Brett is a 12 y/o boy with a history of asthma, diagnosed 2 years ago. He is an outgoing, active boy and participates in a swim club and soccer, but he has a difficult time adjusting to the limitations of his asthma. He has learned to control acute attacks by using albuterol (Proventil) metered-dose inhaler, and because his asthma is often triggered by exercise, he has been using a budesonide (Pulmicort) inhaler and taking montelukast (Singulair). After competing in his swim meet at the local indoor pool, Brett began experiencing respiratory distress. He alerted his coach, who retrieved the albuterol inhaler from Brett’s backpack. After two inhalations, Brett was still in distress and the rescue team was called. On admission to the emergency department, Brett is in obvious distress with pulse oximeter readings of 90% to 91%. He has nasal flaring and bilateral wheezing is heard in is his lung fields, pulse rate is 122 beats/min, and he is orthopneic. While treatment is started, the nurse asks him questions that he can nod or shake to answer. He shakes his head “no” when asked if he used his budesonide inhaler today and shrugs when asked about his last dose of montelukast. What is the mechanism of action of leukotriene receptor antagonists (LTRAs)?

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Case Study 2

Respiratory Drugs

Brett is a 12 y/o boy with a history of asthma, diagnosed 2 years ago. He is an outgoing, active boy and participates in a swim club and soccer, but he has a difficult time adjusting to the limitations of his asthma. He has learned to control acute attacks by using albuterol (Proventil) metered-dose inhaler, and because his asthma is often triggered by exercise, he has been using a budesonide (Pulmicort) inhaler and taking montelukast (Singulair).

After competing in his swim meet at the local indoor pool, Brett began experiencing respiratory distress. He alerted his coach, who retrieved the albuterol inhaler from Brett’s backpack. After two inhalations, Brett was still in distress and the rescue team was called.

On admission to the emergency department, Brett is in obvious distress with pulse oximeter readings of 90% to 91%. He has nasal flaring and bilateral wheezing is heard in is his lung fields, pulse rate is 122 beats/min, and he is orthopneic. While treatment is started, the nurse asks him questions that he can nod or shake to answer. He shakes his head “no” when asked if he used his budesonide inhaler today and shrugs when asked about his last dose of montelukast. What is the mechanism of action of leukotriene receptor antagonists (LTRAs)?
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