Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

hlsc final > Asthma > Flashcards

Asthma Flashcards

1
Q

Asthma

A

Sense of breathlessness and tightness of chest

wheezing, dyspnea, cough

cause: immune-related airway inflammation

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

events leading to inflammation and bronchoconstriction

A

1) Allergen molecule binds to IgE on mast cells

2) Mast cells release mediatotors
–> bronchocontrictions
–> infiltration of inflammatory cells

3) inflammatory cells release more mediators

RESULT: airway inflammation characterized by edema, mucus plugging, smooth muscle hypertrophy = airflow obstruction

4) inflammation cause by bronchial hyperactivity

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

COPD symptoms result from 2 processes

A

1) Chronic bronchitis
- cough, excessive sputum
- hypertrophy of mucus-secreting glands in epithelium of large airways

2) Emphysema
- enlarged airspace within bronchioles and alveoli
- deterioration of walls of air spaces

Both caused by rxn to cigarette smoke

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

Major Drugs for Asthma and COPD: 2 classes

A

1) Antiinflammatory agents
Glucocorticoids: admin on fixed schedule

2) Bronchodilators
B2 aagonist: fixed schedule or as needed
- inhaled

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

Benefits of inhalation

A

direct to site of action

systemic effects minimized

rapid relief of acute attacks

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

Glucocorticoid drugs

A

Beclomethasone (inhaled)

Prednisone (PO prototype)

  • most effective for long term control of airway inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Beclomethasone (inhaled)

Prednisone (PO prototype)

Mechanism

A

decrease synthesis and release of inflammatory mediators (leukotrienes, histamines, prostaglandins)

Decreased infiltration and activity of inflammatory cells (eosinophils, leukocytes)

Decreased edema of airway mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Beclomethasone (inhaled)

Prednisone (PO prototype)

Therapeutic use

A

control inflammation in both asthma and COPD

effective for asthma prophylaxis and management of COPD exacerbations

don’t alter course of conditions
- provide management of symptoms

inhalation use: very effective, fist line therapy

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

Prednisone (PO prototype) use

A

when symptoms cant be controlled with inhaled meds

moderate to severe asthma

high potential for toxicity
- treat brief as possible

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

Beclomethasone (inhaled)

Adverse effects

A

inhaled - devoid of serious toxicity

  • high doses: oropharyngeal candidiasis (thrush), dysphonia (speaking difficulty)
  • long-term high dose: adrenal suppression ( adrenal glands don’t make enough cortisol)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Prednisone (PO prototype) adverse effects

A

prolonged therapy: adreanal suppression, osteoporosis, immunosuppression

KEY: transferring from PO to inhaled requires several months for recovery of adrenocortical function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Beclomethasone (inhaled)

preparations

A

regular schedule

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

Prednisone (PO prototype) prepations dose and administration

A

methylprednisone, prednisone are preferred

adult dose 40-60 mg/day for 3-10 days
children: lower

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

Leukotriene receptor antagonists (LTRAs)

A

suppress leukotriene
- leukotriene involved in recruitment of eosinophils and other inflammatory cells

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

Types of LTRAs

A

Zileuton
- blocks leukotriene synthesis

Montelukast
- block leukotriene receptor

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

Leukotrienes

A

promote smooth muscle contraction, vessel permeability and inflammation

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

Zileuton mechanism

A

effects not immediate

inhibits enzyme that converts arachidonic acid into leukotrienes

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

Zileuton pharmacokinetics

A

PO, rapid absorption

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

Zileuton Adverse effects

A

Liver injury, possible hepatitis

Neuropsychiatric effects

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

montelukast: three indications

A

1) prophylaxis and maintenance in asthma

2) prevention of exercise-induced bronchospasm

3) relief of allergic rhinitis

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

montelukast mechanism

A

high affinity for leukotriene receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

montelukast pharmacokinetics

A

PO rapidly absorbed

Metabolised in liver

Excreted in bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mast cell Stabilizer drug

A

Cromolyn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cromolyn

A

Inhalation agent that suppresses bronchial inflammation

Prophylaxis in patients with mild to moderate asthma

Used when glucocorticoids cause problems
- not as effective as glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Mech of Cromolyn
Stabilizes mast cells - prevent release of histamines - inhibits eosinophils and macrophages
26
cromolyn pharmacokinetics
administrered by nebulizer excreted unchanged in urine
27
Cromolyn therapeutic uses
Maximal effects take weeks to develop prophylaxis for season allergy attacks Administer 10-15 prior to exercise
28
Cromolyn Adverse effects
safest of all anti-asthma medications
29
preparation , dosage and administration of cromolyn
adults/children: 20 mg 4x/day maintenance= lowest effective dose
30
Monoclonal Antiboides
form newest drug for airway inflammation non are approved for first-line agents and for management of acute asthmatic episodes
31
IgE Antibody Antagonist
Omalizumab
32
three categories of monoclonal antibodies
1) IgE Antibody Antagonist 2) Interleukin-5 Antagonist 3) Interleukin-4 Receptor Alpha Antagonist
33
Omalizumab
Second-line agent
34
Omalizumab mechanism of action
-forms complexes with IgE in blood = reduced available IgE = limits availability of allergen to trigger release of histamine
35
therapeutic use of Omalizumbab
when asthma is allergy-related or can't be controlled by glucocorticoid only for patients with a specific allergen
36
Omalizumab pharmacokinetics
administration: subQ injection absorbtion: slow- peak levels in 7-8 days half life 26 days
37
Omalizumab adverse effects
variety: injection site reaction, upper respiratory infection, sinusitis, pharyngitis life-threatening anaphylaxis occurs rarely
38
preparations, dosage, administration omalizumab
powder reconstituted in sterile water - then sub Q dose and dosing interval determined by body weight and total serum IgE
39
Interleukin-5 Receptor Antagonist
Benralizumbab
40
Interleukin-5 (IL-5)
responsible for differentiation and maturation of eosinophils
41
mechanism of action Benralizumab
IL-5 receptor antagonists bind to IL-5 receptor = inhibit = reduced production of eosinophils
42
Therapeutic Use Interleukin-5 Receptor Antagonist
Restricted: only for severe eosinophilic asthma
43
Adverse effects of Benralizumab
SubQ injection: site of reaction, back pain hypersensititivity
44
Interleukin-4 Receptor antagonist
Dupilumab
45
IL-4
Inflammatory cytokine that binds to many cells involved in inflammation
46
Mech of Dupilumab
its a monoclonal antibody (made in lab) that binds to IL-4 receptor = decreased inflammatory response Used for eosinophilic asthma
47
Dupilumab Adverse effects
SubQ injection site reaction, conjectivitis
48
Phosphodiesterase-4 inhibitor
Roflumilast - approved for sever chronic COPD with a primary chronic bronchitis component
49
mechanism of Roflumilast
PDE4 breaks down cAMP There fore PDE-4-inhibior = increased cAMP cAMP reduces inflammation by suppressing cytokine release and decreasing pulmonary infiltration of neutrophils and other WBC
50
therapeutic use of roflumilast
not first line prophylaxis for severe chronic bronchitis patients
51
adverse effects of roflumilast
the greatest concern is anxiety and depression to suicidal behavior
52
Bronchodilators
1. Beta2- Andrenergic Agnosits 2. Anti-Cholinergic
53
Beta 2- Andregnergic Agonists
Inhaled are most effective for acute bronchospasm and preventing EIB
54
Beta2- Andrenergic Agonists mechanism
Drug activates beta2-andrenergic recptors - activated receptors in lung = bronchodilator - limited role in suppressing histamine release
55
administration of bronchodilators
PO- long-term control, long-lasting, fixed schedule - for asthma must be combined with glucocorticoid INHALED - short-acting (3-5hr) - take before exercise to prevent attack
56
Anti-Cholinergic Drug name
Ipratropium - approved only for COPDme
57
mechanism of Anti-cholinergic
blocks bronchi muscarinic receptors = reduced bronchoconstriciton - effects within 30 seconds, persist 6 hr
58
Therapeutic use Ipratropium
Inhalation - system effects are minimal
59
Adverse effects of Ipratropium
dry mouth, irritation of pharynx
60
Combination Drugs
1) Glucocorticoid/ Long-Acting Beta2 Agonists 2) Beta2 adrenergic agonist/ Anticholinergic Combination
61
Glucocorticoid/Long-Active Beta 2 Agonsit Combination
- Anti inflammatory benefits of glucocorticoids - bronchodilation of beta2 agonists - for pt not controlled with inhaled glucocorticoid - not first line - black box
62
Beta 2- adrenergic agonist/ anticholinergic combination
- beta 2 agonist : bronchodilation by stimulating adrenergic receptors - anticholinergic: brochodilation by blocking cholinergic receptors
63
Classification of asthma severity
1) intermittent 2) mild persistant 3) moderate persistent 4) severe persistent
64
what is severity of asthma classification based upon
impairment- quality of life, functional capacity risk- adverse events
65
initial therapy for acute/severe exacertbation
- oxygen: hypoxemia - systemin glucocorticoid: inflammation - nebulized high-dose SABA: airflow obstruction - Nebulized Ipratropium (anti-cholinergic): further reduce airflow obstruction
65
Stepwise managing asthma
1) inhaled SABA (short-acting beta agonist) as needed 2) ling-term control med = generally inhaled glucocorticoid 3) dosage increased or another medication is added 4) after a period of sustained control, move down a step is tried
65
drugs for acute/severe exacerbations goal of drugs
- relieve hypoxia - relieve airway inflammation - relieve airway obstruction - normalize lung function
66
cause of exercise-induced bronchospasm (EIB)
loss of heat or water from lung
67
preventing EIB
inhale SABA (preferred) Cromolyn (mast-cell stabilizer prophylactically

hlsc final (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions