Tutorial Flashcards
Compare COPD and asthma
- Effects of asthma are reversible whereas the effects of COPD are not
- COPD is characterised by
Neutrophils, macrophages and Tc1 lymphocytes - Asthma by eiosinophils, mast cells and Th2 cells
- COPD does not have bronchoconstriction so bronchodilators will not work on it
What do emphysema, small airways disease and chronic bronchitis affect?
emphysema - alveoli
small airways disease - bronchioles
chronic bronchitis - bronchi
What does the COPD assessment include?
Lung function – measure lung decline rate in FEV1 vs age for drugs and placebos.
Bronchoalveolar lavage – inspects activity of the proteases in the lavage, need to see if the drug is effective.
CT scanning – measure the number and size of holes in the lungs to measure the level of emphysema.
What happens to the lung structure during emphysema (2 types)?
Centriacinar Emphysema – inflammation begins at the centre of the ascinar (functional alveolar unit) and spreads from the centre.
Panacinar Emphysema – due to an alpha 1 anti-trypsin deficiency – degeneration is throughout and doesn’t spread from the centre.
Why do the airways collapse, become obstructed and stenosed during COPD?
Collapse – alveolar attachments get digested away.
Obstructed – hyperplasia of goblet cells causing excess mucus production.
Stenosed – Fibrosis of the small airways.
What are the changes in epithelial cells and secretions in bronchitis?
Hyperplasia of goblet cells and hypertrophy of submucosal glands.
Secretions – more mucus produced and cilia become destroyed and beat asynchronously
Why would a protease inhibitor help with COPD?
Why is a dual inhibitor used?
Eliminate proteases which break down the alveoli.
Diff types of proteases
What might cause problems with the efficacy of the inhaled therapy for COPD and how can it be solved?
Mucus blocking the airways which blocks the flow of drug.
Mucolytics to break down mucous
Would bronchodilators make a COPD patient feel better?
Not really as COPD doesn’t cause bronchoconstriction. If he has a co-morbidity of asthma, it might affect him.
