lecture 14 Flashcards
________ is a disorder of the airways usually accompanied attacks of bronchoconstriction
Bronchial Asthma
Bronchial Asthma : hypoactivity of the lung to one or more stimuli
true / false ?
false (hyperactivity )
Most children with asthma have ___ &____
food allergies and eczema
The most common form of asthma is the ___ ?allergic asthma
extrinsic/intrinsic ? asthma
classic
extrinsic
mediators _____ ?the remodeling of the airway
(that’s why
antihistamines are /are not ?indicated in asthma cases
increases
are not
all of the followings are Characteristics of the abnormal airway except :
- Thickened wall
- Hypertrophy of S.M
- dialation
- Mucus
dialation
Characteristics of the abnormal airway in asthma patient ? (4)
- Thickened wall
- Hypertrophy of S.M
- Constriction
- Mucus
Smooth Muscle Hyperplasia lead to ____ of the airway lumen
narrowing
silent chest indicates
complete obstruction of airways
copious sputum is a symptom of bronchial asthma (T/F)
true
asprin and morphine are Iatrogenic asthma t/f ?why?
true
asprin is NSAID
morphine is opioid induce histamine
Iatrogenic asthma (Drug induced asthma) mention 4
- NSAIDs like profin (Aspirin).
- Cholinomimetics
- B –blockers
- Opioids will lead to respiratory depression (Morphine) and releases histamine.
In intermitted asthma (twice or less a week), the patients uses
SABA (short acting beta 2 agonist).
asthma that happens twice or less a week the patients uses ?
SABA
what helps to identify the type of persistent asthma.
The number of times of SABA inhaler usage
we start using low dose inhaled corticosteroids in ____ asthma
persistent
in persistent asthma we start treating by ____ for adults & ______ for childrens
low dose inhaled corticosteroids
montelukast (leukotriene antagonist)
montelukast is used for ____ instead of
persistent asthma in children
inhaler corticosteroids
if low dose of inhaled corticosteroids in persistent asthma not enough/not controlled we ?+ if that didnt work ?+didnt work ?
increase the inhaled corticosteroids to medium dose + LABA or montelukast.
high dose of corticosteroids + LABA or montelukast.
oral systemic corticosteroids (high systemic adverse effect).
step up bronchial asthma treatments
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).
inhaled albuterol is an broncho___ + adv to asthmatic patient
bronchodilator
rapidly effective, safe, and inexpensive.
Patients with only occasional symptoms of asthma require only _?as___
bronchodilator as albuterol
additional treatment is needed in which cases ?
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.
The treatment first recommended in PERSISTENT asthma patient is a low dose of
ICS
for patients who are unable to coordinate inhalation from a metered-dose inhaler ___ therapy is used
Nebulized therapy
what type of Adrenergic agonistis used for asthmatic patient and what not ?
beta 2 agonist causes bronchodilator
not epinephrine because of beta 1
how beta2 agonist help in bronchodilating ?
β2-agonist stimulate adenylyl cyclase thus increase cAMP smooth muscle relaxation and bronchodilation.
Side effects of B agonists:
tremor, tachycardia . Decreases in serum
potassium levels. (Dose-dependent)
salbutamol (Albuterol) is +for + onset +duration of action
SABA
acute attacks of bronchial asthma
Rapid onset 5-10min
short acting 4h
examples of LABA &SABA
Salmeterol ,Formeterol
salbutamol
Salmeterol ,Formeterol/LABA
duration of acting
onset
taken with ? can be taken alone ?
12-24h long acting Slow onset (15-30min) corticosteriod / no mamno3
Ipratropium bromide is
Muscarinic antagonists
Muscarinic antagonists as Ipratropium bromide
onset
acting duration
first line for
10-15min slower thanSABA
slow 3-5h
COPD
first line for COPD
Muscarinic antagonists as Ipratropium bromide
Theophylline : methylxanthine. It is \_\_\_absorbed cheap/expensive oral broncho\_\_\_. Improves the strength of \_\_\_\_ of diaphragm. Inhibit \_\_\_thus increase \_\_\_ (cAMP/PDE4). smooth muscle \_\_\_\_ \_\_\_\_the heartrate
Well - cheap -dilator contraction PDE4 - cAMP RELAXANT increase
Cromolyn which is ____ stabilizer,
increase/decrease the degranulation of mast cells
increase/decrease the release of the mediator from the mast cells
mast cell
decrease
decrease
the most important route for chronic use
Inhalation: Beclomethason
Beclomethason route
inhalation
prednislon is used when ?taken (route)?
severe uncontrolled cases, when the patient is not responding to inhaled corticosteroid & LABA .
orally
Injection: methylprednisolone, hydrcortison
is used in ?
severe uncontrolled cases in the ER.
methylprednisolone, hydrcortison route ?
Injection
