L12.2 Inflammation and Asthma Flashcards
asthma patients experience an increase in ____ ____ and decrease in _____ ______ _____; breathing out is _____, so the net volume of air breathed in ______
asthma patients experience an increase in RESIDUAL VOLUME and decrease in FORCED EXPIRATORY VOLUME; breathing out is INHIBITED, so the net volume of air breathed in DECREASES
describe the asthma presentation.
- the inside lining of the airways becomes red and swollen (inflammation)
- extra mucous (sticky fluid) may be produced
- the smooth muscle around the airways tighten (bronchoconstriction)
- intermittent attacks of wheezing, shortness of breath and regular coughing events
- these lead to an increase in residual volume, and a reduction in forced expiratory volume (ERV/FEV1)
what might trigger an asthma attack?
environmental: allergens, smoking, diet, pollution, infections, occupational sensitizers
host: gender, obesity, predisposing genes
describe the early and late phases of asthma
early phase: bronchoconstriction
late phase: inflammation (mucus hypersecretion, eosinophilic infitration, elevated lgE levels, subepithelial factors), airway hyper-responsiveness
what are preventers and what are relievers/controllers?
relievers/controllers (bronchodilators)
- B2 adrenergic agonists (SABAs and LABAs)
- methylxanthines
- muscarinic receptor antagonists
preventers (anti-inflammatory agents)
- leukotriene receptor antagonists
- glucocorticoids (corticosteriods)
- anti-IgE antibodies
Compare and contrast the mechanisms of action of the drug classes used in asthma treatment
see table
T/F: the early phase of an asthma attack is caused by smooth muscle constriction of the airways
T
T/F: early phase treatment is best done using relievers, which are glucocorticoid based treatments
F (first part T, last part F)
T/F: late phase asthma attacks are effectively managed with beta-2 receptor agonists
F
T/F: a spacer may be used by asthmatics to improve inhalation of the drug at a constant rate, and reducing loss of tongue, mouth and throat
T
In regards to the short acting beta 2 agonists (SABAs) what is its:
- reliever or preventer?
- representative
- mechanism of action
- possible adverse effects
- reliever
- representative: salbutamol
- mechanism of action: short term stimulation of beta 2 receptors on smooth muscle lining the bronchioles; effective in early phase asthma
- possible adverse effects: increased heart rate, muscle tremors, feeling lightheaded or shaky, headache
In regards to the long acting beta 2 agonists (LABAs) what is its:
- reliever or preventer?
- representative
- mechanism of action
- possible adverse effects
- reliever
- representative: salmeterol
- mechanism of action: same as SABAs but longer duration of effects; generally prescribed to individuals whose asthma is poorly controlled and who have been on inhaled corticosteroids for more than 3 months
- possible adverse effects; same as SABAs
In regards to the methylxanthines what is its:
- reliever or preventer?
- representative
- mechanism of action
- possible adverse effects
- reliever
- representative: theophylline (given orally, iv, in addition to corticosteroids and LABAs)
- mechanism of action: inhibition of PDE, may reduce transcription of inflammatory genes as well; stimulation of CNS and increase breathing rate may be beneficial
- possible adverse effects: cardiac dysrhythmia, GI disturbance, seizures, narrow therapeutic window, P450 metabolism (some antibiotics inhibit P450s, leading to toxic effects)
In regards to the muscarinic antagonists what is its:
- reliever or preventer?
- representative
- mechanism of action
- possible adverse effects
- reliever
- representative: ipratropium
- mechanism of action: blockade of M3 receptors, preventing parasympathetic contraction of smooth muscle; can be used with beta 2 agonists or steroids in acute severe asthma
- possible adverse effects: limited as not readily permeable into systemic circulation. bitter taste of inhaled ipratropium. nebulized patients of age may develop glaucoma if using face mask
In regards to the leukotriene receptor antagonists (LTRAs) what is its:
- reliever or preventer?
- representative
- mechanism of action
- possible adverse effects
- preventer
- representative: montelukast
- mechanism of action: taken orally to reduce leukotriene activity. relaxation of smooth muscle, no effects on inflammation
- possible adverse effects: some GI irritation, but generally well tolerated
