Which of the following term best describes the antagonism of bronchoconstrictor effect (mediated at the leukotriene receptors)of leukotrienes by terbutaline (acting at the adrenoceptors) in a patient with asthma?
The question is asking about the antagonism of bronchoconstrictor effects of leukotrienes by terbutaline. Terbutaline acts on adrenoceptors, while leukotrienes act on their own receptors. So, they are acting through different receptors. That would mean they're using different pathways. Antagonism here isn't about blocking the same receptor but counteracting the effect through different mechanisms.
So, the type of antagonism here might be physiologic antagonism. Because they're acting on different receptors but producing opposite effects. Physiologic antagonism occurs when two drugs act on different receptors but produce opposite physiological effects. For example, adrenaline acting on beta-2 receptors to cause bronchodilation versus histamine causing bronchoconstriction via H1 receptors. So terbutaline's action on beta-2 receptors would oppose the leukotriene's action on their receptors (like CysLT1), leading to bronchodilation.
Non-competitive antagonism would involve binding to an allosteric site on the same receptor, but since they're using different receptors, that's not the case here. Competitive antagonism is when two drugs compete for the same receptor. So that's not it either.
The options might have included terms like pharmacologic, chemical, physiologic, or functional antagonism. The correct answer here would be physiologic antagonism. Let me recall the definitions: pharmacologic antagonism is when two drugs act on the same receptor but with opposite effects, and they might compete. But if they act on different receptors but oppose each other's effects, it's physiologic.
So, in this case, terbutaline (beta-2 agonist) and leukotriene receptors (like CysLT1) are different pathways. Therefore, their antagonism is physiologic. That makes sense. Let me make sure there's no other type. Functional antagonism is sometimes used interchangeably with physiologic, but I think physiologic is more precise here.
The clinical pearl would be to remember the difference between pharmacologic and physiologic antagonism. For example, using beta-agonists and anticholinergics in asthma is also physiologic because they act on different receptors. Another example is calcium channel blockers and nitrates in angina.
So the correct answer is physiologic antagonism. Let me structure the explanation accordingly, making sure to explain each part as per the user's instructions.
**Core Concept**
This question tests understanding of **drug antagonism mechanisms**, specifically **physiologic vs. pharmacologic antagonism**. Terbutaline (a beta-2 adrenergic agonist) and leukotrienes (which act on CysLT1 receptors) mediate opposing bronchial effects via distinct receptors and pathways.
**Why the Correct Answer is Right**
Physiologic antagonism occurs when two drugs act on *different receptors*