Asthma (Chapter 9)

Question 1

what is asthma ?

Answer 1

a chronic respiratory disease, characterized by reversible and intermittent airway hyper-reactivity of bronchial tube dilation and contration

Question 2

what are symptoms of asthma ?

Answer 2

shortness of breath
coughing
wheezing
tightness in chest

Question 3

what are triggers of asthma ?

Answer 3

smoking, humidity, heat, viral infections, NSAIDs, sulfites, psychosomatic

Question 4

which medications can trigger asthma ?

Answer 4

NSAIDs

Question 5

what is the cause of asthma ?

Answer 5

combination of genetic and environmental factors

Question 6

can asthma be cured?

Answer 6

sometimes spontaneously

Question 7

what is the asthmatic lung characterized by ?

Answer 7

inflamed tissue, red, swollen, edema, excessive mucus production

Question 8

how do mast cells work ?

Answer 8

full of granules that contain toxic chemicals (leukotrienes, prostaglandins)

Question 9

what are the two types of asthma ?

Answer 9

eosinophilic and neutrophilic

Question 10

what is eosinophilic asthma ?

Answer 10

characterized by increased levels of eosinophils in the airway.
associated with more severity of the disease

eosinophils, mast cells, basophils bind to IgE which releases histamine

Question 11

what is neutrophilic asthma ?

Answer 11

characterized by increased levels of neutrophils and T-Cells in airway

Question 12

how is asthma triggered ?

Answer 12

IgE triggers release of chemicals from mast cells.

arachidonic acid pathway is stimulated by the increase of phospholipase A2. arachidonic acid is substrate for 5-lipoxygenase to produce leukotrienes.

Leukotrienes activate receptors on smooth muscle, causing bronchoconsriction, mucus secretion, edema.

Question 13

what is the arachidonic pathway stimulated by ? inhibited by ?

Answer 13

catalyzed by phospholipase A2

inhibited by corticosteroids

Question 14

what are the two therapeutic goals in treating asthma ?

Answer 14

1) cause bronchodilation

2) reduce inflammation underlying disease

Question 15

how many different drugs can help treat asthma ?

Answer 15

20

Question 16

what are the 4 types of asthma ?

Answer 16

intermittent (1-2 attacks/week, awakening at night occasionally)

mild persistent (more than 2 attacks/week, waking up frequently 3-4/month)

moderate persistent (daily attacks, wake up once/week)

severe persistent (attacks throughout day, regular night awakening)

Question 17

what is a sign asthma is quite severe ?

Answer 17

waking up at night

Question 18

daily attacks, wake up once/week

what kind of asthma?

Answer 18

moderate persistent

Question 19

more than 2 attacks/week, waking up frequently 3-4/month

what kind of asthma ?

Answer 19

mild persistent

Question 20

what are 2 ways of diagnosing asthma ?

Answer 20

1- talking to a doctor, telling them you wake up at night, etc

2- FEV between 60-80%

Question 21

what are the 5 main drugs used to treat asthma ?

Answer 21

short-acting beta-agonist
anticholinergics
corticosteroids (oral/parenteral)
long-acting beta-agonist
corticosteroids (inhaled)

Question 22

what are short-acting beta agonists ?

Answer 22

they provide quick relief, can prevent imminent attack

only taken as needed to prevent branchoconstriction

Question 23

give 2 examples of SABA

Answer 23

terbutaline

salbutamol

Question 24

what are anticholinergics ?

Answer 24

similar in use to SABA
prevent bronchoconstriction

however, many side effects as all cholinergics do, so shouldn’t be the first drug of choice

Question 25

what are oral and parenteral corticosteroids ?

Answer 25

used when needed prevent bronchoconstriction have same side effects as other corticosteroids

Question 26

what are LABA ?

Answer 26

they are inhaled and prevent bronchoconstriction more slow-acting than SABA slow release at a dose safe to take everyday unlike SABA

Question 27

give 2 examples of LABA

Answer 27

formoterol | salmeterol

Question 28

what are inhaled corticosteroids ?

Answer 28

used for daily maintenance do not affect bronchoconstriction/dilation reduces inflammatory reactions in tissue

Question 29

what drug increases the response of SABA ?

Answer 29

inhaled corticosteroids

Question 30

what is an example of an inhaled corticosteroid ?

Answer 30

flovent

Question 31

drugs through inhalation are considered what sort of consumption ?

Answer 31

topical application

Question 32

what are the advantages of inhalation ?

Answer 32

no first pass effect

Question 33

improper use of inhalers can lead to what ?

Answer 33

a low dose, and accumulation in back of throat

Question 34

what are the side effect of corticosteroids inhaled ?

Answer 34

fungus growth

Question 35

why is it better to inhale beta-agonists ?

Answer 35

because NE have BP increase and pupillary dilation

Question 36

how many different points of mutation on the gene does the b2 adrenergic receptor have ?

Answer 36

9

Question 37

what is the b2-adrenergic pathway ?

Answer 37

adenylyl cyclase activation -> cAMP increase -> airway opens