Asthma Flashcards
What is the definition of asthma
Inflammation of airway
Bronchospasms
Thickened mucous secretions
Edema
What is the primary response of the airway to an insult
Tracheal receptor activation - cough reflex
Increase in amount and stickiness of mucous produced
What is the secondary response of the airway to an insult
Prolonged irritation - immune system is activated
What is the result of an activated immune system
Release of mediators from mast cells
Bronchoconstriction and edema
Migration of immune cells to the lung
Airway inflammation
What kind of agents are the initial drugs of choice for short term relief of asthma
Bronchodilators
Mode of admission of B2 agonists
Orally, inhalation or injection
What are the 2 least selective B2 receptor agonists
Epinephrine and isoproterenol
Epinephrine mode of admission, mechanism of action and effects
Inhalation or injection
Activate all adrenergic receptors - not specific
Increase HR, vasoconstriction -> very high BP
Isoproterenol
More specific B2 agonist
Short half life
5 relatively more selective B2 agonists
Albuterol Pirbuterol Bitolterol Levalbuterol Terbutaline
More selective B2 agonists characteristics
6 hour half lives
All can be inhaled - few systemic effects
Very rapid - lower dose
What causes down regulation of more selective B2 agonists
Any agent that acts by activating a receptor
4 longer acting B2 agonists
Formoterol
Arformoterol
Salmoterol
Indicaterol
Disadvantages of longer acting B2 agonists
Not as effective for rapid relief
More liklihood of down regulation
Side effects of all B2 agonists
Tremor, tackycardia, palpitations of heart -B1 effect
2 Cholinergic blockers
Ipratropium
Tiotropium
What are cholinergic blockers analogs of
Atropine
Cholinergic blocker side effects
Antimuscarinic effects - opposite DUMBBELS
CNS: psychosis
Cholinergic blocker characteristics
Given as aerosol - not absorbed - few systemic effects
Slow onset of action
Used more for COPD
Careful with urinary retention and glaucoma
Theophylline mechanism of action
Inhibits cAMP PDE - elevates cellular cAMP
Theophylline characteristics
Given orally or IV
A methylxanthine like caffeine
Low TI
Theophylline side effects
Cardiac stimulation - arrhythmias
CNS stimulation - tremors, insomnia, seizures
GI upset
2 anti inflammatory agents
Cromolyn sodium
Nedocromil
Anti inflammatory agent mechanism of action
Inhibit mast cells and their release of mediators
Inhibit Cl- channels and decrease Ca uptake necessary for secretion
