20. asthma and copd Flashcards
(26 cards)
bronchial asthma
narrowing of peripheral airways in the lung
predominantly inflammatory
primarily reversible
FEV1 and PEFR used to measure
copd
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
bronchitis
persisitent cough with mucus production
emphysema
destruction of tissues around alveoli
status asthmaticus
severe acute asthma that is not readily reversed
anatomy of airways
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
asthmatic airway
smooth muscle hypertrophy epithelial desquamation thickening of basement membrane infiltration of the submucosa by eosinophils and neutrophils goblet cell metaplasia
asthma attacks are biphasic
first phase is bronchospasm and the second phase is nflammatory
allergic astma, inflammation of the lung
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
mast cell
when IgE antibodies on surface of mast cells become cross linked with antigen causes hem to degranulate and release preformearly mediatorsed protein meditors
early mediators
histamines proteases proteoglycans and chemotactic factors
later mediators
derived from embrane lipids
leukptrienes B4, prostaglandins D2, thromboxanes and prostacyclins
what causes bronchospasm
leukotrient b4 and prostagland d2 cause contraction of the bronchiall smooth muscle
what is epithelial desquamation cause dby
allergen binding to ige on mast cell which causes them to release toxic major basic protein thst damages the respiratory endothelium
histamines
early mediaotrs
causes contrction of airway smooth muscle, increased vascular permeavilty and increased bronchial secretions
chemotactic factor
early mediators
cause infiltration of lung tissue by neutrophils and eosinophils
leaukotriens c4 d4 e4 and prostaglandin d2
later mediators
cause contraction of airways smooth muscle, increased vascular permeability and increased nronchial secretions
the major basic protein comes from eosinophils
asthma relievers or bronchodilators
beta 2 adrenoceptor agonists
leukotriene antagonists
theophylline
mAChR antagonists
preventers of asthma
long acting beta 2 agonsits
glucocorticosteroids
monoclonal antibodies
leukotriene antagonists
non selective b adrenoceptor potency
isoprenaline, adrenaline and then noradrenaline
selective beta agonisys
beta 1 dolbutamine
beta 2 is salbutamol
dhort acting bronchodilators
salbutamol and terbutaline
long acting bronchodilators
salmeterol
has relative lipophilicity allows It to remain in the tissues for longer
can anchornitself to the recetpro
how do beta 2 adrenoceptor agonists cause relaxation
gs protein and adenylyl cyclase, leads to active protein kinase a and phosphorylated protein that reduces intracellular calcium conc and leads to relaxation
