Inflammation and Treatment of Asthma

Question 1

In the Asthmatic, Exposure to an allergen initiates a ___ immune response causing IgE-mediated activation of ____ cells.

Answer 1

Th2

Mast

Question 2

What mediators do Mast cells release upon activation to an allergen? How do they affect the lungs?

Answer 2

Histamine, Leukotrienes, and Eosinophils

Constrict the Bronchia and Promote Mucus secretion

Question 3

What enzyme converts Arachadonic Acid to Leukotrienes?

Answer 3

5-Lipoxygenase

Question 4

What are the 2 main types of drugs used in Asthma treatment?

Answer 4

1-Immunosuppresive/Anti-Inflammatory Drugs

2-Drugs that Dilate the Bronchia

Question 5

Leukotrienes are further converted to what 2 products? Which of these products is an important target in Asthma Drug Therapy?

Answer 5

LTB4 and LTD4

LTD4 is a target for Asthma Drug Therapy

Question 6

How does Aspirin induce Asthma?

Answer 6

By shifting Arachadonic Acid metabolism from Prostaglandin to Leukotriene Production

Question 7

Budesonide

1) Mechanism of Action
2) Use
3) Route of Admin

Answer 7

1) Glucocorticosteroid: inhibits T-cell cytokine IL-4 (thus reducing Th2 immune response) AND inhibits Arachadonic Acid pathway (inhibits Phospholipase A2) thereby reducing Leukotriene production
2) Asthma MAINTENANCE Therapy
3) Inhalation

Question 8

Fluticasone

1) Mechanism of Action
2) Use
3) Route of Admin

Answer 8

1) Glucocorticosteroid: inhibits T-cell cytokine IL-4 (thus reducing Th2 immune response) AND inhibits Arachadonic Acid pathway (inhibits Phospholipase A2) thereby reducing Leukotriene production
2) Asthma MAINTENANCE Therapy
3) Inhalation

Question 9

Prenisone

1) Mechanism of Action
2) Use
3) Route of Admin

Answer 9

1) Glucocorticosteroid:inhibits T-cell cytokine IL-4 (thus reducing Th2 immune response) AND inhibits Arachadonic Acid pathway (inhibits Phospholipase A2) thereby reducing Leukotriene production
2) Asthma MAINTENANCE Therapy **when not adequately controlled with other therapies
3) Oral
* Long-term treatment adverse effects include: Adrenal Excess (aka Cushing Syndrome), Increased Infection Risk

Question 10

Zileuton

1) Mechanism of Action
2) Use
3) Adverse Effect

Answer 10

1) Leukotriene Modulator: inhibits 5-Lipoxygenase, therefore inhibiting Leukotriene production
2) Asthma MAINTENANCE Therapy
3) Liver Toxicity

Question 11

Montelukast/Zafirlukast

1) Mechanism of Action
2) Use

Answer 11

1) Leukotriene Modulator: blocks LTD4 release, reducing Bronchoconstriction
2) Asthma MAINTENANCE Therapy

Question 12

Cromolyn

1) Mechanism of Action
2) Use
3) Route of Admin
4) Adverse Effects

Answer 12

1) Degranulation Inhibitor: inhibits Mast cell Degranulation (inhibits release of Histamine)
2) Asthma MAINTENANCE Therapy
3) Inhaled Powder Aerosal
4) Airway irritation and Cough (d/t powder)

Question 13

Vilanterol

1) Mechanism of Action
2) Use
3) Route of Admin
4) Adverse Effects

Answer 13

1) Beta2 Adrenergic Receptor Agonist: stimulates Beta2 receptors activating Gs-protein coupled receptor, increasing cAMP and relaxing bronchial smooth muscle (aka Bronchodilation)
* LONG-acting Agent
2) Asthma MAINTENANCE Therapy
* Generally combined w/Glucocorticosteroids
3) Inhaled aerosal
4) Increased frequency of death (unknown mechanism)

Question 14

Albuterol

1) Mechanism of Action
2) Use
3) Route of Admin
4) Adverse Effects

Answer 14

1) Beta2 Adrenergic Receptor Agonist: stimulates Beta2 receptors activating Gs-protein coupled receptor, increasing cAMP and relaxing bronchial smooth muscle (aka Bronchodilation)
* SHORT-acting Agent
2) RESCUE Asthma Treatment
3) Inhaled aerosal
4) Tachycardia, HA

Question 15

Ipatropium

1) Mechanism of Action
2) Use
3) Route of Admin

Answer 15

1) Muscarinic Cholinergic Antagonist: inhibits bronchoconstriction associated w/parasympathetic stimulation
2) MAINTENANCE Therapy in Asthmatics that are intolerant to Beta2 Agonists
3) Inhaled aerosal

Question 16

Theophylline

1) Mechanism of Action
2) Use
3) Route of Admin

Answer 16

1) Inhibits phosphodiesterase degradation of cAMP, increasing cAMP levels and relaxing bronchial smooth muscle (aka Bronchodilation)
2) Asthma MAINTENANCE Therapy
3) Oral

Question 17

Newer Asthma therapies include Asthma Antibody Drugs that target ____ Immune response.

Answer 17

Th2 (includes cytokines IL-4 and IL-5)

Question 18

Dupilumab

1) Mechanism of Action
2) Use
3) Adverse Effects

Answer 18

1) Binds IL-4 to reduce Th2 Immune response in order to decrease release of Mast cell inflammatory mediators
2) Severe PERSISTANT Asthma
3) Reduced resistance to parasitic infections (helminth)

Question 19

Omalizumab

1) Mechanism of Action
2) Use
3) Adverse Effects

Answer 19

1) Binds IgE antibodies to prevent binding to Eosinophils and Mast cells in order to decrease IgE-mediated allergic responses
2) Severe PERSISTANT Asthma
3) Reduced resistance to parasitic infections (helminth)

Question 20

Benralizumab

1) Mechanism of Action
2) Use
3) Adverse Effects

Answer 20

1) Blocks IL-5 receptor and opsonizes/depletes Eosinophils decreasing airway Hyper-reactivity
2) Severe PERSISTANT Asthma
3) Reduced resistance to parasitic infections (helminth)