Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

pharmaco > asthma > Flashcards

asthma Flashcards

1
Q

What causes an asthma in general

A

bronchoconstriction and inflammatory cells and debris filling the airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the characteristic of asthma

A
  1. recurrent reversible airway obstruction
  2. hyperresponsiveness of airway
  3. chronic airway inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the types of inflammation for asthma

A

type 1 inflammation: allergic asthma

type 2 inflammation: eosinophilic asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is type 1 inflammation mediated by

A

IgE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens during a type 1 inflammation reaction

A

antigen bounded to IgE crosslinks on the Fc3RI receptor on mast cell

mast cell degranulates, releasing histamines, leukotrienes and other inflammatory mediators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what interleukins promote mast cell activity

A

IL4 and IL13 plays a role in IgE production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

WHat happens in a type 2 inflammation reaction

A

IL5 causes eosinophils to have a late reaction, releasing other inflammatory mediators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does B2 agonist help with asthma

A

bronchodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some examples of fast acting B2 agonists and long acting B2 agonist

A

fast acting: salbutamol, formoterol(fast acting and long acting)

long acting: salmeterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is long acting B2 agonist contraindicated for

A

for patients of all ages without concomitant use of asthma preventer medication like inhaled corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How long does formoterol act, what is its onset of action timing, how is it taken

A

12 hr, fast acting 2-3 minutes, via inhalation/ oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the duration of action for salbutamol, what is the method of administration

A

3-6 hrs, via IV in emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the adverse effects of B2 agonist

A

too high a dose can escape into systemic absorption causing

  1. tremors, muscle cramp, peripheral vasodilation, hypokalemia, hyperglycemia, tachycardia palpitation, B2 adrenoceptor tolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does B2 agonist regulate bronchial tone

A

It increases adenylyl cyclase, converts Ac to phosphodiesterases, increase cAMP which promotes bronchodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are examples of muscarinic receptor antagonist

A

ipratropium bromide(short acting), and tiotropium bromide(long acting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some adverse effect of muscarinic receptor antagonist

A
  • parasympatholytic effects like dry mouth, urinary retention especially in elderly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does muscarinic receptor antagonist regulate bronchial tone

A

blocking ach which causes bronchoconstriction through parasympathetic effects

18
Q

What molecules causes bronchoconstriction

A

leukotriene, adenosine, acetylcholine

19
Q

what is the mechanism of action for methylxanthines

A

inhibits phosphodiesterases , blocks adeosine receptors, increase adrenaline release from adrenal medulla, CNS stimulant action on respiration

has some anti-inflammatory effect on mast cell and T cell, and also decrease microvascular leakiness

20
Q

What are some examples of methylxanthine

A

theophylline and aminophylline

21
Q

What are the adverse effect of methylxanthine

A

narrow therapeutic window

many drug drug interactions

GI effect: nausea, vomitting, abdominal discomfort, anorexia

CNS effect: tremor, nervousness, anxiety, insomnia, seizure

CVS: arrythmia

22
Q

What are some ways in general that are used for anti inflammatory

A
  1. inhaled corticosteroids
  2. leukotriene pathway inhibitors
  3. mast cell stabilisers
  4. anti IgE monoclonal antibody
  5. anti IL4, IL5 signallng monoclonal antibodies
23
Q

why is inhaled corticosteroids good

A
  1. high receptor binding affinity ( so low dose required)
  2. extensive first pass metabolism ( lesser systemic side effects)
  3. highly lipophillic ( can be absorbed by tissues much easier)
24
Q

What are some examples of inhaled corticosteroid

A
  1. budesonide
  2. fluticasone
  3. ciclesonide
25
Q

what is the adverse effect of fluticasone

A

greater risk of adrenal suppression, affect adrenal gland secretion

26
Q

Ciclesonide is a prodrug, what is it activated by

A

esterase, which is found in the lungs

27
Q

What are the effects of glucocorticoid receptor

A
  1. reduce pro inflammatory mediators, T cell, mast cell, decrease pro inflammatory cytokines, decrease mucus, decrease shedding of epithelial cells, decrease 5-LOX, reduce production of leukotrienes, decrease inducible nitric oxide synthase, which decrease nitric oxide production
  2. increase anti inflammatory mediators like annexin A1 and B2 adrenoceptors
28
Q

what is inhaled corticosteroids used for

A
  1. first line prophylactic for asthma treatment
  2. nocturnal asthma due to delayed eosinophilic reaction
29
Q

what are some adverse effect of inhaled corticosteroid

A
  1. oropharyngeal candidiasis
  2. dysphonia
  3. cough/ throat irritation
  4. adrenal suppression
  5. easy bruising
  6. posterior subcapsular cataract
  7. osteoporosis
30
Q

What are some example of leukotriene pathway inhibitors

A
  1. 5LOX inhibitor like zileuton
  2. cysLT receptor antagonist like montelukast
31
Q

What are leukotriene pathway inhibitors good for

A

treating aspirin induced/ nsaid exacerbated asthma

treat exercise induced asthma

32
Q

What are some side effect of leukotriene pathway inhibitors

A

few and mild, gi disturbances, headache

suicide thinking and neurophychiatric adverse effect in some patients

33
Q

What is an example of a mast cell stabiliser

A

cromoglicic acid

34
Q

What does cromoglicic acid do

A

decrease mast cell degranulation induced by IgE mediated Fc3ri crosslinking

decrease secretion of inflammatory mediators from eosinophils, neutrophils and macrophages

control chloride channels to inhibit cellular activation

increase secretion of annexin A1, inhibits prostaglandin and leukotriene

35
Q

What is cromoglicic acid used for

A

prophylactic control of asthma by inhalation only.

prophylactic control of allergic rhinitis, allergic conjunctivities, vernal keratoconjunctivitis

36
Q

what is an example of anti ig-E monoclonal antibody

A

omalizumab

37
Q

What does omalizumab do

A

depletes level of free IgE in serum, so reduced binding to antigen, decreases Fc3RI expression on mast cell, reduce the trigger of allergic asthma

38
Q

What are the cons of anti-IgE monoclonal antibody

A

-expensive
- associated with small increase in risk of heart attack, transient ischemic attacks and blood clot

  • potential for anaphylaxis
39
Q

What are examples of anti IL4 and IL5 signalling monoclonal antibodies

A

Reslizumab (IL5)

Dupilumab(IL4)

40
Q

What is reslizumab and dupilumab indicated for

A

patients with severe persistent eosinophilic asthma older than 18

pharmaco (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions