Asthma

Question 1

Cells involved in COPD

Answer 1

Neutrophils macrophages CD8 lymphocytes
Eosinophils, endothelial, epithelial, fibroblasts

Question 2

Acute asthma attack

Answer 2

short attack B agonist
Xanthine preparation
Anti muscarinics

Question 3

Anti inflammatory agents i. Asthma

Answer 3

Corticosteroids
Mast cell stabilisers
Leukotrienes antagonists
Anti ig E monoclonal amtibody
Long acting B blockers

Question 4

Acetylcholine and adenosine

Answer 4

BRONCHOCONSTRICTION

Theophylline and muscarinic antagonists inhibit them

Question 5

CAMP

Answer 5

Bronchodilation

Theophylline inhibits PDE
B blockers + AC to increase camp

Question 6

B blockers

Answer 6

Short acting
B2= Albuterol, levalbuterol, terbutaline, metaproterenol,
pirbuterol, MeTAL P

LABA:- salmeterol, formoterol, Indacaterol, olodaterol, vilanterol (given wd corticosteroids and anti muscarinics)
β2 agonists have other beneficial effects including inhibition of mast cell-mediator release, prevention of microvascular leakage and airway edema, and enhanced mucocillary clearance.

Question 7

Methylxanthine drugs

Answer 7

Methylxanthine Drugs
– MOA: inhibits phosphodiesterase, leading to increased cyclic AMP
– Inhibition of cell surface receptors for adenosine, enhancement of histone deacetylation
– Physiologic effect: direct relaxation of respiratory tract, leading to bronchodilation
– Inhibition of release of cytokines and chemokines (decrease in immune cell migration and activation)
– Uses: chronic bronchitis and COPD
– Side effects: nausea and vomiting, nervousness, tremor, insomnia, tachycardia, flushing, vasodilation, and hypotension, may cause excessive cardiac stimulation and arrythmias, diures

Question 8

Ipratropium, tiotropium (Anti muscarinics)

Answer 8

Inhibits Ach
First line in COPD

Dry mouth

Question 9

Corticosteroids (beclomethasone, budesonide, fluticasone)

Answer 9

Inhibition of phospholipase A2
􏰀 ↓ prostaglandin and leukotrienes
􏰀 ↓ Number of inflammatory cells in airways.
􏰀 Mast cell stabilization →↓ histamine release.
􏰀 ↓ capillary permeability and mucosal edema.
􏰀 Inhibition of antigen-antibody reaction.
􏰀 Upregulate β2 receptors and restore their efficacy

Immunosupression
Hyperglycemia, protein catabolism, hypertension
Depression, osteoporosis

Question 10

Mild intermittent

Answer 10

B2 bronchodilator

Question 11

Mild persistent

Answer 11

Corticosteroids
Nedocromil
Anti leukotrienes

Question 12

Moderate persistent

Answer 12

Corticosteroids
B2 bronchodilators

Question 13

Severe persistent

Answer 13

Theophylline
O2 therapy
Anti leukotrienes
B2 bronchodilators
Corticosteroids