asthma Flashcards
what does the pathophysiology of asthma involve
eosinophils, IgE production and release, IgE receptor expression on mast cells and eosinophils
what occurs during the immediate phase of an asthma attack?
spasm of bronchial smooth muscle
mast cells releases inflammatory mediators
release of chemotaxins and chemokines attracts leukocytes
what occurs during the late phase of an asthma attack
inflammatory cells release mediators that damage epithelium
inflammatory cells release GFs that cause hyperplasia and hypertrophy of airway smooth muscle cells
what are the 4 types of bronchodilators
beta-adrenoceptors agonists
theophylline/ aminophylline
cysteinyl leukotriene receptor antagonists
muscarinic receptor antagonists
what kind of receptors are Beta-2? how do they cause vasodilation?
G-protein coupled, increase cAMP, activate PKA, decrease Ca
also inhibit mediator release from mast cells
increase mucuc clearance
what are the short acting beta-2 adrenoceptor agonists
salbutamol, terbutaline
what are the long acting beta-2 adrenoceptor agonists
formoterol, salmeterol
what are the adverse effects of beta2 adrenoceptor agonists
tachycarida, termors , dysryhtmias, vasodilation in the periphery, hypokalcemia, hyperglycemia
what are the bronchodilators that act on PDE
theophylline, aminophylline
how do theophylline and aminophylline work?
elevate cAMP levels by inhibiting PDE
inhibit adenosine receptors
inhibit release of calcium
which asthmna drug has a narrow therapeutic window
theophylline / aminophylline
what are theo/aminophylline metaboilizes by?
cytochrome p450 enzymes
what are adverse effects of theophylline/ aminophylline
cardiovascular dysryhtmia, CNS toxicities, upset GI
what are the cysteinyl leukotriene receptor antagonists ?
montelukast and zafirlukast
what are adverse effects of cysteinyl leukotriene antagonists
GI and headache
what are anti-inflammatory agents for asthma
glucocorticosteroids
name 4 glucocorticosteroids
beclometasone, budenoside, fluticasone, prednisolone
what is transactivation
ligand binds to GR dimer and upregulates transcription
what is transrepression
ligand binds to GR dimer and turns off transcription
how do glucocorticosteroids for asthma work
reduce transcription of IL-2 gene
less eosinphils
reduce IgE and receptors
what are the negative side effects of glucocorticosteroids
thrush, croaky voice, adrenal suppression
what drug us used for anti-IgE treatment
omalizumab
what are the adverse effects of omalizumab
anaphylaxix
what drugs used for IL-5 inhibition
mepolizumab, reslizumab
