Asthma (Chapter 9) Flashcards
what is asthma ?
a chronic respiratory disease, characterized by reversible and intermittent airway hyper-reactivity of bronchial tube dilation and contration
what are symptoms of asthma ?
shortness of breath
coughing
wheezing
tightness in chest
what are triggers of asthma ?
smoking, humidity, heat, viral infections, NSAIDs, sulfites, psychosomatic
which medications can trigger asthma ?
NSAIDs
what is the cause of asthma ?
combination of genetic and environmental factors
can asthma be cured?
sometimes spontaneously
what is the asthmatic lung characterized by ?
inflamed tissue, red, swollen, edema, excessive mucus production
how do mast cells work ?
full of granules that contain toxic chemicals (leukotrienes, prostaglandins)
what are the two types of asthma ?
eosinophilic and neutrophilic
what is eosinophilic asthma ?
characterized by increased levels of eosinophils in the airway.
associated with more severity of the disease
eosinophils, mast cells, basophils bind to IgE which releases histamine
what is neutrophilic asthma ?
characterized by increased levels of neutrophils and T-Cells in airway
how is asthma triggered ?
IgE triggers release of chemicals from mast cells.
arachidonic acid pathway is stimulated by the increase of phospholipase A2. arachidonic acid is substrate for 5-lipoxygenase to produce leukotrienes.
Leukotrienes activate receptors on smooth muscle, causing bronchoconsriction, mucus secretion, edema.
what is the arachidonic pathway stimulated by ? inhibited by ?
catalyzed by phospholipase A2
inhibited by corticosteroids
what are the two therapeutic goals in treating asthma ?
1) cause bronchodilation
2) reduce inflammation underlying disease
how many different drugs can help treat asthma ?
20
what are the 4 types of asthma ?
intermittent (1-2 attacks/week, awakening at night occasionally)
mild persistent (more than 2 attacks/week, waking up frequently 3-4/month)
moderate persistent (daily attacks, wake up once/week)
severe persistent (attacks throughout day, regular night awakening)
what is a sign asthma is quite severe ?
waking up at night
daily attacks, wake up once/week
what kind of asthma?
moderate persistent
more than 2 attacks/week, waking up frequently 3-4/month
what kind of asthma ?
mild persistent
what are 2 ways of diagnosing asthma ?
1- talking to a doctor, telling them you wake up at night, etc
2- FEV between 60-80%
what are the 5 main drugs used to treat asthma ?
short-acting beta-agonist anticholinergics corticosteroids (oral/parenteral) long-acting beta-agonist corticosteroids (inhaled)
what are short-acting beta agonists ?
they provide quick relief, can prevent imminent attack
only taken as needed to prevent branchoconstriction
give 2 examples of SABA
terbutaline
salbutamol
what are anticholinergics ?
similar in use to SABA
prevent bronchoconstriction
however, many side effects as all cholinergics do, so shouldn’t be the first drug of choice
what are oral and parenteral corticosteroids ?
used when needed
prevent bronchoconstriction
have same side effects as other corticosteroids
what are LABA ?
they are inhaled and prevent bronchoconstriction
more slow-acting than SABA
slow release at a dose safe to take everyday unlike SABA
give 2 examples of LABA
formoterol
salmeterol
what are inhaled corticosteroids ?
used for daily maintenance
do not affect bronchoconstriction/dilation
reduces inflammatory reactions in tissue
what drug increases the response of SABA ?
inhaled corticosteroids
what is an example of an inhaled corticosteroid ?
flovent
drugs through inhalation are considered what sort of consumption ?
topical application
what are the advantages of inhalation ?
no first pass effect
improper use of inhalers can lead to what ?
a low dose, and accumulation in back of throat
what are the side effect of corticosteroids inhaled ?
fungus growth
why is it better to inhale beta-agonists ?
because NE have BP increase and pupillary dilation
how many different points of mutation on the gene does the b2 adrenergic receptor have ?
9
what is the b2-adrenergic pathway ?
adenylyl cyclase activation -> cAMP increase -> airway opens
