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PHRM 825 > PHRM 825: Asthma - Hazbun > Flashcards

PHRM 825: Asthma - Hazbun Flashcards

1
Q

How are mast cells activated?

A

Cross linking of the Fc receptor and IgE via an antigen

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2
Q

What do mast cells release?

A

PGD2, LTC4, LTD4, Histamine, tryptase

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3
Q

What causes the early reaction in asthma?

A

Antigen binding to IgE antibodies triggering degranulation of mast cells

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4
Q

What causes the delayed reaction in asthma?

A

Activation of TH2 lymphocytes

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5
Q

What do eosinophils contain a lot of?

A

histamine molecules

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6
Q

Which receptors cause the development of hyperplasia?

A

EGFR and CLCA

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7
Q

Which receptor causes the maintenance of hyperplasia?

A

Bcl-2

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8
Q

What polymorphism contributes to goblet cell hyperplasia?

A

R576 polymorphism in the IL-4alpha receptor

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9
Q

What polymorphism induces hyperreactivity to inhaled antigens?

A

Q576R in the IL-4alpha receptor

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10
Q

Which receptors are upregulated in asthma?

A

IL-13

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11
Q

What happens to the epithelium during airway remodeling?

A

Mucous hyperplasia and hypersecretion

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12
Q

What happens to the basement membrane during airway remodeling?

A

It thickens

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13
Q

What happens to the smooth muscle during airway remodeling?

A

It undergoes hypertrophy (increase in size, NOT NUMBER of cells)

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14
Q

What are 3 results of COPD?

A
  • Fibrosis of small airways
  • Alveolar wall destruction (aka emphysema)
  • Mucus hypersecretion
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15
Q

What are the main 3 places that the CFTR channel is expresses?

A
  • Airway epithelium
  • Sweat duct epithelium
  • Pancreatic duct epithelium
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16
Q

What is an early sign of CF and what causes it?

A

Excessively salty sweat - caused by loss of CFTR function

17
Q

What are the 2 treatment strategies in asthma?

A
  • Bronchodilation

- Anti-inflammation

18
Q

What is a prevention strategy for asthma?

A

Inhibition of mast cell degranulation

19
Q

SABAs are resistant to what enzymes?

A

COMT

20
Q

LABAs are resistant to what enzymes?

A

COMT and MAO

21
Q

What is the administration route of choice for acute attacks?

A

Inhalation

22
Q

What is one advantage of using inhaled products versus oral products?

A

Fewer systemic adverse effects

23
Q

What medications are contraindicated as monotherapies in asthma but not COPD?

A

LABAs (e.g. salmeterol and formoterol)

24
Q

What do glucocorticoids do?

A

Decreases the hyperresponsiveness of bronchial smooth muscle cells that occurs in chronic asthma

25
Q

Which medication has a narrow therapeutic range?

A

Theophylline (10-15mcg/mL)

26
Q

Pre-treatment with Cromolyn sodium and Nedocromil sodium prevents asthma attacks by blocking what?

A

bronchoconstriction caused by antigen inhalation, exercise, aspirin, and environmental toxins

27
Q

How does Xolair work?

A

Inhibits binding of IgE antibodies to the Fc(epsilon)R1 Receptor on mast cells and basophils inhibiting degranulation

28
Q

What is an important AE of Zileuton?

A
  • Doubles the blood levels of theophylline

- Causes increase in prothrombin time of patients taking warfarin

29
Q

What 4 drug classes can be used to treat COPD?

A
  • Inhaled muscarinic receptor antagonists
  • Long-acting beta2-adrenergic agonists
  • Short-acting beta2-adrenergic agonists
  • Alpha1-antitrypsin replacement (rare)
30
Q

What are 2 muscarinic antagonist medications?

A

Ipratropium and Tiotropium

Quaternary ammonium compounds that limit systemic absorption

31
Q

What 3 things happen during lung remodeling in COPD?

A
  • Fibrosis of small airways
  • Hyperinflation of lungs (alveolar wall destruction)
  • Mucus hypersecretion
32
Q

What genetic deficiency occurs in <1% of COPD patients?

A

Alpha 1 antitrypsin

33
Q

What medications are used to treat alpha 1 antitrypsin deficiency?

A
  • Prolastin
  • Aralast
  • Zemaria
34
Q

Where is the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) expressed?

A
  • Airway epithelium
  • Sweat duct epithelium
  • Pancreatic duct epithelium
35
Q

What happens to the CFTR protein in most CF cases?

A

Defective processing - it never reaches the membrane surface

36
Q

What drug is used to treat CF in the small subset of patients?

A

Ivacaftor

37
Q

What drug classes are used to treat CF in the majority of patients?

A

Mucolytics (Dornase alfa, Pulmonase, Mucomyst, Hypersal)
Bronchodilators (albuterol)
Antibiotics (Tobramycin and azithromycin)

PHRM 825 (36 decks)

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