Exam2Lec5Asthma&COPDPharmTherapy Flashcards
Which drug(s) are B2 agonists?
Albuterol and Salmeterol
incr cAMP
Which drug(s) are leukotriene antagonists ?
Montelukast
“luk” for LEUKotriene antag, block glucotrienes
Which drug(s) are muscarininc antagonists?
Ipratropium, Tiotroopium
blocks ACh
Which drug(s) are inhaled corticosteroid?
Fluticasone
blocks cytokines
Which drug(s) are monoclonoal anti-IGE antibodies?
Omalizumab
blocks abs
Which drugs are can be used as both a RESCUE for asthma and a CONTROL for COPD?
Ipratropium and Tiotropim
Which drugs are used as a RESCUE for BOTH asthma and COPD?
Albuterol
Which drug(s) are used as a control for ASTHMA only?
Montelukast, Omalizumab
Which drug(s) are used as control for BOTH asthma and copd?
Salmeterol, Fluticasone
Incr in airway resistance is a hallmark of what type of lung disease?
Obstructive
What are 2 characersistics of obstructive lung disease?
- Decr airflow (b/c decr elasticity or incr raw in zone 0-10)
- Limited airflow during EXPIRATION
Low lung-cw compliance is a hallmark of what type of lung disease?
Restrictive
parenchyma fibrosis
A pt with restrictive lung disease has
a.Low FEV1/FVC
b. High FEV1/FVC
c. Normal FEV/FVC
Normal FEV/FVC
equal decr in fev1 andfvc
What is asthma
spasmodic contrctiion of smooth muscle in the bronchi
What is COPD
- Bronchitis: inflammation of the bronchi and bronchioles (inr mucus)
- Emphysema: alveolar destruction
- Combination
also cystic fibrosis and bronchiectasis
Which zone has higheset resistanace to airflow?
a. CZ
b. RZ
CZ (zone 1-10)
Alveoli does not have ____
smooth muscle
The further down we go in the airway towards the RZ the ____ the cross-sectional area
higher
lower resistance
What are the factors that determine airway resistance?
- Structure of airways
- Airway smooth muscle contraction
- Lumen obstruction (mucus)
- Elasticity of Lung parenchyma
“SALE”
For airway smooth muscle contraction, when receptors activates, they will incr ____ by g protein ____ causing smooth muscle contraction
Intracellular Ca2+
G protein Q
What are diff receptors that can lead to airway smooth muscle contraction when activated?
- Histamine
- Muscuranic
- LTD4
- Substance P
you can have histamine induced bronchospasm
What does autonomic control of airway resistance to the airways provide?
- Provides reflex arc for airway constriction following inhalation of irritants
- Provides airway dilation during exercise
Explain the reflex arc for autonomic control of airway resistance
- You have an irritant come in
- Signal travels up to the medualla via afferent neurons
- Activates PNS and ACh is released
- Constriction of airway to remove irritant
Explain how autonomic control of airway resistance can dilate airways during exercise
- Decr PNS influence
- incr CIRCULATING epi (no direct SNS innervation of smooth airway muscle)
- Bronchodilation
Airway diameter depends on ____ of tissue surrounding airways in lung parenchyma.
retractile force
as the lung expands, retractile force on airways incr
As the lung expands , what is pulling on the airway to keep it open, and if we loose this what can occur?
Alveoli, airway can collapse (emphysema)
Fxn of spirometry
used to acess lung parameters (airway resistance)
measures airflow
A pt with COPD (obstructive lung disease) has a high, low, or normal FEV1/FVC ratio?
Low, this is because with higher resitance it takes longer and it is harder for them to breathe out
men and taller ppl have higher FVC
FVC decr as you age from 45 on
Emphysema
a. major pathological changes
b. High or low resistance
c. high or low FEV1/FVC
a. airspace enlargemnent, destruction of alveoli
b. High resistance
c. Low FEV1/FVC
LOW elastic recoil reduces structural support for bronchioles, this leads to high resistance
Chronic Bronchitis
a. major pathological changes
b. High or low resistance
c. high or low FEV1/FVC
a. mucus gland hyperplasia, hypersecretion, bronchiole fibrosis
b. high resistance due to clogged bronchioles
c. low FEV1/FVC
Asthma
a. major pathological changes
b. High or low resistance
c. high or low FEV1/FVC
a. smooth muscle hyperplasia/spasmodic contraction, mucus inflammation, AHR
b. High resistance due to contracted bronchi
C. Low FEV1/FVC
Chronic disroder of the airrways that is complex and characterized by variable and recurring symptoms, airflow obstruction (bronchospasm). bronchial hyperresponsiveness, and underlying inflammation.
Asthma
lot of endotypes, we don’t know why some ppl have mild or severe asthma
What is the “hallmark” of asthma?
Reversibility with bronchodilator.
True or false: Airway obstruction may be absent between attacks
True
pt is not constanly breathless, or having attacks
Explain the concept of airway hyperactivity
For a given concentration of chemical that causes bronchospasm, they will have a much bigger bronchospams
Muscurininc agonist, will activate ____ receptor and cause constriction
M3
You can test the severity of asthma by measuring airway responsiveness using what?
Methacholine
How do we measure the severity of asthma/airway responsiveness using methacholine?
We look at the amount of methacholine given to drop FEV by 20%
incr dose until FEV dropped by 20%
How can you tell if someone has severe asthma using methacholine?
If 0.3 mg/ml of methacholine causes a drop of FEV by 20%
asthmatis react to low dose of methocholine
How is asthma linked to allergy?
- Allergen sensitization
- Allergen-induced mast cell activation
allergen sensitization: B cells produce IGE instead of IGG (antigen becomes an allergen
Allergen-induced mast cell activation: IGE binds to mast cells and basophills which has a receptor called FCeR1. They release their granules with inflammatory agents