lecture 14

Question 1

________ is a disorder of the airways usually accompanied attacks of bronchoconstriction

Answer 1

Bronchial Asthma

Question 2

Bronchial Asthma : hypoactivity of the lung to one or more stimuli
true / false ?

Answer 2

false (hyperactivity )

Question 3

Most children with asthma have ___ &____

Answer 3

food allergies and eczema

Question 4

The most common form of asthma is the ___ ?allergic asthma

extrinsic/intrinsic ? asthma

Answer 4

classic

extrinsic

Question 5

mediators _____ ?the remodeling of the airway
(that’s why
antihistamines are /are not ?indicated in asthma cases

Answer 5

increases

are not

Question 6

all of the followings are Characteristics of the abnormal airway except :

1. Thickened wall
2. Hypertrophy of S.M
3. dialation
4. Mucus

Answer 6

dialation

Question 7

Characteristics of the abnormal airway in asthma patient ? (4)

Answer 7

1. Thickened wall
2. Hypertrophy of S.M
3. Constriction
4. Mucus

Question 8

Smooth Muscle Hyperplasia lead to ____ of the airway lumen

Answer 8

narrowing

Question 9

silent chest indicates

Answer 9

complete obstruction of airways

Question 10

copious sputum is a symptom of bronchial asthma (T/F)

Answer 10

true

Question 11

asprin and morphine are Iatrogenic asthma t/f ?why?

Answer 11

true
asprin is NSAID
morphine is opioid induce histamine

Question 12

Iatrogenic asthma (Drug induced asthma)
mention 4

Answer 12

1. NSAIDs like profin (Aspirin).
2. Cholinomimetics
3. B –blockers
4. Opioids will lead to respiratory depression (Morphine) and releases histamine.

Question 13

In intermitted asthma (twice or less a week), the patients uses

Answer 13

SABA (short acting beta 2 agonist).

Question 14

asthma that happens twice or less a week the patients uses ?

Answer 14

SABA

Question 15

what helps to identify the type of persistent asthma.

Answer 15

The number of times of SABA inhaler usage

Question 16

we start using low dose inhaled corticosteroids in ____ asthma

Answer 16

persistent

Question 17

in persistent asthma we start treating by ____ for adults & ______ for childrens

Answer 17

low dose inhaled corticosteroids

montelukast (leukotriene antagonist)

Question 18

montelukast is used for ____ instead of

Answer 18

persistent asthma in children

inhaler corticosteroids

Question 19

if low dose of inhaled corticosteroids in persistent asthma not enough/not controlled we ?+ if that didnt work ?+didnt work ?

Answer 19

increase the inhaled corticosteroids to medium dose + LABA or montelukast.

high dose of corticosteroids + LABA or montelukast.

oral systemic corticosteroids (high systemic adverse effect).

Question 20

step up bronchial asthma treatments

Answer 20

1-SABA

2-low dose inhaled corticosteroids {adult}
montelukast (leukotriene antagonist){child}

3-corticosteroids medium dose + LABA or montelukast

4-high dose of corticosteroids + LABA or montelukast.

5-oral systemic corticosteroids (high systemic adverse effect).

Question 21

inhaled albuterol is an broncho___ + adv to asthmatic patient

Answer 21

bronchodilator

rapidly effective, safe, and inexpensive.

Question 22

Patients with only occasional symptoms of asthma require only _?as___

Answer 22

bronchodilator as albuterol

Question 23

additional treatment is needed in which cases ?

Answer 23

 If symptoms require this “rescue” therapy more than twice a week.
 If nocturnal symptoms occur more than twice a month.
 Or if the FEV1 is less than 80% of predicted.

Question 24

The treatment first recommended in PERSISTENT asthma patient is a low dose of

Answer 24

ICS

Question 25

for patients who are unable to coordinate inhalation from a metered-dose inhaler ___ therapy is used

Answer 25

Nebulized therapy

Question 26

what type of Adrenergic agonistis used for asthmatic patient and what not ?

Answer 26

beta 2 agonist causes bronchodilator

not epinephrine because of beta 1

Question 27

how beta2 agonist help in bronchodilating ?

Answer 27

β2-agonist stimulate adenylyl cyclase thus increase cAMP smooth muscle relaxation and bronchodilation.

Question 28

Side effects of B agonists:

Answer 28

tremor, tachycardia . Decreases in serum

potassium levels. (Dose-dependent)

Question 29

salbutamol (Albuterol) is +for + onset +duration of action

Answer 29

SABA
acute attacks of bronchial asthma
Rapid onset 5-10min
short acting 4h

Question 30

examples of LABA &SABA

Answer 30

Salmeterol ,Formeterol

salbutamol

Question 31

Salmeterol ,Formeterol/LABA
duration of acting
onset
taken with ? can be taken alone ?

Answer 31

12-24h long acting
Slow onset (15-30min)
corticosteriod / no mamno3

Question 32

Ipratropium bromide is

Answer 32

Muscarinic antagonists

Question 33

Muscarinic antagonists as Ipratropium bromide
onset
acting duration
first line for

Answer 33

10-15min slower thanSABA
slow 3-5h
COPD

Question 34

first line for COPD

Answer 34

Muscarinic antagonists as Ipratropium bromide

Question 35

Theophylline : methylxanthine.
  It is \_\_\_absorbed cheap/expensive oral
 broncho\_\_\_.
  Improves the strength of \_\_\_\_ of 
 diaphragm.
  Inhibit \_\_\_thus increase \_\_\_ (cAMP/PDE4). 
smooth muscle \_\_\_\_
 \_\_\_\_the heartrate

Answer 35

Well - cheap -dilator
contraction
 PDE4 - cAMP
RELAXANT
increase

Question 36

Cromolyn which is ____ stabilizer,
increase/decrease the degranulation of mast cells
increase/decrease the release of the mediator from the mast cells

Answer 36

mast cell
decrease
decrease

Question 37

the most important route for chronic use

Answer 37

Inhalation: Beclomethason

Question 38

Beclomethason route

Answer 38

inhalation

Question 39

prednislon is used when ?taken (route)?

Answer 39

severe uncontrolled cases, when the patient is not responding to inhaled corticosteroid & LABA .
orally

Question 40

Injection: methylprednisolone, hydrcortison

is used in ?

Answer 40

severe uncontrolled cases in the ER.

Question 41

methylprednisolone, hydrcortison route ?

Answer 41

Injection