Asthma Flashcards
(21 cards)
Is airway obstruction is asthma reversible?
Yes
What type of cytokines are activated by T helper cells in the bronchial mucosa of asthmatics?
Th2
What do Th2 cytokines do?
Attract other inflammatory granulocytes to the musocal surface (eosinophils)
Promotes IgE synthesis and responsiveness (in some asthmatics)
What is the immediate phase of an asthma attack caused by?
Spasm of bronchial smooth muscle
What initiates the late phase of an asthma attack
Th2
What do B2-adrenoceptor agonists do?
Dilate the bronchi by direct action on the b2-adrenoceptors of smooth muscle
They inhibit mediator release from eosinophils
They also increase mucous clearance by an action on cilia
What are the side effects of B2-adrenoceptor agonists?
Tremor
Tachycardia
Cardiac dysthrhythmia
What does theophylline do?
It inhibits phosphodiesterase and blocks adenosine receptors
When is theophylline used?
IV in status asthmaticus
Oral add on to inhaled corticosteroids and LABAs
What type of drug is theophylline?
Xanthine
Monteleukast and Zafirlukast are types of which class of drug?
Cysteinyl leukotriene receptor antagonists
What do Cysteinyl leukotriene receptor antagonists do?
Reduce acute reactions to aspirin in sensitive patients
Inhibit exercise-induced asthma
Decreases both early and late responses to an inhaled antigen.
When is a Cysteinyl leukotriene receptor antagonist used?
It is 3rd line: Used as an add on to corticosteroids and LABAs
Name a short(er) acting and a long(er) acting muscarinic receptor antagonist.
Ipratropium
Tiotropium
What are glucocorticoids main action in asthma?
Anti-inflammatory action
How do glucocotricoids work?
They decrease formation of cytokines in particular the Th2 cytokines
What is the main glucocorticoid used in asthma treatment?
Beclometasone
What are the side effects of glucocorticoids?
Oral candidiasis, sore throats, adrenal suppression
What are the treatments given in severe acute asthma (status asthmaticus)?
Oxygen Nebulised salbutamol IV hydrocortisone Oral prednisalone Additional measures: Nebulised ipratropium IV salbutamol/aminophylline antibiotics
What changes does chronic asthma involve?
Increased smooth muscle mass
Accumulation of interstitial fluid
Increased mucous secretion
Epithelial damage
List the order of drugs in the asthma guidelines.
(Identification + avoidance of triggers)
1. Occasional use of SABA
2. Low dose inhaled corticosteroid
(Add anti-histamine if reaction is to known allergen)
3. Love-moderate dose inhaled corticosteriod + LABA
4. High dose inhaled corticosteroids + Regular brochodilators + Leukotriene receptor antagonist or theophylline
5. Regular oral corticosteroids
