asthma

Question 1

what does the pathophysiology of asthma involve

Answer 1

eosinophils, IgE production and release, IgE receptor expression on mast cells and eosinophils

Question 2

what occurs during the immediate phase of an asthma attack?

Answer 2

spasm of bronchial smooth muscle
mast cells releases inflammatory mediators
release of chemotaxins and chemokines attracts leukocytes

Question 3

what occurs during the late phase of an asthma attack

Answer 3

inflammatory cells release mediators that damage epithelium
inflammatory cells release GFs that cause hyperplasia and hypertrophy of airway smooth muscle cells

Question 4

what are the 4 types of bronchodilators

Answer 4

beta-adrenoceptors agonists
theophylline/ aminophylline
cysteinyl leukotriene receptor antagonists
muscarinic receptor antagonists

Question 5

what kind of receptors are Beta-2? how do they cause vasodilation?

Answer 5

G-protein coupled, increase cAMP, activate PKA, decrease Ca
also inhibit mediator release from mast cells
increase mucuc clearance

Question 6

what are the short acting beta-2 adrenoceptor agonists

Answer 6

salbutamol, terbutaline

Question 7

what are the long acting beta-2 adrenoceptor agonists

Answer 7

formoterol, salmeterol

Question 8

what are the adverse effects of beta2 adrenoceptor agonists

Answer 8

tachycarida, termors , dysryhtmias, vasodilation in the periphery, hypokalcemia, hyperglycemia

Question 9

what are the bronchodilators that act on PDE

Answer 9

theophylline, aminophylline

Question 10

how do theophylline and aminophylline work?

Answer 10

elevate cAMP levels by inhibiting PDE
inhibit adenosine receptors
inhibit release of calcium

Question 11

which asthmna drug has a narrow therapeutic window

Answer 11

theophylline / aminophylline

Question 12

what are theo/aminophylline metaboilizes by?

Answer 12

cytochrome p450 enzymes

Question 13

what are adverse effects of theophylline/ aminophylline

Answer 13

cardiovascular dysryhtmia, CNS toxicities, upset GI

Question 14

what are the cysteinyl leukotriene receptor antagonists ?

Answer 14

montelukast and zafirlukast

Question 15

what are adverse effects of cysteinyl leukotriene antagonists

Answer 15

GI and headache

Question 16

what are anti-inflammatory agents for asthma

Answer 16

glucocorticosteroids

Question 17

name 4 glucocorticosteroids

Answer 17

beclometasone, budenoside, fluticasone, prednisolone

Question 18

what is transactivation

Answer 18

ligand binds to GR dimer and upregulates transcription

Question 19

what is transrepression

Answer 19

ligand binds to GR dimer and turns off transcription

Question 20

how do glucocorticosteroids for asthma work

Answer 20

reduce transcription of IL-2 gene
less eosinphils
reduce IgE and receptors

Question 21

what are the negative side effects of glucocorticosteroids

Answer 21

thrush, croaky voice, adrenal suppression

Question 22

what drug us used for anti-IgE treatment

Answer 22

omalizumab

Question 23

what are the adverse effects of omalizumab

Answer 23

anaphylaxix

Question 24

what drugs used for IL-5 inhibition

Answer 24

mepolizumab, reslizumab

Question 25

what are the adverse effects of mepolizumab and reslizumab

Answer 25

headache, injection site reactions, oropharyngeal pain

Question 26

what is the treatment options for COPD

Answer 26

INHALED anticholinergics and rofluilast

Question 27

how do inhaled anticholinergics helps with COPD

Answer 27

limit parasympathetic contraction

Question 28

what are the 2 anticholinergics used for COPD`

Answer 28

ipratropium and tiotropium

Question 29

what is the selectivity of ipratropium and tiotropium

Answer 29

tiotropium = M3
ipratropium = M1-M3

Question 30

how does roflumilast help with COPD

Answer 30

inhibitor of phopshodiesterase 4 which reduces inflammation