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39 Cards in this Set

  • Front
  • Back
What is asthma?
characterized by bronchoconstriction due to hyperresponsiveness of the airways to physical, chemical & pharmacological stimuli
what are some symptoms of asthma?
wheezing, cough, SOB, tightness in chest

occur on repeated stimuli
What are the pathological processes that contribute to asthma?
decreased airway caliber, edema, increased SM contractility, increased secretions, epithelial damage, inflammation
What is a clinical test that you can quantify asthma with?
decrease in FEV1
What types of receptors to you find in bronchial smooth muscle?
muscarinic cholinergic
adrenergic
Undernormal conditions airway SM tone is controlled by?
1. PNS - Ach from the vagal n
2. SNS - epi from adrenal medulla on B2 to cause relaxation
What are some other vasoactive substances that act on airway SM?
AA metabolites (PG, TX, leukotrienes)
histamine
adenosine
What are the main actions of airway epithelium?
permeability barrier & secrete mucus
What is the secretion of mucus by airway epithelium regulated by?
muscarinic receptors on PNS ganglia in dubmucosal glands
What are the main actions of vascular epithelium?
barrier to fluid flux
barrier to extravasation of inflammation
What are some mediators of bronchoconstriction?
histamine, adenosine, leukotrines, thromboxane
What are some mediators of inflammation?
prostaglandins, leukotrienes, cytokines, histamine, proteases
What are the classes of bronchodilators?
methylxanthines
B2 adrenoceptor agonists
Anti-cholinergics
What are the broncho-dilator drugs?
theophylline
albuterol
salmeterol
ipratropium bromide
What are the classes of anti-inflammatory agents?
glucocorticosteroids
inhibitors of mast cell activation
Anti-leukotrienes
What are the anti-inflammatory drugs?
beclomethasone
cromolyn sodium
zafirlukast
zileuton
What are the B2 agonists?
albuterol - short
salmeterol - long
What do B2 agonists do?
relaxes airway smooth muscle
stimulates mucociliary transport
What is the mechanism of action of B2 agonists?
GP activation, inc adenylyl cyclase, inc cAMP, inc conductance of Ca sensitive K channels causing SM
Why is the mechanism of action of salmeterol longer?
long lipophilic tail that plants itself in the plasma membrane
What are the downsides of B2 agonists?
overreliance
cardiac toxicity
desensitization
cant tx pts with HTN with beta blockers
What group is caffeine in?
methylxanthines
What is the main drug in methylxanthines?
theophyllines
What is the mechanism of action of theophylline?
phospodiesterase inhibitor and adensoine antagonist

relaxes SM
What are the downsides to using theophyllines?
narrow theraputic window due to stimulant effects on CNS & cardiovascular system
What is the anti-cholinergic drug?
ipratropium bromide
What does ipratropium bromide do?
relaxes airway SM
decreases mucus secretion
Why does ipratropium bromide not the best?
cause sympathetic tone dominates
What is good about ipratropium bromide?
poorly absorbed limiting access to CNS
What is the glucocorticosteroid used to tx asthma?
beclomethasone
What is beclomethasone most effective in treating?
chronic asthma
What does beclomethasone do?
reduces hyperreactivity caused by inflammation
What are the mechanisms of action of beclomethasone?
inc txn of lipocortin 1 (inhib phospholipase A2)
dec txn of inflam mediators
inc receptors of B2 receptors
What is the drug that inhibits mast cell degranulation?
cromolyn sodium
What does cromolyn sodium do?
prevent bronchoconstriction & inflammation by preventing transmembrane influx of Ca required for degranulation
What is the key to cromolyn sodium?
must be used BEFORE exposure
What are the drugs that block leukotrienes?
zarfirlukast
zileuton
What is the mechanism of action of zafirlukast?
leukotriene receptor antagonist
What is the mechanism of action of zileuton?
5-LOX inhibitor