Asthma and COPD and allergies

Question 1

what is asthma

Answer 1

a long term respiratory condition in which airways may unexpectedly and suddenly narrow in response to an allergen, cold air, exercise, or stress.

Question 2

symptoms of asthma

Answer 2

wheezing, shortness of breath, chest tightness, coughing

Question 3

what is COPD

Answer 3

chronic bronchitis and emphysema, a pair of two commonly coexisting diseases of the lungs in which the airways become narrowed.

Question 4

symptoms of COPD

Answer 4

limitation of flow of air to and from the lungs causing shortness of breath

Question 5

Asthma results from what and what are mediators of asthmas

Answer 5

asthma is a disease resulting from an excessive active immune system and attenuation of the immune response is important for treatment!
T effector cells are mediators
Th cells determine course of inflammation

Question 6

sequence of events leading to infiltration of eosinophils in the lung

Answer 6

allergen > mast cell > Th2 > infiltration of eosinophils

Question 7

what mediates an inflammatory response in eosinophilic asthma leading to eosinophil infiltration of the lung

Answer 7

Th2 cells by the virtue of cytokines

Question 8

Aspects of Th1

Answer 8

cell mediated immunity, intracellular pathogens, against yeast, viruses, intracellular bacteria, and cancer

Question 9

Aspects of Th2

Answer 9

humoral/ AB mediated immunity, extracellular pathogens, parasites, normal bacteria, toxins, and allergens

Question 10

what regulates the balance between Th1 and Th2

Answer 10

cytokines!

Question 11

what is atopy

Answer 11

Atopy is the prediposition to Th2 responses - frequently linked to asthma

Question 12

Explain eosinophilic asthma and what is used to treat them

Answer 12

eosinophils and basement membrane thickening treated by Inhalational corticosteroids

Question 13

Explain Non eosinophilic asthma

Answer 13

no eosinophils, no Basement membrane thickening. Treatments still needed

Question 14

Th1 asthma

Answer 14

chronic inflammatory autoimmune disorders

Question 15

Th2 asthma

Answer 15

allergic (atopic) disorders > eosinophilic asthma

Question 16

Th17 asthma

Answer 16

Th17 asthma is chronic inflammatory and autoimmune disorder > neutrophilic asthma

Question 17

goals of asthma treatment

Answer 17

1. relieve/ prevent bronchoconstriction
2. inhibit airway inflammation - RED mucus production
3. prevent airway remodeling
   Goal: manage disease so symptoms are minimized

Question 18

Asthma onset
allergic response:
with treatment
late stage inflammation leads to what

Answer 18

onset: typically during childhood or adolescence
allergic response: bronchoconstriction
Treatment: near normal lung function and symptom free life possible
Late stage inflammation usually involves eosinophil recruitment

Question 19

COPD
Onset: 
bronchoconstriction from: 
Treatment:
Inflammation involves

Answer 19

Onset: typically in smokers and former smokers in 40s
bronchoconstriction results from change in vagal tone
treatment: PTs still experience symptoms, airflow obstruction is only partially reversible
Inflammation: involves neutrophil recruitment (neutrophilia)

Question 20

drug classes TX for allergic rhinitis

Answer 20

H1 receptor antagonists (antihistamines)
A1-adrenergic receptor agonists (decongestants)
and intranasal corticosteroids

Question 21

What does nasal corticosteroids do

Answer 21

reduce swelling and inflammation in mucous membranes and reduce mucus production

Question 22

side effects of nasal corticosteroids

Answer 22

rare but irritation, bad taste, nose bleeds, and sores in nose and perforation of nasal septum can occur

Question 23

what are oral decongestants

Answer 23

A1 adrenergic receptor agonists that constrict blood vessels and relive congestion

Question 24

two oral decongestants

Answer 24

phenylephrine- low bioavailability

pseudoephrine - particularly effective for nasal membranes, can be alone or with anti-histamines and pain relievers

Question 25

side effects of oral decongestants

Answer 25

tachycardia, hypertension, CNS stimulation, tremors

Question 26

what are antihistamines

Answer 26

antihistamines are H1 antagonist

Question 27

what are oral antihistamines used for

Answer 27

for systemic or local relief

Question 28

what are topical antihistamines used for

Answer 28

topical = urticaria (hives)

Question 29

what are ophthalmic antihistamines used for

Answer 29

for eye allergies

Question 30

what are intranasal antihistamines used for

Answer 30

for seasonal rhinitis

Question 31

Describe 1st generation antihistamines

Answer 31

1st generation antihistamines had significant entry into brain, sedative effect, anti -emetic, anti motion sickness effects

Question 32

describe 2nd generation antihistamines

Answer 32

limited entry into brain, more selective, fewer adverse effects

Question 33

name some common 1st ten antihistamines and their main drawbacks

Answer 33

benadryl, nyquil, dramamine | PRODUCE Drowsiness! short half lives and cross BBB

Question 34

what does Histamine receptor activity on vascular endothelium do

Answer 34

INC intracellular Ca leading to NO mediated relaxation of smooth m and vasodilation

Question 35

what produces broncho constriction in asthma

Answer 35

contents of mast cells granulation such as histamine, cystidinyl leukotrienes, prostaglandins

Question 36

agent INC Ca in smooth m will act as what | Agents Dec Ca in smooth m will act as what

Answer 36

INC Ca= broncho constrictors | Dec Ca= broncho dilators

Question 37

what produces relaxation of smooth m

Answer 37

B2 adrenergic receptor agonists