Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics > W20 - Asthma > Flashcards

W20 - Asthma Flashcards

1
Q

what is an inflammatory disease of the airways characterized by

A

recurrent reversible airway obstruction in response to irritant stimuli

hypersecretion of mucus by bronchial epithelial cells

Eosinophil infiltration

Bronchial smooth muscle cells hyperplasia causing airway hyper responsiveness and bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is hyperplasia

A

increase in number of cells in an organ or tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is hypertrophy

A

increase in size of smooth muscle suspected contribute to the irreversible airflow obstruction and permanently impaired pulmonary function observed in patients with chronic asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is bronchospasm

A

abnormal contraction of the smooth muscle of the bronchi resulting in an acute narrowing and obstruction of the respiratory airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what happens to the airway in an asthmatic attack

A

increased smooth muscle contracts meaning hard to breathe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what factors are the chances to develop the condition

A 
a family history 
bronchiolitis as a child
exposure to tobacco smoke
being born prematurely 
type of job occupational exposures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are some triggers of asthma

A 
indoor environment
house dust mites
moulds + fungi
pollen
food
drugs
stress or even a fit of laughter
cold and viral infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is intrinsic asthma

A

asthma caused by substances within the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

do people with intrinsic asthma benefit from allergy shots or allergy medications

A

nop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is extrinsic asthma

A

asthma caused by inhaling or ingesting foreign substane from without the body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the symptoms of asthma

A 
wheeze
breathlessness
cough
daily or seasonal variation
chest tightness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are some tests we can use to diagnose asthma

A

airway inflammation measurement
lung function tests
airway hyperreactivity measurement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what does airway inflammation measure

A

fractional exhaled nitric oxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is a potive test on the airway inflammation

A

40 parts per billion +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is a positive test of the obstructive airway test

A

<70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is forced vital capacity

A

maximal amount of air that can be exhaled after a maximal breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the thought process behind obstructive airway

A

measure lung volumes and capacity to determine the presence of an obstructive or a restirctive disease

changes will differ depending on type of disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is a positive test on the bronchodilator reversibility test

A

FEV1 12 or more

+

Increase in volume of 200 ml or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is FEV1

A

forced expiraytory volume 1 second

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is a postive test on a peak flow variability test

A

20% +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is a positive test on bronchial challenge test

A

provocative concentration of methacholine causing a 20% fall in FEV1 of 8mg / ml or less

22
Q

describe the mechanism behind an asthma attack

A

a trigger occurs e.g. pollen

causes release of mast cell spasmogens e.g. histamine
+ chemotaxins

spasmogens causes bronchospasm

Chemotaxins cause influx and activation of inflammatory cells which release leuktriens, cytokines,eosinophil proteins

these can cause

  • Bronchospasm
  • wheezing
  • cough
  • increase of hyper reactivity and inflammation

leading to reduction in size of lumen of bronchiole

23
Q

what are the two phases of an asthma attack

A

immediate

delayed

24
Q

describe immediate phase of asthma attack

A

trigger

release mast cell spasmogen + chemotaxin

spasmogen cause bronchospasm

25
Q

describe delayed phase of an asthma attack

A

influx of inflamatory cells which release leikotrienes cytokines eosinophil protein etc

these can cause

  • Bronchospasm
  • wheezing
  • cough
  • increase of hyper reactivity and inflammation

leading to reduction in size of lumen of bronchiole

26
Q

what primary prevention (non pharmacological methods do we have to manage chronic asthma

A

multifcaceted approach to avoid indoor asthma

Aeroallergen and food avoidance

Weight loss interventions for overweiht and obese adults and children with asthma

Microbial exposure and hygiene hypothesis

avoid smoking and air pollution

27
Q

what secondary prevention do we have to manage chronic asthma

A

house dust mite avoidance should not be routinely recommended

breathing exercise programmes can be offered to adult to improve quality of life and reduce symptoms

family therapy with pharmacotherapy

28
Q

what can be used to relieve asthma

A

inhaled short acting fast onset beta adrenoceptor agonists

inhaled long acting fast onset beta adrenoceptor agonists as MART only

29
Q

why are relievers used

A

they are used to relieve asthma symptoms and for asthmatic patients with infrequent short lived wheeze and normal lung function to control the symptoms quickly

30
Q

what can be used to control + prevent

A

long acting bronchodilators and anti inflammatory drugs

  • inhaled long acting beta 2 adrenoceptor agonists in combination with ICS
  • inhaled and systemic corticosteroids
  • leukotriene receptor antagonists
  • long acting muscarinic receptor antagonists
  • theophylline
31
Q

why are controllers used

A

regular maintenance therapy to improve symptoms lung function and prevent asthma attack

32
Q

what is salbutamol used for

A

occasional reliever and for acute asthma attacks it is suitable for this due to the fast onset, however it has short action

33
Q

what is salmeterol onset compared to salbutamol

A

longer but longer duraiton

34
Q

what are the advantage of long acting adrenceptor agonists

A

allow reduction of corticosteroid dose

reduction of symptoms and improvement of lung functions

35
Q

what are the disadvantage of long acting adrenoceptor agonists

A

risk increase of asthma exarcerbation hospitilization and death

36
Q

what does MART stand for

A

maintenance and reliever therapy and is a combined form of ICS and LABA treatment

37
Q

what are the adverse affect of beta 2 adrenoceptor agonists

A

arrythmias
angina precipitation
palpitation
tachycardia

peripheral vasodilation
headache
tremor

38
Q

what are contraindications and use with caution in regards to beta 2 adrenoceptor agonists

A

cardiovascular diseases

pregnancy

39
Q

what might interact with other drugs beta 2 adrenoceptor agonists

A

hypokalaemia

40
Q

what are the most effective anti inflammatory therapy for asthma

A

corticosteroids

41
Q

what are the two mechanisms of action

A

trans repression

trans activation

42
Q

What is trans repression

A

switch off multiple activated inflammatory genes and decrease transcription of

cytokines

chemokines

inflammatory enzymes

inflammatory receptors

others

43
Q

what is trans activation

A

activate anti inflammatory gene expression and increase transcription of beta adrenergic receptor

44
Q

what are the unwanted side effects of long term corticosteroid use

A

reduction of bone mineral density, osteoporosis

hypertension

cataracts and glaucoma

hyperglycaemia, diabetes

weight gain

increased vulnerability to infection
- lower respiratory tract infections

thinning of the skin and easy bruising hoarseness dysphonia, throat irritation, and candidiasis

45
Q

what do blt1 and 2 mediate

A

chemotaxis and immunomodulation in several leukocyte populations and are in addition expressed on non myeloid cells such as vascular smooth muscle and endothelial cells.

46
Q

what do cysLT1 and 2 exhibit

A

distinct expression patterns in human tissues, mediating for example smooth muscle cell contraction, regulation of vascular permeability and leukocyte activation

47
Q

describe the mechanism of action for leuktriene receptor antagonists

A

block csyteinyl leukotrine receptors on bronchial tissue + others to reduce bronchoconstriction, mucus secretion, edema, eosinophil migration

48
Q

Mechanism of action of anticholinergic agents

A

Antagonist of muscarinic acetylcholine receptors.

-Blockage of M3receptors reduces bronchoconstriction (promoting relaxation of pulmonary smooth muscle and bronchodilation) and reduces mucus secretion

49
Q

Mechanism of action of theophylline

A

Non-selective phosphodiesterase inhibtor (=↑cAMP)

Non-selective antagonist at adenosine receptors

Activates histone deacetylases (HDACs)

Others unknown

50
Q

mechanism of action of Anti lgE

A

Antibody binds to circulating IgE decreasing binding of IgE to the high-affinity IgE receptor (FceRI) in mast cells.

Therapeutics (50 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions