Podcast
Questions and Answers
What is a characteristic of patients with allergic asthma?
What is a characteristic of patients with allergic asthma?
- Often in adulthood
- Respond less well to ICS
- Not associated with allergy
- Associated with a past and/or family history of allergic disease (correct)
What is a feature of non-allergic asthma?
What is a feature of non-allergic asthma?
- Not associated with allergy (correct)
- Associated with a past and/or family history of allergic disease
- Respond well to ICS
- Often in childhood
What can be revealed by examining the induced sputum of patients with allergic asthma?
What can be revealed by examining the induced sputum of patients with allergic asthma?
- IgG and neutrophils
- IgE and/or eosinophilic airway inflammation (correct)
- Neutrophils and macrophages
- Lymphocytes and basophils
What is a type of medication used to treat asthma?
What is a type of medication used to treat asthma?
What is the mechanism of bronchodilation promoted by cAMP?
What is the mechanism of bronchodilation promoted by cAMP?
What is a characteristic of airway wall in patients with severe asthma?
What is a characteristic of airway wall in patients with severe asthma?
What is a type of medication that can be used to treat asthma?
What is a type of medication that can be used to treat asthma?
What is a potential outcome of airflow obstruction in patients with severe asthma?
What is a potential outcome of airflow obstruction in patients with severe asthma?
What is the primary mechanism of corticosteroids in treating asthma?
What is the primary mechanism of corticosteroids in treating asthma?
What is the characteristic of formoterol?
What is the characteristic of formoterol?
What is the purpose of combining ultralong acting β agonists with an ICS?
What is the purpose of combining ultralong acting β agonists with an ICS?
What is the effect of corticosteroids on airway obstruction?
What is the effect of corticosteroids on airway obstruction?
What is the characteristic of salmeterol?
What is the characteristic of salmeterol?
What is the mechanism of theophylline in treating asthma?
What is the mechanism of theophylline in treating asthma?
What is the effect of corticosteroids on bronchial reactivity?
What is the effect of corticosteroids on bronchial reactivity?
What is the duration of action of ultralong acting β agonists?
What is the duration of action of ultralong acting β agonists?
What is the duration of action of salmeterol and formoterol?
What is the duration of action of salmeterol and formoterol?
Why are salmeterol and formoterol not used as monotherapy?
Why are salmeterol and formoterol not used as monotherapy?
What is the characteristic of salmeterol and formoterol that allows them to achieve their long duration of action?
What is the characteristic of salmeterol and formoterol that allows them to achieve their long duration of action?
What is the effect of combining salmeterol and formoterol with inhaled corticosteroids?
What is the effect of combining salmeterol and formoterol with inhaled corticosteroids?
What is the type of agents that include tiotropium, aclidinium, umeclidinium, and glycopyrrolate?
What is the type of agents that include tiotropium, aclidinium, umeclidinium, and glycopyrrolate?
How are salmeterol and formoterol taken?
How are salmeterol and formoterol taken?
What is the systemic side effect of salmeterol and formoterol?
What is the systemic side effect of salmeterol and formoterol?
What is the indication for the use of tiotropium, aclidinium, umeclidinium, and glycopyrrolate?
What is the indication for the use of tiotropium, aclidinium, umeclidinium, and glycopyrrolate?
What is the typical duration of therapy for oropharyngeal candidiasis management?
What is the typical duration of therapy for oropharyngeal candidiasis management?
Why is it recommended to administer corticosteroids in the late afternoon for prevention of nocturnal asthma?
Why is it recommended to administer corticosteroids in the late afternoon for prevention of nocturnal asthma?
What is the first choice of treatment for milder forms of oropharyngeal candidiasis?
What is the first choice of treatment for milder forms of oropharyngeal candidiasis?
Why is tapering corticosteroid dose not necessary for short bursts of treatment?
Why is tapering corticosteroid dose not necessary for short bursts of treatment?
What is the advantage of administering corticosteroids in the morning for severe exacerbations?
What is the advantage of administering corticosteroids in the morning for severe exacerbations?
What is the role of topical agents in oropharyngeal candidiasis management?
What is the role of topical agents in oropharyngeal candidiasis management?
What is the most effective way to avoid the systemic adverse effects of corticosteroid therapy?
What is the most effective way to avoid the systemic adverse effects of corticosteroid therapy?
What is the cornerstone of chronic asthma therapy?
What is the cornerstone of chronic asthma therapy?
What is the only therapy shown to reduce the risk of asthma death?
What is the only therapy shown to reduce the risk of asthma death?
What is a characteristic of products such as beclometasone dipropionate and budesonide?
What is a characteristic of products such as beclometasone dipropionate and budesonide?
What is the mechanism of action of cromolyn sodium and nedocromil sodium?
What is the mechanism of action of cromolyn sodium and nedocromil sodium?
In which patients is systemic therapy necessary?
In which patients is systemic therapy necessary?
What is an example of systemic therapy for OPC?
What is an example of systemic therapy for OPC?
What is a characteristic of cromolyn sodium and nedocromil sodium?
What is a characteristic of cromolyn sodium and nedocromil sodium?
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Study Notes
Pathophysiological Characteristics of Asthma
- Refers to structural changes, including an alteration in the amount and composition of extracellular matrix in the airway wall, leading to airflow obstruction
- In patients with more severe asthma, some phenotype-guided treatments are available, but may become only partially reversible
Asthma Phenotypes
- Allergic Asthma:
- Most easily recognized phenotype
- Associated with a past and/or family history of allergic disease (e.g. eczema, allergic rhinitis, or food or drug allergy)
- Patients usually respond well to inhaled corticosteroid (ICS) treatment
- Non-Allergic Asthma:
- Not associated with allergy
- Often in childhood
- Cellular profile of sputum may be neutrophilic, eosinophilic, or contain only a few inflammatory cells (paucigranulocytic)
- Patients with non-allergic asthma often respond less well to ICS
Asthma Medications
- Sympathomimetic Agents: Beta Agonists
- Promote bronchodilation by increasing cAMP
- Examples: Salmeterol, Formoterol, Indacaterol, Olodaterol, Vilanterol, and Bambuterol
- Methylxanthines:
- Theophylline
- Duration of therapy usually ranges from 3 to 10 days, but longer therapy may be necessary for severe exacerbations
- Antimuscarinic Agents:
- Longer acting antimuscarinic agents (LAMA), including Tiotropium, aclidinium, umeclidinium, and glycopyrrolate
- Corticosteroids:
- Inhaled, Systemic
- Broad anti-inflammatory efficacy, mediated in part by inhibition of production of inflammatory cytokines
- Stabilizers of Mast and Other Cells:
- Cromolyn and Nedocromil
- No bronchodilatory effect
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