Exam 4; Asthma Flashcards
What is the cycle that results from prolonged irritation of the normal airway pathway
the immune system becomes involved realizing immune mediators from cells resulting in bronchoconstriction and edema, those cells migrate to the lungs because of this result in airway inflammation which then results in immune mediators, and vice versa
Wha are the two non-pharmacologic treatments of asthma
education
change in environment
These are the initial drugs of choice for short term relief of asthmatic symptoms
bronchodilators
What is the mechanism behind β2 receptor agonist bronchodilators
increases cAMP and decreases inflammatory response
This β2 receptor agonist is non specific and activated all adrenergic receptors
epinephrine
What is the result of epinephrine on β1 and ɑ1
β1 = increase in HR ɑ1 = vasoconstriction
This β2 receptor agonist is more selective for β2
isoproterenol
What is the half life of selective β2 agonists
6 hours
What is different about the method of absorption regarding the selective β2 agonists and the more non-selective β2 agonists
the selective β2 agonists can be inhaled, especially good since you want it affecting the lungs
Any agent that acts by activating a receptor can cause what
down regulation of receptors and loss of effect
What are the 5 relatively selective β2 agonists
albuterol pubuterol bitolerol levabuterol terbutaline "buterol's" essentially
What are the four longer lasting β2 agonists (not effective for rapid release)
formoterol arformoterol salmeterol indicaterol "terol's"
What are the three major side effects of the β agonists
tremors
techycardia
palpations of the heart due ti β1 effects
What class of drugs is mainly used for treating COPD
cholinergic blockres; atropine analogs
What are the two drugs to treat COPD
Ipratropium
tiotropium
What condition should you watch for when treating someone with COPD
patients with urinary retention
What is a symptom of the cholinergic blockers
dry mouth
What is the mechanism behind theophylline
phosphodiesterase inhibitor, inhibiting cAMP PDE which elevated cellular cAMP
What is theophylline used for
chronic asthma; it is a methylxanthine
What are the three main symptoms of theophylline
cardiac stimulation; arrthymias
CNS stimulation; tremors, insomnia, seizures
GI upset
True or False
The anti-inflammatory agents are NOT bronchodilators
True
What are the two mast cell inhibitors
cromolyn sodium
nedocromil
What is the mechanism behind cromolyn sodium and nedocromil
they inhibit the treats of mediators from immune cells by inhibiting Cl channels and decreasing Ca uptake
What class of drugs are the drug of choice for asthma prophylaxis, most given by inhalation
glucocorticoids
What are the seven glucocorticoids
beclomethasone budesonide fluticasone mometasone ciclesonide prednisone dexamethasone "-son or -sone"
What is the mechanism behind the glucocorticoids
binds to intracellular receptors which alter DNA transcription
glucocorticoids increase this, which inhibits the synthesis of phospholipase 2
lipocortin
What are the side effects of glucocorticoids
since they are inhibitors of the immune response;
infections
dysphonia (trouble speaking)
systemic effects
This drug blocks the IgE receptors; blocking stimulation
omalizumab
This drug is a leukotriene synthesis inhibitor
zileuton
What is the mechanism behind zileuton
enzyme inhibitor
inhibits the enzyme 5-lipoxygenase which is necessary for the synthesis of leukotrienes
What are the two leukotriene receptor blockers
zarfirlukast
montelukast
