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53 Cards in this Set
- Front
- Back
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main effects of Th2 cells
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activate b cells
differentiation of eosiniphiles |
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two types of asthma drugs
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anti-inflammatory
bronchodilators |
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most effective type of drug to treat asthma
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antiinflammatory
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four antiinflammatory drug classes
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corticosteroids
omalizumab leukotriene modifiers mast cell stabilizers |
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steroids are administered how for long term asthma therapy
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inhaled
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when are steroids used systemically
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acute and severe exacerbations
chronic severe asthma |
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inhaled corticosteroids
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...one
flunisolide budesonide ciclesonide |
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MOA of inhaled corticosteroids
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potentiate B adrenergic agents by increasing cAMP and upregulating receptor
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effect of corticosteroids on the muscle tension
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none
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clinical use of inhaled corticosteroids in asthma
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long term asthma control
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side effects of inhaled corticosteroids
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oral candidiasis
dysphonia unpleasant taste reflex cough and bronchospasm |
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how to prevent adverse effects of inhaled steroids
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spacers
rinse and spit use short acting B2 agonist before inhalation (to prevent bronchospasm) |
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oral systemic corticosteroids
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prednisone
prednisolone methylprednisolone |
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mechanisms of blocking mediators of mast cells
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prevent mast cell degranulation
prevent IgE binding to mast cells block leukotriened |
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mast cell stabilizers
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cromolyn
nedocromil |
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difference between nedocromil and cromolyn
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nedocromil affects a broader range of inflammatory cells
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mast cell stabillizer side effects
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nedocromil: unpleasant taste
cough transient bronchospasm |
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side effects of nedocromil
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unpleasant taste
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mast cell stabilizers are administered how
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inhaled
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an exaggerated response from this immune cell predominates in asthma
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Th2
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leukotrienes are derived from what
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arachadonic acid
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LTB4 is involved in what disease
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COPD
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LTD4 is involved in what disease
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asthma
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enzyme that converts AA to leukotriene
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5 LOX
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5-LOX inhibitor
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zileuton
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CytLT1 (leukotriene receptor) blocker
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montelukast
zafirlukast |
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leukotriene modifier side effects
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churg strauss syndrome (vasculitis)
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anti-IgE drug
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omalizumab
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omalizumab is administered how
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IV
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omalizumab side effects
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anaphylaxis
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first line tx of asthma
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inhaled corticosteroids
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mast cell stabilizers clinical use
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alternative for long term asthma tx
prophylactic before exercise or exposure to known allergy |
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maximal therapeutic response of mast cell stabilizers is seen at about
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2 weeks
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leukotriene modifier clinical use
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alternative for long term asthma
combined with inhaled steroids aspirin-sensitive asthmatics |
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aspirin sensitive asthmatics can be treated with
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leukotriene modifiers
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leukotriene modifiers are administered how
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oral
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how are leukotriene modifiers helpful in reducing bronchoconstriction from aspirin induced asthma
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inhibiting LOX pathway helps prevent bad effects
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pathogenesis of aspirin induced asthma
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COX is inhibited which increases the conversion of AA to leukotrienes which causes asthma
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omalizumab clinical use
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adjunctive therapy for pt with uncontrolled allergies and asthma
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omalizumab is administered by
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subQ every 2-4 weeks
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serum half life of omalizumab
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26 days
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short acting b2 agonists
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pirbuterol
metaproterenol albuterol levalbuterol terbutaline |
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long acting b2 agonists
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formoterol
arformoterol salmeterol |
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anticholinergics
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ipratropium bromide
tiotropium bromide |
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bronchodilator mechanism of B2 agonists
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activates Gs which increases cAMP and causes relaxation of smooth muscle
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bronchodilator mechanism of anticholinergics
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blocks M3 receptors and PNS stimulated bronchoconstriction
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bronchodilator mechanism of methylxanthines
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inhibits PDE increasing cAMP and causing relaxation
inhibits adenosine receptors which has anti inflammatory effects |
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methylxanthines
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theophylline
aminophylline |
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drug of choice for treating acute asthma exacerbations
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SABAs
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side effects of methylxanthines
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gastric mucosa irritation
CNS stimulation: headache, irritability, insomnia, hyper-reflexivity CV effects: palpitations, flushing, hypotension, arrythmias |
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used as an adjunct to inhaled corticosteroids
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LABAs
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administered along with SABA in moderate or severe asthma exacerbations in the ER
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Ipratropium bromide
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used to prevent exercise induced bronchospasm
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SABAs
LABAs |
