Pulmonary Flashcards
Asthma
A heterogeneous disease, usually characterized by chronic
airway inflammation
Reps symptoms of asthma
wheeze
SOB
Chest tightness
cough
Making the Diagnosis for asthma
Should be based on the history of characteristic symptom patterns
and evidence of airflow limitation.
- Evidence of airflow limitation with bronchodilator reversibility
dults: Increase in FEV1 >12% and >200 mL from baseline, 10‒15 minutes after 200‒400 mcg albuterol or equivalent
reliever meds to treat bronchospasm
SABA
inhaled corticosteroids
- Controller To minimize development
of airway inflammation
Example- Inhaled corticosteroid
Leukotriene modifier is used to
To prevent inflammation development
* LTM such as montelukast
(Singulair®)
Long-acting muscarinic antagonists
To provide long-acting bronchodilation, potentially anti-eosinophilic/anti- inflammatory/controller effect
example: tiotropim bromide
Long-acting bronchodilators are used to
To prevent development of
bronchospasm
Examples
Long-acting beta2-agonist (LABA, salmeterol, formoterol)
Long-acting muscarinic antagonists
(LAMA, tiotropium bromide)
Systemic corticosteroids
To treat acute inflammation
* Example: Oral prednisone/prednisolone
MOA of corticosteroids
- Normally endogenously by adrenal cortex * Therapeutic use
Inhibit production of inflammatory agents
- Including cytokines, which reduces eosinophil infiltration, inhibits macrophage and eosinophil function
- Decreases epithelium mediator cells, reduces vascular permeability, reduces the production of leukotrienes
MOA of Leukotriene modifiers
Selective and competitive antagonists of the cysteinyl leukotriene
(Cys LT1) receptor
Cysteinyl leukotriene (LTC4, LTD4 and LTE4) production and receptor occupation, including airway edema, smooth muscle constriction, and altered cellular activity associated with inflammatory process
