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Sem 2 Case 2 > Pathophysiology of Asthma > Flashcards

Pathophysiology of Asthma Flashcards

Vaginal secretions

1
Q

What does chronic mean

A

persistent

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2
Q

What does a idiosyncratic mean

A

doctors don’t have a fucking clue

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3
Q

What do dust mites eat

A

keratin

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4
Q

What are the main differences in an asthmatic airway and a healthy airway

A

Asthmatic has a mucus plug, Goblet cells metaplasia, epithelial desquamation, thickening of basement membrane and smooth muscle hypertrophy and hyperplasia

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5
Q

What white blood cells infiltrate the oedema in an asthma patient

A

Eosinophils and neutrophils

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6
Q

What does the mucus plug contain

A

eosinophils

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7
Q

What causes Epithelial desquamation

A

Eosinophil bearing igE antibody

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8
Q

What does a histamine do

A

constriction of smooth muscle

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9
Q

What are Leukotrienes

A

C4 D4 E4 and constriction off airways smooth muscle

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10
Q

What is the first line of drugs for asthma

A

B2 adrenergic agonists

Glucocorticoids

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11
Q

What is the 1st phase of an asthma allergen inhaled thing called

A

Early phase = bronchospasm

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12
Q

What is the 2nd phase of an asthma allergen inhaled thing called

A

Late phase = inflammation

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13
Q

What drugs are needed for an early phase attack and late phase attack

A

Early phase = bronchodilators

Late phase = Anti inflammatory

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14
Q

Where are the smooth muscle cells

A

bronchioles

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15
Q

What are the types of bronchodilator

A

B2 adrenergic receptor agonists
Theophylline
Muscarinic receptor antagonist
Leukotriene receptor antagonists

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16
Q

What do Beta2 act on

A

Beta 2 adrenoceptors on bronchiole smooth muscle to relax muscle

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17
Q

What kind of receptor is a Beta 2 receptor

A

G-protein coupled receptors

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18
Q

Where does the Gs (stimulatory protein) come from

A

cell membrane

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19
Q

What happens to the Beta 2 receptor

A

It undergoes a conformational change

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20
Q

What secondary thing happens after Gs has fucked the receptor

A

A fucks it ( adenylate cyclase)

21
Q

What does Adenylate cyclase do ma g

A

Uses ATP to activate Cyclic AMP which then makes the inactive PKA become activated

22
Q

What does activated PKA do

A

Protein Phosphorylation

23
Q

what does protein phosphorylation do

A

MUSCLE RELAXATION

24
Q

What are the 3 types of Beta 2 agonists

A

Short acting - 30 min effect and lasts 4-6 hours use as needed
Longer-acting (LABA) - lasts 12 hours and twice daily
Ultra-long acting

25
Q

What is the brown inhaler

A

Corticosteroid

26
Q

What is the blue inhaler

A

Bronchodilators

27
Q

What are the unwanted effects of the Beta 2 receptors

A

termor due to skeletal muscle having Beta 2 receptors

28
Q

What is a xanthine compound

A

Theophylline

29
Q

what does Theophylline do

A

Phosphodiesterase PDE inhibitors

30
Q

When is Theophylline given

A

severe asthma when Beta 2 isnt sufficient

31
Q

Side effects to Theophylline

A

CNS - stimulant soo tremor
Cardiovascular - stimulates heart
GI tract - anorexia vomiting

32
Q

When are Muscarinic receptor antagonists given

A

when B2 antagonists and steroids arent working

33
Q

The action of Muscarinic receptor antagonists

A

competes with ACh and prevents it stimulating smooth muscles

34
Q

Leukotriene receptor antagonists

A

Prevent exercise-induced and aspirin-sensitive asthma

35
Q

What does a leukotriene receptor antagonist do

A

Binds too leukotriene receptors and stops them causing bronchoconstriction and stops them stimulating mucus secretions

36
Q

What do leukotriene C4 and D4 do

A

Bronchial spasmogens and stimulate mucus secretions

37
Q

What do leukotrienes act on

A

Leukotriene receptors dumb ass

38
Q

What does aspirin inhibit

A

Cyco oxygenase thus more arachidonic acid converts to leukotrienes

39
Q

What doesn’t work on a lot of people

A

Leukotriene antagonists ( only 40% of asthmatics)

40
Q

What is the mechanism of glucocorticoid action

A 
Enters cells
Binds to intracellular receptors in the cytoplasm (GRalpha and GR Beta) 
Receptor complex moves to the nucleus 
Binds to DNA in the nucleus 
Alters gene transcription
41
Q

What does the mechanism of glucocorticoid inhibit

A

Phospholipase A2 thus the Cyclo-oxygenase and 5-lipoxygenase pathway

42
Q

How long does the glucocorticoid take too work

43
Q

Why would glucocorticoid be taken IV

A

So they can travel to the sight of action

44
Q

Do children respond better than adults to drugs

45
Q

What is given in subcutaneous injection every 2-3 weeks

A

OMALIZUMAB - IgG monoclonal antibodies

46
Q

What cells make the IgE

47
Q

what is OMALIZUMAB only for

A

allergic asthma as it binds to IgE

48
Q

side affects of OMALIZUMAB

A

anaphylaxis

Sem 2 Case 2 (8 decks)

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