Asthma Flashcards
Asthma is an obstructive airway disease. True or false?
Is it reversible?
True
Reversible airway obstruction
What happens to smooth muscle in airway remodelling?
Hypertrophy - (reduces lumen of airway)
More mucus is produced by asthmatics. Why is this? What complication can arise from this?
Increase number of goblet cells
Mucus plugs can form -> (lung collapse)
What leukocyte is associated with asthma?
Eosinophils
Describe the balance between TH1 and TH2 cells in asthma?
Increase in both
Higher ratio of TH2 to TH1
What antibody mediates asthma?
IgE
What effect does the parasympathetic system have on airways?
Bronchoconstriction
What must be noted about sympathetic nervation of the bronchi?
There is no innervation
Relies on adrenaline released from adrenal glands to act on B2 receptors -> vasodilation
What is a wheeze?
High pitched expiratory sound
Classic presentation of asthma?
CDE
Cough - dry
Dyspnoea/ diurnal variation
Expiratory wheeze
What is the difference between atopic/extrinsic and non-atopic/intrinsic asthma?
Atopic/extrinsic = allergic -> e.g. dust mites, animal fur, pollen
Non-atopic/intrisnic = non-allergic -> cold air, polluted air, smoking, exercise
Describe spirometry results for asthma
FEV1/FVC <75%
FVC normal
FEV1 reduced
Describe peak flow results for asthma
<80% of average
Average of 3 readings
How much of a positive result must have a patient have to B agonists?
> 15%
How do you treat an asthma attack?
OH SHIT MAN
Oxygen - high flow 100% Salbutamol - nebuliser Hydrocortisone IV/ prednisilone oral Ipratropium nebuliser via oxygen Theophylline IV Magnesium sulphate IV and call Anathesist
Pathway of treatment for asthmatics
SABA (PRN) -> Gluccocortoid Steroids (2x daily) -> LABA -> Increase steroid/ CysLT1 agonist -> ^^/ add LAMA/ methyl-xanthines -> Anti-IgE injection
What can be used to increase drug efficiency?
Spacer
Feature of severe acute asthma attack?
Silent chest
Name a SABA
Salbutamol
What drug would be used in exercise induced asthma in children/ allergic asthma?
Inhaled sodium cromoglycate
Name a methyl-xanthine (has many side effects and drug interactions)
Theophylline
Name a selective LAMA and non-selective SAMA
What does the selective LAMA block?
Selective LAMA (M3) - Tiotroponine
Non-selective SAMA - ipatropium
Name the anti-IgE injection used in symptomatic atopic patients of Max steroid intake
Omalizumab
Prevents IgE binding -> no inhibitor release from basophils and mast cells
What are the PEFR of the following categories of asthma:
Acute moderate
Acute severe
Life threatening
Acute moderate - 50-75%
Acute severe - 33-50%
Life-threatening - <33%
