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Medical Pharmacology Exam 1 > Asthma > Flashcards

Asthma Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the two main precipitators of allergic asthma? How do recruited leukocytes contribute?

A
  • Mast cell activation
  • Release of inflammatory mediators
  • Initiate second wave of inflammatory reactions
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2
Q

How does chronic airway inflammation affect responsiveness to airway irritants?

A

Asthmatic episodes can now be triggered in the absence of allergens

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3
Q

Clinically, what are 2 features of an asthmatic airway? How are these measured?

A

Bronchial hyperreactivity to aerosolized histamine or adenosine - FEV
Increased eosinophils below epithelium - Sputum or lavage

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4
Q

There are 2 reaction phases associated with asthma, the early and late reactions. How is each treated / prevented?

A

Early - Prophylactic corticosteroids, cromolyn, Beta-2-agonists
Late - Inhaled corticosteroids

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5
Q

What is the class of drug used for quick relief of asthma symptoms?

A

Beta-2- agonists

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6
Q

What are the 3 anti-inflammatory types of drugs used for the long term treatment of asthma?

A

Corticosteroids
Cromolyn
Leukotriene antagonists

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7
Q

What are 2 types of agents used for long term prevention of airway constriction?

A

Long acting beta 2 receptor antagonists

Methylxanthines

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8
Q

What are the 2 leukotrienes associated with asthma?

A

LTB and LTD

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9
Q

How does LTB affect asthma? How dies LTD affect asthma?

A

LTB - Increased neutrophil chemotaxis

LTD - Increased capilary permeability, bronchial constriction and eosinophil chemotaxis

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10
Q

What are 2 oral steroids that can be used for the treatment of asthma?

A

Prednisone

Methylprednisolone

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11
Q

What are the 3 main mechanisms by which steroids work for asthma?

A

Inhibition of PLA2 expression
Reduced synthesis of chemotactic factors
Inhibition of cytokine expression

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12
Q

Why are steroid not immediately effective for the treatment of asthma?

A

They require protein synthesis

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13
Q

What is the major leukotriene associated with bronchoconstriction and edema of the airway? What produces it?

A

LTD4

Made by mast cells

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14
Q

Which leukotriene is chemotactic fo eosinophils? Which is chemotactic for neutrophils?

A

LTD (eosinophils)

LTB (neutrophils)

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15
Q

What is the enzyme target of zileuton? What products of this enzymes are reduced?

A

5-lipoxygenase

LTB and LTD

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16
Q

Zileuton is associated with what organ toxicity? What else should you be aware of when using zileuton?

A

Liver

Inhibits CYP enzymes

17
Q

What are 2 drugs provided as examples of leukotriene receptor antagonists?

A

Montelukast

Zafirlukast

18
Q

What is aspirin induced asthma? What is the likely mechanism? Is this a form of asthma allergy?

A

Bronchoconstriction resulting from aspirin usage (not allergy)
Increased synthesis of leukotrienes vs. prostaglandins from arachidonic acid
No, not allergy

19
Q

What are 2 examples of non-steroid inhaled long term controller of asthma? What is the proposed mechanism?

A

Cromolyn
Nedocromyl
Block mast cell degranulation (block Ca++ channels)
Block Cl channels

20
Q

What is the mechanism by which beta-2 agonists treat asthma?

A

Stimulate adenyl cyclase and cAMP, lead to bronchial smooth muscle relaxation

21
Q

What are 3 beta-2 agonists used to treat asthma?

A

Albuterol
Metaproterenol
Pirbuterol

22
Q

What are 2 long acting beta-2 agonists used to treat asthma?

A

Salmeterol

Formoterol

23
Q

What is a muscarinic antagonist used to treat asthma? What type of response does it inhibit? How does it compare to the beta-2 agonists?

A

Ipratropium
Inhibits the parasympathetic responses associated with asthma
Slower, less effective

24
Q

What is a methylxanthine used for the treatment of asthma? How does it work?

A

Theophilline

Block phophodiesterase, increasing cAMP and thus relaxation of bronchial smooth muscle

25
Q

How does cyclosporin work for asthma?

A

Reduces inflammation by causing immunosupression

26
Q

What branch of the immune response is associated with asthma, and what is its associated antibody?

A

TH2

IgE

Medical Pharmacology Exam 1 (15 decks)

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