20. asthma and copd Flashcards

(26 cards)

1
Q

bronchial asthma

A

narrowing of peripheral airways in the lung
predominantly inflammatory
primarily reversible
FEV1 and PEFR used to measure

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2
Q

copd

A

chronic obstructive pulmonary disease ]narrowing of peripheral airways in the lung
caused by smoking and exposure to environmental pollutants
predominantly inflalmmatory
combindation of bronchitis and emphysema

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3
Q

bronchitis

A

persisitent cough with mucus production

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4
Q

emphysema

A

destruction of tissues around alveoli

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5
Q

status asthmaticus

A

severe acute asthma that is not readily reversed

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6
Q

anatomy of airways

A

trachea primary bronchi have rings of cartilage
secondary and tertiary bronchi have plates of cartilage
bronchioles don’t have cartilage, have smooth muscle which determines the diameter of the bronchiole and thus the flow of air to the alveoli

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7
Q

asthmatic airway

A
smooth muscle hypertrophy
epithelial desquamation
thickening of basement membrane 
infiltration of the submucosa by eosinophils and neutrophils 
goblet cell metaplasia
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8
Q

asthma attacks are biphasic

A

first phase is bronchospasm and the second phase is nflammatory

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9
Q

allergic astma, inflammation of the lung

A

iteraction of antigen presenting cell with t helper cell activates it to release cytokines such as interleukins
interleukins activate eosinophils and mast cells and also trigger b lymphocytes to differentiate into plasma cells that release IgE antibodies which attach to the mast cells and eosinophils

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10
Q

mast cell

A

when IgE antibodies on surface of mast cells become cross linked with antigen causes hem to degranulate and release preformearly mediatorsed protein meditors

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11
Q

early mediators

A

histamines proteases proteoglycans and chemotactic factors

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12
Q

later mediators

A

derived from embrane lipids

leukptrienes B4, prostaglandins D2, thromboxanes and prostacyclins

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13
Q

what causes bronchospasm

A

leukotrient b4 and prostagland d2 cause contraction of the bronchiall smooth muscle

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14
Q

what is epithelial desquamation cause dby

A

allergen binding to ige on mast cell which causes them to release toxic major basic protein thst damages the respiratory endothelium

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15
Q

histamines

A

early mediaotrs

causes contrction of airway smooth muscle, increased vascular permeavilty and increased bronchial secretions

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16
Q

chemotactic factor

A

early mediators

cause infiltration of lung tissue by neutrophils and eosinophils

17
Q

leaukotriens c4 d4 e4 and prostaglandin d2

A

later mediators
cause contraction of airways smooth muscle, increased vascular permeability and increased nronchial secretions
the major basic protein comes from eosinophils

18
Q

asthma relievers or bronchodilators

A

beta 2 adrenoceptor agonists
leukotriene antagonists
theophylline
mAChR antagonists

19
Q

preventers of asthma

A

long acting beta 2 agonsits
glucocorticosteroids
monoclonal antibodies
leukotriene antagonists

20
Q

non selective b adrenoceptor potency

A

isoprenaline, adrenaline and then noradrenaline

21
Q

selective beta agonisys

A

beta 1 dolbutamine

beta 2 is salbutamol

22
Q

dhort acting bronchodilators

A

salbutamol and terbutaline

23
Q

long acting bronchodilators

A

salmeterol
has relative lipophilicity allows It to remain in the tissues for longer
can anchornitself to the recetpro

24
Q

how do beta 2 adrenoceptor agonists cause relaxation

A

gs protein and adenylyl cyclase, leads to active protein kinase a and phosphorylated protein that reduces intracellular calcium conc and leads to relaxation

25
unwanted effects of b agonist bronchodilators
tremor tachycardia nervous tension hypokalaemia
26
ways to administer bronchodilators
metered dose inhaler spacer nebuliser