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RESP > Asthma > Flashcards

Asthma Flashcards

1
Q

What are obstructive airway diseases?

A

Diseases that affect the airways

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2
Q

What is the triad of asthma?

A
  1. Airway hyper responsiveness
  2. Airway inflammation
  3. Reversible obstruction
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3
Q

What is the end result of asthma on the airways?

A

Airway remodelling.

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4
Q

What are the three hallmarks of airway remodelling

A
  1. Basement membrane thickens
  2. collagen deposition on Sub mucosa
  3. Smooth muscle hypertrophy
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5
Q

Summarise the pathogenesis of asthma (steps) (4)

A
  1. Genetic predisposition/ Triggers
  2. Eosinophilic inflammation
  3. TH2 cytokines and mediators
  4. Twitchy smooth muscle
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6
Q

Common allergens for asthma?

A
  • Animal dander
  • dust mites
  • pollen
  • fungi
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7
Q

Are symptoms and signs of asthma episodic/non?

A

Episodic

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8
Q

What kind of cough does asthma produce

A

Non productive. Can have wheeze tho

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9
Q

Does the asthma get worse at specific times?

A

Diurnal variablility

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10
Q

What other diseases can asthma be linked to?

A

Allergic triad

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11
Q

Can asthma be dependent on family history

A

Yes, common to have asthmatics in the family

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12
Q

What findings can confirm asthma?

A
  • history/ exam
  • Diurnal variability of PEFR
  • Reduced FEV1/FEV <75%
  • response to salbutamol >15%
  • Provocation test: bronchospasm
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13
Q

How would you treat an acute presentation of asthma?

A
  1. Oral steroid- Prednisolone

2. B2 agonist- NEBULISED salbutamol.

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14
Q

What are the treatment steps for chronic asthma? (4)

A
  1. SABA
  2. Inhaled steroid
  3. Add LABA/LAMA
  4. Anti IgE, Anti IL5, Leukotriene antagonists, theophylline, Cromone
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15
Q

Example of SABA?

A

Salbutamol/ terbutaline

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16
Q

Example of LABA?

A

Salmeterol/ formoterol

17
Q

What is the action mechanism for SABA’S/LABA’S? (Refer to the specific molecular pathway)

A
  • B2 Agonist joins to adenylyl cyclase
  • AC produces CAMP
  • CAMP= Reduces Ca conc
  • CAMP= stimulates PKA
  • PKA= inactivates MLCK, Activates MLCphosphatase
  • Relaxation
18
Q

End result of B2 agonists?

A
  • Relaxes smooth muscle

- Dilates bronchial airways

19
Q

What are the common combination therapies used of B2 agonists in Asthma? Eg?

A

LABA/LAMA + ICS

Eg- Formoterol + beclamethasone

20
Q

Example of an inhaled steroid used in asthma?

A

Beclomethasone

21
Q

Why is a spacer device useful?

A
  • Avoids systemic effects
  • Good lung deposition
  • Lowers oropharyngeal and laryngeal side effects
  • Avoids coordination problems
22
Q

What are the actions of Cromones?

A

Anti inflammatory- Mast cell Stabilisers

Prevent histamine release.

23
Q

Example of Cromone?

A

Cromoglycate

24
Q

How do Leukotriene antagonists work?

A

Competitively block CysLT1 receptor.

Receptor to LTC4, LTD4 & LTE4 which cause smooth muscle contraction, mucus secretion and oedema

25
Q

Example of leukotriene antagonist?

A

Montelukast. Admin- ORAL

26
Q

Action mechanism for Anti IgE therapeutics?

A

Inhibits IgE receptor preventing mediator (histamine) release from basophils and mast cells.

27
Q

Example of an anti IgE?

A

Omalizumab. Injections once 2-4 weeks

28
Q

Action mechanism for Anti Il-5?

A

Blocks TH2 cytokine IL-5 receptor which causes eosinophilic inflammation.
Injection- 1nce 4 weeks

29
Q

What are the effects of M1 ,M2 and M3 cholinergic receptors?

A

M1- Enhance cholinergic reflex
M2- Inhibit Ach release
M3- Cause bronchoconstriction + mucus secretion

30
Q

What are the main effects of anti cholinergics?

A

Block M3 receptor- prevents broncho-constriction and mucus secretion

31
Q

Example of SAMA and LAMA?

A

SAMA- Ipratropium

LAMA- Tiotropium

32
Q

What is an example of a methylxanthine?

A

Theophylline

33
Q

Action mechanism for theophylline?

A

Inhibits PDE enzyme, enhancing action of CAMP

Result- increased smooth muscle relaxation

RESP (25 decks)

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