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Physiology: Alessio > Asthma > Flashcards

Asthma Flashcards

1
Q

What are some causes of asthma?

A

Allergens
Exercise
Respiratory infections
Smoke, dust

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2
Q

What is acute asthma?

A

Airway obstruction caused by contraction of smooth muscle in the airway (inflammation)

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3
Q

What are symptoms of acute asthma?

A

Dyspnoea
Wheezing
Coughing

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4
Q

Which two reactions are in asthma?

A

Immediate and delayed

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5
Q

What happens in the early phase of asthma? (bronchospasm)

A

Bronchoconstriction
Increased mucous production
Vasodilation
Release of inflammatory mediators

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6
Q

What happens in the late phase of asthma? (inflammation)

A

Recruitment of leukocytes and T cells, produced by mast and epithelial cells
More release of mediators

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7
Q

Which T helper cells stimulate release of mediators?

A

Th2

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8
Q

Which receptors are activated by Th2 release?

A

IL4
IL5
IL13

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9
Q

What does IL-4 do?

A

stimulates the production of IgE by B cells and activate mast cells

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10
Q

What does IL-5 do?

A

Activates local eosinophils

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11
Q

What does IL-13 do?

A

Stimulates mucus secretiom and stimulate IgE production and activate mast cells

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12
Q

What is the immediate response on re-exposure to antigen?

A

Antigen binds to IgE-IgE receptor complex

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13
Q

What does the IgE-IgE receptor complex stimulate?

A

Calcium entry into mast cells

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14
Q

What does calcium entry into cells cause?

A

Release of histamine and leukotrienes (LTC4 and LTD4) which causes smooth muscle contraction

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15
Q

What causes inflammation in airway?

A

LTB4 (chemotaxin)

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16
Q

What are the effects of mast cell mediators (histamine and leukotrienes)?

A

Bronchospasm
Increased vascular permeability and vasodilation
Mucus production
Recruit additional mediator releasing cells

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17
Q

What happens at the late phase?

A

Arrival of recruited basophils, eosinophils, neutrophils, lymphocytes (pro-inflammatory mediators)

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18
Q

What do the pro-inflammatory mediators cause?

A

Eotaxin - further recruitment of eosinophils

Major basic protein- epithelial damage and more airway constriction
Cytokines amplify inflammation

19
Q

What happens in chronic asthma?

A

Increased mass of smooth muscle
Accumulation of oedema
Increased secretion of mucus
Epithelial damage by exposing sensory nerve ending

20
Q

What are the diagnostic tests for chronic asthma?

A

Increase in airflow obstruction (spirometry nd peak flow test)
Difficulty with exhalation (wheezing)
Eosinophil count
Allergy tests

21
Q

What is the autonomic regulation of airways? (Parasympathetic)

A

M3 choinergic receptors

Bronchoconstriction and increases mucus secretion

22
Q

What is the autonomic regulation of airways? (Sympathetic)

A

Adrenergic acts on B2 receptors – bronchodilation

Noradrenergic– neuronal noradrenaline decrease mucus secretion

23
Q

What can we use to target mast cells?

A

Chromolyn

24
Q

What can we use to target Bronchospasm?

A

B agonists
M2 agonists
Xanthines

25
Q

What can we use for inflammation?

A

Glucocotricoids

26
Q

What do B2 adrenergic agonists do?

A

Bronchodilation

Decrease mucus secretion

27
Q

What is given as a B2 adrenergic agonists?

A

Inhalation
salbutamol
long acting salmeterol
tremor

28
Q

Mechanism of action of salbutamol?

A

Salbutamol binds to B2 receptor, activation of adenyl cylase, more 2nd messenger cAMP, smooth relaxation

29
Q

What do muscarinic agonists do?

A

Dilate the bronchi

Decreased mucus secretion

30
Q

What is an example of an M3 antagonist?

A

Ipratropium

dry mouth and tachychardia

31
Q

What are Xanthines?

A

Derivatives of caffeine and theobromine

32
Q

What do Xanthines causes?

A

Bronchodilation-

Anti-inflammatory properties

33
Q

How do Xanthines cause bronchodilation?

A

Block phosphodiesterase III and IV, increasing cAMP, bronchodilation

34
Q

What is an example of a Xanthine?

A

Theophylline
Narrow therapeutic index
side effects, tachychardia

35
Q

How is the delayed phase targetted?

A

Glucocorticoids

36
Q

What do glucocorticoids do?

A

Suppress the inflammatory response by inhibiting transcription of phospholipase A2 so decreases production of inflammatory mediators
LTC4 LTD4 - spasmogens
LTB4- chemotaxins
PGE2, PGI2, vasodilators, cytokines

37
Q

What are examples of glucocorticoids?

A

Beclomethasone
Prednisolone
Hydrocortisone

38
Q

What are some side effects

A

Oral candidiasis

39
Q

Which two things target both immediate and delayed?

A

Chromolyn

Cysteinil Leukotriene receptor antagonist

40
Q

What is Sodium Cromolyn?

A

Originally proposed to be a mast cell stabiliser

inhibits hyper responsivity

41
Q

What do CysLT1 receptor antagonists do?

A

Block leukotriens’ induced bronchospasm

42
Q

Name all the targets for asthma?

A

1) B2 agonist
2) Muscarinic agonist
3) Xanthines
4) Antileukotrienes
5) Cromolyn
6) Glucocorticoids

43
Q

What must you be careful of? (avoid)

A

B antagonists, can precipitate asthma, propanolol and other beta blockers to treat hypertension
ACE inhibitors can induce cough
NSAIDs can precipitate asthma

Physiology: Alessio (5 decks)

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