ASTHMA Flashcards
Differentiates between parasympathetic and sympathetic innervation of the lungs, in relation to the lung.
Autonomic innnervation of the lungs
During parasympathetic the M3 receptors become stimulated resulting to bronchoconstriction (constrict in bronchioles smooth muscles)
During sympathetic the B2 receptors become stimulated resulting to bronchodilation (bronchioles smooth muscles relaxes.
- Common symptoms of pulmonary dieases
- Treatment focuses on what?
- name types of obstructive diseaseses
- Respiratory diseases maybe due to what?
- Wheeze, shortness of breath, cough with or without suputum, and chest pains
- focuses on underlying diseases or symptoms
- COPD and Asthma
- Infection or malignancy
- Define asthma
- how do asthma attacks occur
- symptoms of Asthma
- Common in children with what?
- Inflammatory condition recurrent reversible airway obstruction in response to irritant stimuli
- Intermittent
- Wheezing, shortness of breath, difficult in breathing out (worse at night)
- Atopy=allergic asthama
Common triggers of asthma
Pets, mould, cleaning materials, tobacco smoke, air pollution
Asthma is characterized by what?
- Inflamation of the airways
- Bronchial hyperectivity
- reversible airway obstruction
Name Eliciting agents of immediate phase of asthma
- Allergens
- Non-specific stimulus
Names of cells involved in immediate asthma phase
Mast cells and monuclear cells
During immediate phase of asthma the cells secretes which substances
- Chemokines and chemotaxins
- Spasiminogens Histamine, PGD2, CysTL
Chemicals releasesed during immediate phase of asthma result to which physiological change
Bronchospams
Bronchospams is usually reversed by which drugs?
- Theophylline
- B2 adrenoceptor agonists
- CysTL Receptor antagonists
Explain what happens during late phase of asthma
Infiltration of cytokines realising Th2 cells and monocytes and activation of inflammatory cells particulary easinophils
Name four mediators released in late phase of asthma attacks
- NO
- Adenosine
- Neuropetides
- CysTLs
Name proteins that are released in late phase of asthma
- Eosinophilic Cationic Protein
- Eosinophil major basic Proteins
The proteins that are released in late phase of asthma causes what?
Epithelial damage
what happens to the airways late phase of astma
Airway inflammationa and airway hyperactivity
Late phase of asthma is inhibited by what?
Glucocorticoids
PEFR is the indicator of what?
- ventilate adequacy
- airway obstruction
List examples of B2 agonists drugs use to treat asthma and classify them according to SABA and LABA
- SABA: Salbutamol, fenoterol and terbutaline
- LABA: Salmeterol and formoterol
List Glucorcoticoids drugs
Beclomethasone
Budesonide
Fluticasone
All inhlaled
M3 receptor antagonist for asthma
Ipatropium bromide (inhaled)
Xanthines drugs for asthma
Theophylline and aminophylline
IV/ORAL
drug that antagonise leukotrines
Montelukast
Explain the mechanism of action of B2 adrenoceptor agonist
- B2 activation causes relaxation of bronchial smooth muscles
- Clearing of mucus using cilia
SABAs
1. Clinical use/ indication
2. Route of administration
3. Onset
4. Duration of action
5. Maximum effect
6. Salbutamol dosage
- Acute bronchospasm
- Inhaled
- 5-15 min
- 4-6 hours
- 30 minutes
- 1-2 puffs prn
- Instruction usage of SABAs
- What to note when comes to SABAs
- As needed for acute bronchospasm
- tolerance may develop to bronchodilator effects with continous use or inappropriate
Clinical usage of LABA
COPD, Uncontrolled persistent asthma attack combination with steroids, never use alone for asthma
Route of administration for LABA and onset of action
Inhaled, Onset of action longer than of SABA.
which drugs fall under LABA that you should not use for acute attack?
Salmeterol
Duration of LABA and when to admister LABA
8-12 HOURS
Administer twoce daily consistently
List the adverse effects of B2 adrenoceptor agonists
- discolouration of teeths, mouth dryness, taste alteration
- Nervousness ( B2 stimulation results to increases of catecholimines in nerve terminals
- dizzness, headache, muscle tremor, tachycardia and palpitation (dose related)
Caution for B2 adrennoceptor agonists
- Cardiac arrythmias, IHD, HCF and uncontrolled HT
- Pregnancy: delay labour pain, asthma need to be well controlled, inhalled preparation prefered
DI of B2 adrenoceptor agonists
Non-selective B blockers
