L6:The pharmacology of asthma

Question 1

asthma is

Answer 1

bronchoconstriction

Question 2

how long does allergic asthma take to develop

Answer 2

15 mins

Question 3

pathology of allergic asthma=

Answer 3

antigen binds 2 IgE on mast cell causing degranulation of mast cell

Question 4

degranulated mast cell releases

Answer 4

histamine

leukotrienes

Question 5

main bronchocontrictor in allergic asthma-

Answer 5

leukotrienes

Question 6

what reverses bronchocontriction

Answer 6

beta agonists

Question 7

what do beta agonists work on

Answer 7

beta adrenergic receptors

Question 8

Sort acting beta agonist=

Answer 8

salbutamol

Question 9

long acting beta agonists=

Answer 9

salmeterol

formoterol

Question 10

most important cells in allergic component of allergic asthma

Answer 10

eosinophils

Question 11

5 cells involved in asthma

Answer 11

APC 
CD4+ 
B-cells 
mast cell 
eosinophils

Question 12

what recruits eosinophils

Answer 12

leukotriene from mast cells

Question 13

where do steroids bind

Answer 13

receptors inside the cell

Question 14

what do steroids cause apoptosis of

Answer 14

eosinophils

Question 15

e.g of inhaler steroid

Answer 15

beclomethasone

Question 16

first step in asthma treatment

Answer 16

give salbutamol (blue inhaler)

Question 17

beta agonists cause

Answer 17

bronchodilation

smooth muscle relaxation

Question 18

if using blue inhaler more than 3 times a day give

Answer 18

low dose inhaled corticosteroid

Question 19

if still severe symptoms after inhaled steroid

Answer 19

-long acting beta agonist/ combination inhaler (symbicort)

Question 20

symbicort=

Answer 20

budesonide

formoterol

Question 21

severe symptoms after all previous treatment

Answer 21

prednisolone or
leukotriene antagonist or
theophylline

Question 22

leukotriene antagonist=

Answer 22

montelukast

Question 23

when montelukast is combined with steroids what happens

Answer 23

blocks duel pathways of inflammation

Question 24

theophylline=

Answer 24

methylxanthine

smooth muscle relaxant

Question 25

downside of theophylline

Answer 25

poorly tolerated

Question 26

mepolizumab=

Answer 26

anti-IL5 drug

Question 27

in asthma what does IL5 recruit

Answer 27

eosinophils

Question 28

key priorities in COPD treatment

Answer 28

smoking cessation
inhaled therapy
pulmonary rehabilitation
non-invasive ventilation

Question 29

treatment of COPD with FEV1/FVC >50%=

Answer 29

LABA + SAMA or/

LAMA + SABA

Question 30

long acting anticholinergic bronchodilator=

Answer 30

tiotropium

Question 31

sort acting bronchodilators=

Answer 31

ipratropium

salbutamol

Question 32

ipratropium=

Answer 32

anticholinergic agent

Question 33

if FEV <50% and 2 or more acute exacerbations in the last 6 months –>

Answer 33

LABA + inhaled corticosteriod