Asthma Flashcards

0
Q

2nd generation histamine

A
Certirizine
Loratidine
Fexofenadine
Long QTc Syndrome (off market)
Astemizole
Terfenadine
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1
Q

1st generation histamine

A
Diphenhydramine
Chlorpheniramine
Hydroxyzine
Meclizine
Cyclizine
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2
Q

Effects of Leukotrienes

A
  • BRONCHOCONSTRICTION
  • EDEMA
  • MUCUS PRODUCTION
  • INHIBIT MUCOCILIARY TRANSPORT
  • BRONCHIAL HYPERREACTIVITY
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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

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4
Q

Leukotrienes….

A
  • 5-LIPOXYGENASE
  • CHEMOATTRACTANT
  • BRONCHOCONSTRICTION
  • MUCUS SECRETION
  • LT B4, LT C4, LT D4
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5
Q

Properties of cytokines

A
Small PEPTIDES OR GLYCOPROTEINS
Picomolar CONCENTRATIONS
Increase 1000-FOLD
Many DIFFERENT CELL TYPES
Interleukin, INTERFERON, ETC
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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
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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)
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8
Q

Chemoattractants

A
  • EOTAXIN - EOSINOPHILS
  • C5a, LT-B4, PAF - NEUTROPHILS
  • BETA-CHEMOKINES (RANTES, IL-8, MIP)
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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
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10
Q

Treatment for asthma

A
  • BETA2 AGONISTS
  • METHYLXANTHINES
  • ANTI-CHOLINERGICS
  • CORTICOSTEROIDS
  • LEUKOTRIENE INHIBITORS
  • MASTOCYTE STABILIZERS
  • ANTI-IgE THERAPY
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11
Q

Beta agonist

A
•ALBUTEROL
•METAPROTERENOL
•SALMETEROL
•FORMOTEROL
•ISOPROTERENOL
•PIRBUTEROL
•RITODRINE
•TERBUTALINE
•EPINEPHRINE
*Salmeterol and formoterol are long-acting ligand
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12
Q

Methylxanthines

A
  • AMINOPHYLLINE
  • THEOPHYLLINE
  • INCREASE cAMP by preventing breakdown
  • INHIBIT ADENOSINE RECEPTORS
  • Toxicity – can cause arrhythmias, tremors, tachypnea
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13
Q

Anticholinergics

A
  • IPRATROPIUM
  • TIOTROPIUM
  • BEST CHOICE FOR BETA-BLOCKER INDUCES ASTHMA
  • SIDE EFFECTS: Dry mouth, Tachycardia, Increased IOP, Mydriasis, Constipation, etc.
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14
Q

Corticosteroids

A
  • INHIBITS INFLAMMATION
  • INHIBITS PRODUCTION OF CYTOKINES, PGs, LTs
  • POTENTIATES BETA AGONISTS
  • LONG DURATION
  • MANY SIDE EFFECTS
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15
Q

Leukotriene inhibitors

A
  • ZILEUTON - Inhibits Lipoxygenase. Metabolized by CYP3A4, 2C9, 1A2. Decreases clearance of propranolol, warfarin, theophylline, etc.
  • ZAFIRLUKAST - Antagonist of LT D4 Receptor
  • MONTELUKAST - Antagonist of LT D4 Receptor
16
Q

Mast cell stabilizer

A
  • CROMOLYN
  • NEDOCROMIL
  • PROPHYLAXIS
  • PREVENT ANTIGEN AND EXERCISE INDUCED ASTHMA
  • INHIBITS CHLORIDE ION CHANNELS
17
Q

Omalizunab

A

Recombinant Humanized Monoclonal Antibody – IgG
Binds to IgE and prevents them from binding and activating mast cells and basophils
Decreases steroid use for asthma treatment
Elimination t½ = 26 days
Side Effects minimal

18
Q

COPD

A

Treatment includes bronchodialtors, steroids, anticholinergic agents
Chronic progressive disease