView({behavior:'smooth',block:'center'});\n }\n\n function initObserver() {\n var sentinel = gid('sentinel'), bar = gid('progress');\n if (!sentinel || !bar || !window.IntersectionObserver) return;\n new IntersectionObserver(function (entries) {\n bar.className = entries[0].isIntersecting ? 'mr-progress' : 'mr-progress visible';\n }, {threshold:0}).observe(sentinel);\n }\n\n function init() {\n gid('submit').addEventListener('click', showScore);\n gid('retry').addEventListener('click', function () { build(); window.scrollTo(0,0); });\n initObserver(); build();\n }\n\n if (document.readyState === 'loading') { document.addEventListener('DOMContentLoaded', init); } else { init(); }\n}());\n<\/script>\n<\/body>\n<\/html>\n\n\n","protected":false},"excerpt":{"rendered":"<p>Morning Rounds · Asthma Pharmacology ASTHMA PHARMACOLOGY — SITES OF DRUG ACTION Antigen (allergen) IgE on mast cell surface Mediator release Early response Bronchoconstriction Late response Inflammation Symptoms (wheeze, SOB) Hyperresponsiveness Avoidance Omalizumab Chromones β2-agonists Theophylline Muscarinic antagonists Corticosteroids Antileukotrienes Anti-IL-5 \/ Anti-IL-4 Points of pharmacological intervention in asthma pathophysiology Asthma drug action cascade. Left:… <\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[24],"tags":[],"class_list":["post-36666","post","type-post","status-publish","format-standard","hentry","category-neet-pg"],"yoast_head":"\n<title>Asthma Pharmacology - atsixty<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Asthma Pharmacology - atsixty\" \/>\n<meta property=\"og:description\" content=\"Morning Rounds · Asthma Pharmacology ASTHMA PHARMACOLOGY — SITES OF DRUG ACTION Antigen (allergen) IgE on mast cell surface Mediator release Early response Bronchoconstriction Late response Inflammation Symptoms (wheeze, SOB) Hyperresponsiveness Avoidance Omalizumab Chromones β2-agonists Theophylline Muscarinic antagonists Corticosteroids Antileukotrienes Anti-IL-5 \/ Anti-IL-4 Points of pharmacological intervention in asthma pathophysiology Asthma drug action cascade. Left:… \" \/>\n<meta property=\"og:url\" content=\"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/\" \/>\n<meta property=\"og:site_name\" content=\"atsixty\" \/>\n<meta property=\"article:published_time\" content=\"2026-04-23T04:00:48+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-23T07:30:24+00:00\" \/>\n<meta name=\"author\" content=\"Avi\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Avi\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/\"},\"author\":{\"name\":\"Avi\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"headline\":\"Asthma Pharmacology\",\"datePublished\":\"2026-04-23T04:00:48+00:00\",\"dateModified\":\"2026-04-23T07:30:24+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/\"},\"wordCount\":126,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"articleSection\":[\"NEET PG\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/\",\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/\",\"name\":\"Asthma Pharmacology - atsixty\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\"},\"datePublished\":\"2026-04-23T04:00:48+00:00\",\"dateModified\":\"2026-04-23T07:30:24+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/23\\\/asthma-pharmacology\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/atsixty.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Asthma Pharmacology\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\",\"url\":\"https:\\\/\\\/atsixty.com\\\/\",\"name\":\"At Sixty\",\"description\":\"The Option Taken\",\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/atsixty.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\",\"name\":\"Avi\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"url\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"contentUrl\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"width\":200,\"height\":200,\"caption\":\"Avi\"},\"logo\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\"},\"sameAs\":[\"https:\\\/\\\/atsixty.com\"],\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/author\\\/avinaux\\\/\"}]}<\/script>\n","yoast_head_json":{"title":"Asthma Pharmacology - atsixty","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/","og_locale":"en_US","og_type":"article","og_title":"Asthma Pharmacology - atsixty","og_description":"Morning Rounds · Asthma Pharmacology ASTHMA PHARMACOLOGY — SITES OF DRUG ACTION Antigen (allergen) IgE on mast cell surface Mediator release Early response Bronchoconstriction Late response Inflammation Symptoms (wheeze, SOB) Hyperresponsiveness Avoidance Omalizumab Chromones β2-agonists Theophylline Muscarinic antagonists Corticosteroids Antileukotrienes Anti-IL-5 \/ Anti-IL-4 Points of pharmacological intervention in asthma pathophysiology Asthma drug action cascade. Left:… ","og_url":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/","og_site_name":"atsixty","article_published_time":"2026-04-23T04:00:48+00:00","article_modified_time":"2026-04-23T07:30:24+00:00","author":"Avi","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Avi","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/#article","isPartOf":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/"},"author":{"name":"Avi","@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"headline":"Asthma Pharmacology","datePublished":"2026-04-23T04:00:48+00:00","dateModified":"2026-04-23T07:30:24+00:00","mainEntityOfPage":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/"},"wordCount":126,"commentCount":0,"publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"articleSection":["NEET PG"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/","url":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/","name":"Asthma Pharmacology - atsixty","isPartOf":{"@id":"https:\/\/atsixty.com\/#website"},"datePublished":"2026-04-23T04:00:48+00:00","dateModified":"2026-04-23T07:30:24+00:00","breadcrumb":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/23\/asthma-pharmacology\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/atsixty.com\/"},{"@type":"ListItem","position":2,"name":"Asthma Pharmacology"}]},{"@type":"WebSite","@id":"https:\/\/atsixty.com\/#website","url":"https:\/\/atsixty.com\/","name":"At Sixty","description":"The Option Taken","publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/atsixty.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d","name":"Avi","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","url":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","contentUrl":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","width":200,"height":200,"caption":"Avi"},"logo":{"@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png"},"sameAs":["https:\/\/atsixty.com"],"url":"https:\/\/atsixty.com\/index.php\/author\/avinaux\/"}]}},"_links":{"self":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36666","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/comments?post=36666"}],"version-history":[{"count":2,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36666\/revisions"}],"predecessor-version":[{"id":36668,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36666\/revisions\/36668"}],"wp:attachment":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/media?parent=36666"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/categories?post=36666"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/tags?post=36666"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}