Asthma Flashcards
0
Q
2nd generation histamine
A
Certirizine Loratidine Fexofenadine Long QTc Syndrome (off market) Astemizole Terfenadine
1
Q
1st generation histamine
A
Diphenhydramine Chlorpheniramine Hydroxyzine Meclizine Cyclizine
2
Q
Effects of Leukotrienes
A
- BRONCHOCONSTRICTION
- EDEMA
- MUCUS PRODUCTION
- INHIBIT MUCOCILIARY TRANSPORT
- BRONCHIAL HYPERREACTIVITY
3
Q
Kallikreins and kinins
A
Pain – intense burning pain causing release of Substance P and Calcitonin gene-related peptide
Inflammation – including edema and vascular permeability
Bronchoconstriction
Increased renal blood flow
Stimulates tPA production
4
Q
Leukotrienes….
A
- 5-LIPOXYGENASE
- CHEMOATTRACTANT
- BRONCHOCONSTRICTION
- MUCUS SECRETION
- LT B4, LT C4, LT D4
5
Q
Properties of cytokines
A
Small PEPTIDES OR GLYCOPROTEINS Picomolar CONCENTRATIONS Increase 1000-FOLD Many DIFFERENT CELL TYPES Interleukin, INTERFERON, ETC
6
Q
Chemokins
A
- PEPTIDES (70-90 AMINO ACIDS)
- ALPHA (C-X-C) - NEUTROPHIL ACTIVATORS
- BETA (C-C) - ACTIVATORS OF MONOCYTES, LYMPHOCYTES, BASOPHILS AND EOSINOPHILS
- TARGETS OTHER CELLS
7
Q
Functions of Epithelial cells
A
- INVOLVED IN INFLAMMATORY PROCESS
- RELEASES MEDIATORS: NO, PGE2, 15-HETE, ARACHIDONIC ACID
- CYTOKINES: GMCSF, IL-8, RANTES (CCL-5), EOTAXIN (TH-2)
8
Q
Chemoattractants
A
- EOTAXIN - EOSINOPHILS
- C5a, LT-B4, PAF - NEUTROPHILS
- BETA-CHEMOKINES (RANTES, IL-8, MIP)
9
Q
Immune cell synthesis
A
- HGMCSF stimulates Granulocytes, Macrophages, RBCs, Eosinophils
- IFN & IL-2 stimulate Macrophages and B-cells (TH1)
- IL-4 & IL-5 stimulate B-cells and Eosinophils (TH2)
- IL-3 stimulates Mastocytes and increases their half-life; also increases IgE synthesis and expression
10
Q
Treatment for asthma
A
- BETA2 AGONISTS
- METHYLXANTHINES
- ANTI-CHOLINERGICS
- CORTICOSTEROIDS
- LEUKOTRIENE INHIBITORS
- MASTOCYTE STABILIZERS
- ANTI-IgE THERAPY
11
Q
Beta agonist
A
•ALBUTEROL •METAPROTERENOL •SALMETEROL •FORMOTEROL •ISOPROTERENOL •PIRBUTEROL •RITODRINE •TERBUTALINE •EPINEPHRINE *Salmeterol and formoterol are long-acting ligand
12
Q
Methylxanthines
A
- AMINOPHYLLINE
- THEOPHYLLINE
- INCREASE cAMP by preventing breakdown
- INHIBIT ADENOSINE RECEPTORS
- Toxicity – can cause arrhythmias, tremors, tachypnea
13
Q
Anticholinergics
A
- IPRATROPIUM
- TIOTROPIUM
- BEST CHOICE FOR BETA-BLOCKER INDUCES ASTHMA
- SIDE EFFECTS: Dry mouth, Tachycardia, Increased IOP, Mydriasis, Constipation, etc.
14
Q
Corticosteroids
A
- INHIBITS INFLAMMATION
- INHIBITS PRODUCTION OF CYTOKINES, PGs, LTs
- POTENTIATES BETA AGONISTS
- LONG DURATION
- MANY SIDE EFFECTS