Case studies of asthma

Case 1:

A)-A.J is a 30-year-old woman has had asthma since the age of 5 years. Her current medications:

-Beclomethasone 500ug twice daily.

-Salbutamol 200ug when required.

Questions:

1-What are the signs & symptoms of bronchial asthma?

2-Is there any investigation done for indication bronchial asthma?

3-What is the mechanism of action of the present medications?

4-What are their suspected SE?

 

B)A.J visits her (GP) as she has been feeling increasingly short of breath over the past few weeks, so Zafirlukast 200mg twice daily PO is prescribed. Two months later she was admitted to hospital experiencing flu-like symptoms, abdominal pain and loss of appetite. On examination A.J appeared to be jaundiced.

Liver function tests were as follows:

-Bilirubin = 44umol/l     (Normal range <17umol/l)

-Alanine transaminase (ALT)=200u/l (Normal = 0-35u/l)

-Aspartate transaminase (AST)=150u/l(Normal =0-35u/l) 

Questions:

1-What is the MOA of Zafirlukast?

2-What is the likely cause for these symptoms?

3-What is the good alternative?