M5 RESPIRATORY Flashcards
(90 cards)
RISK FACTORS
allergens, genetics (atopy)
ASTHMA
RISK FACTORS
alpha-1 antitrypsin deficiency (anti protease)
COPD
KEY INFLAMMATORY CELLS
Eosinophils
mast cells
Th2 lymphocytes
ASTHMA
KEY INFLAMMATORY CELLS
Neutrophils
macrophages
CD8+ T-cells
COPD
AIRWAY OBSTRUCTION
Reversible (spontaneously or with treatment)
ASTHMA
AIRWAY OBSTRUCTION
Irreversible (progressive, fixed obstruction; partial reversibility possible)
COPD
SYMPTOMS
- Episodic wheezing
- dyspnea
- cough (often nocturnal/early morning)
ASTHMA
SYMPTOMS
- chronic cough
- sputum
- progressive dyspnea (worsens with exertion)
COPD
STRUCTURAL CHANGES
- Airway remodeling (subepithelial fibrosis, smooth muscle hypertrophy)
- Goblet cell hyperplasia
Goblet cell - produces mucus
ASTHMA
STRUCTURAL CHANGES
- Alveolar destruction (emphysema caused by a-1 antitrypsin)
- Mucus gland hyperplasia (too much mucus production)
- Airway fibrosis
COPD
CLASSIFICATION
- Primarily given to treat the bronchospasm RIGHT AWAY
- induce relief of acute bronchospasm
- SHORT-ACTING
RELIEVERS
CLASSIFICATION
- Primarily PROPHYLACTIC drugs (PREVENTION)
- Given to decrease the severity, duration, frequency of subsequent attacks of BA or COPD
- LONG-acting
CONTROLLERS
BRONCHODILATORS | B2 AGONISTS | SHORT-ACTING
RELIEVERS:
only SUBCUTANEOUS
TERBUTALINE
BRONCHODILATORS | B2 AGONISTS
CONTROLLERS:
only ORAL
BAMBUTEROL
BRONCHODILATORS | B2 AGONISTS
- 1st line relievers in BA
- ALTERNATIVE relievers in COPD
RELIEVERS
BRONCHODILATORS | B2 AGONISTS
- ALTERNATIVE/ADJUNCTIVE controllers in BA
- 1st line controllers with inhaled glucocorticosteroids for COPD
CONTROLLERS
BRONCHODILATORS | B2 AGONISTS | TOXICITY
easily overcome by the routine administration of supplemental oxygen
WORSENED HYPOXEMIA
BRONCHODILATORS | B2 AGONISTS | TOXICITY
precipitation of ____
cardiac arrythmia
BRONCHODILATORS | B2 AGONISTS | TOXICITY
induction of ____ reflected by loss of protection afforded by acute treatment with beta agonist
- resolved by LABA
tachyphylaxis
BRONCHODILATORS | METHYLXANTHINES
MOA
Adenosine antagonism, PE ihibition
BRONCHODILATORS | METHYLXANTHINES
MOA:
Inhibition of ____ appears to be the most involved in relaxing airway smooth muscle
PDE3
BRONCHODILATORS | METHYLXANTHINES
MOA:
inhibition of ____ in inhibiting release of cytokines and chemokines, thus decreasing immune cell migration and activation
PDE4
BRONCHODILATORS | METHYLXANTHINES
- A SELECTIVE PDE4 inhibitor that has shown efficacy in reducing the frequency of exacerbations of COPD
- APPROVED TREATMENT FOR COPD BUT NOT FOR ASTHMA
- has better therapeutic index than Theophylline
ROFLUMILAST
BRONCHODILATORS | METHYLXANTHINES
MOA:
inhibition of cell surface receptors for ____
ADENOSINE