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39 Cards in this Set
- Front
- Back
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What is asthma?
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characterized by bronchoconstriction due to hyperresponsiveness of the airways to physical, chemical & pharmacological stimuli
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what are some symptoms of asthma?
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wheezing, cough, SOB, tightness in chest
occur on repeated stimuli |
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What are the pathological processes that contribute to asthma?
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decreased airway caliber, edema, increased SM contractility, increased secretions, epithelial damage, inflammation
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What is a clinical test that you can quantify asthma with?
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decrease in FEV1
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What types of receptors to you find in bronchial smooth muscle?
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muscarinic cholinergic
adrenergic |
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Undernormal conditions airway SM tone is controlled by?
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1. PNS - Ach from the vagal n
2. SNS - epi from adrenal medulla on B2 to cause relaxation |
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What are some other vasoactive substances that act on airway SM?
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AA metabolites (PG, TX, leukotrienes)
histamine adenosine |
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What are the main actions of airway epithelium?
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permeability barrier & secrete mucus
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What is the secretion of mucus by airway epithelium regulated by?
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muscarinic receptors on PNS ganglia in dubmucosal glands
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What are the main actions of vascular epithelium?
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barrier to fluid flux
barrier to extravasation of inflammation |
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What are some mediators of bronchoconstriction?
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histamine, adenosine, leukotrines, thromboxane
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What are some mediators of inflammation?
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prostaglandins, leukotrienes, cytokines, histamine, proteases
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What are the classes of bronchodilators?
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methylxanthines
B2 adrenoceptor agonists Anti-cholinergics |
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What are the broncho-dilator drugs?
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theophylline
albuterol salmeterol ipratropium bromide |
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What are the classes of anti-inflammatory agents?
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glucocorticosteroids
inhibitors of mast cell activation Anti-leukotrienes |
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What are the anti-inflammatory drugs?
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beclomethasone
cromolyn sodium zafirlukast zileuton |
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What are the B2 agonists?
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albuterol - short
salmeterol - long |
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What do B2 agonists do?
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relaxes airway smooth muscle
stimulates mucociliary transport |
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What is the mechanism of action of B2 agonists?
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GP activation, inc adenylyl cyclase, inc cAMP, inc conductance of Ca sensitive K channels causing SM
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Why is the mechanism of action of salmeterol longer?
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long lipophilic tail that plants itself in the plasma membrane
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What are the downsides of B2 agonists?
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overreliance
cardiac toxicity desensitization cant tx pts with HTN with beta blockers |
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What group is caffeine in?
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methylxanthines
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What is the main drug in methylxanthines?
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theophyllines
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What is the mechanism of action of theophylline?
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phospodiesterase inhibitor and adensoine antagonist
relaxes SM |
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What are the downsides to using theophyllines?
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narrow theraputic window due to stimulant effects on CNS & cardiovascular system
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What is the anti-cholinergic drug?
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ipratropium bromide
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What does ipratropium bromide do?
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relaxes airway SM
decreases mucus secretion |
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Why does ipratropium bromide not the best?
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cause sympathetic tone dominates
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What is good about ipratropium bromide?
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poorly absorbed limiting access to CNS
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What is the glucocorticosteroid used to tx asthma?
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beclomethasone
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What is beclomethasone most effective in treating?
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chronic asthma
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What does beclomethasone do?
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reduces hyperreactivity caused by inflammation
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What are the mechanisms of action of beclomethasone?
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inc txn of lipocortin 1 (inhib phospholipase A2)
dec txn of inflam mediators inc receptors of B2 receptors |
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What is the drug that inhibits mast cell degranulation?
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cromolyn sodium
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What does cromolyn sodium do?
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prevent bronchoconstriction & inflammation by preventing transmembrane influx of Ca required for degranulation
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What is the key to cromolyn sodium?
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must be used BEFORE exposure
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What are the drugs that block leukotrienes?
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zarfirlukast
zileuton |
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What is the mechanism of action of zafirlukast?
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leukotriene receptor antagonist
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What is the mechanism of action of zileuton?
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5-LOX inhibitor
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