asthma/COPD

Question 1

eosinophilic asthma most common - allergy

standard treatment?

Answer 1

inhalation corticosterioids

Question 2

mast cells produce _ in the lung for asthma eosinophillic allergy

Answer 2

leuktrienes in lung - contraction of SM bronchoconsctriction

histmines in ose(rhinitis)

Question 3

in eosinophilic asthma, _< triggered by activation of mast cells, help orchestrate an inflammatory resnse in asthma leading to eosinophil infiltration of the lung

Answer 3

Th2 cells

atopy - pregenetic predispositioned to Th2 responses - frequent in asthma - allergies

Question 4

why is inflammation evil in the context of asthma

Answer 4

bronchconstriction
airway remodeling
mucous

Question 5

tools to treat asthma/COPD

_ agents stimulating PKA will act as bronchodilators

Answer 5

beta 2 agonist

preventing MLCK or Ca - less SM contraction

SABA(rescue med inhaler) or LABA(stick in membrane -not acute tx, short and long acting beta 2 agonists

Question 6

Tx with inhalational _ are a critical component of the strategy for managing(eosinophilic) asthma

they act as general immuno-suppressant agents

Answer 6

corticosteroids - antiinflammatory

marker for effectiveness is reduction of eosinophils in the lung

Question 7

cortisol fxn in body

protein/glc

lipids

cardiovas and resp

bone and skin

fibroblast

skin
CNS

Answer 7

carb and protein metabolism

mobilize Gluclose and catabolism protein - atrophy

lipid redistribution - moon face

cardiovas and resp - hypertension (increases expression of adrengeric receptors - vasoconstriction and improved airway performance

bone skin- decreased protein synethisis and increased break down, decreased osteoblast activity and increase clast

fibroblast - inhib fxn and proliferation of fibroblasts - decrease vollagen slow down wound healing

thinning skin

CNS - changes steriod receptors, mood elevation, euphoria, insomina, increased motor activity - take in morning

Question 8

main fxn of cortisol

more effective in asthma or COPD

Answer 8

anti-inflammatory

more in asthma

Question 9

drug?
attenuate leukocyte trafficking

reduced expression of adhesion molecules (endothelial and immune cells)

reduce cytokines

Answer 9

anti-inflammatory effects of glucocorticoids

also effects on innate immunity PMNs (NLMEB)

reduce leukotrienes from mast cells (PG more reduced though)

Question 10

major MOA actions of _

1. most important - direct blocking of NFkappaB mediated transcription responsible for both innate and acquired immune responses
2. 2nd most improtant - direct activation of gene expression via DNA binding target genes - ANNexin-A1 attenuates eicosanoid production - block phospholipase A2 - arachidonic acid blocking PG and leukotrienes

Answer 10

glucocorticoids = anti NFkB

block this we block cytokines and adhesion molecules

Question 11

_ acute treatment systemic ER injection

and longterm managemnt - inhaled

Answer 11

corticosteroids (glucocorticoids)

combined with LABAs

with use adrenal gland shrinks - rinse mouth after inhalation

Question 12

anti-cholinergics to tx asthma or COPD

Answer 12

COPD

Question 13

an increase in vagal tone contributes mightily to bronchoconstriction in asthma or COPD

Answer 13

COPD

this effect is produced by SM contraction mediated by ACh acting on muscarinic ACh receptors

Question 14

_ refer to antagonist of muscarininc ACh receptors

like Atropine
blockade of mainly M3 can lead to bronchodilation and attenuation of mucous production

Answer 14

anti-chilinergics

COPD

Question 15

_ is the first line of defense in treating COPD

Answer 15

anti-cholinergics
block action of Ach on M3

inhibit SM contraction
decrease mucous secretion

it is a quaternanry amine here - but it is inhaled

Question 16

allergic rhinitis )hay fever) pretty much the same thing as _ but in the nose

Answer 16

asthma

Tx not same though

snot nose kid - they have same number of mucous glands but smaller nose

antihisamines
alpha1 agonists - decongestants) - SM vasoconstriction
intranasal corticosteroids