Podcast
Questions and Answers
Which of the following is NOT commonly associated with asthma triggers?
Which of the following is NOT commonly associated with asthma triggers?
- Cold air
- Fumes and toxic substances
- Regular exercise (correct)
- Animal dander
What symptom is commonly reported as worsening at night in asthma patients?
What symptom is commonly reported as worsening at night in asthma patients?
- Wheezing
- Chest tightness
- Coughing (correct)
- Shortness of breath
Which of the following indicates a positive response in asthma diagnosis when tested?
Which of the following indicates a positive response in asthma diagnosis when tested?
- Diminished Peak Expiratory Flow Rate
- Past history of bronchiolitis
- Increase in asthma symptoms with regular medication use
- Heightened response to Methacholine Test (correct)
What is a common misconception about asthma medication?
What is a common misconception about asthma medication?
Which of the following is a common objective measure used to diagnose asthma?
Which of the following is a common objective measure used to diagnose asthma?
What is the primary goal of asthma therapy?
What is the primary goal of asthma therapy?
Which of the following is a characteristic of the early asthmatic response?
Which of the following is a characteristic of the early asthmatic response?
What are the potential risks of not treating asthma?
What are the potential risks of not treating asthma?
What is a typical goal regarding peak flow rate variability in asthma therapy?
What is a typical goal regarding peak flow rate variability in asthma therapy?
Which cytokines are predominantly involved in the late asthmatic response?
Which cytokines are predominantly involved in the late asthmatic response?
What is a major factor in the heterogeneity of asthma?
What is a major factor in the heterogeneity of asthma?
What can be a consequence of starting asthma treatment late?
What can be a consequence of starting asthma treatment late?
What action is primarily prevented by bronchodilators in asthma management?
What action is primarily prevented by bronchodilators in asthma management?
Which medication was primarily used for asthma therapy in the 1960s?
Which medication was primarily used for asthma therapy in the 1960s?
What was a significant addition to asthma therapy in the 2000s?
What was a significant addition to asthma therapy in the 2000s?
Which therapy was introduced for asthma care in the 1990s?
Which therapy was introduced for asthma care in the 1990s?
Which class of medication is associated with quick relief for asthma patients?
Which class of medication is associated with quick relief for asthma patients?
What combination was common in asthma therapy during the 2000s?
What combination was common in asthma therapy during the 2000s?
In which decade did the use of Inhaled Corticosteroids become prevalent?
In which decade did the use of Inhaled Corticosteroids become prevalent?
What was a major therapeutic advancement for asthma in the 2010s?
What was a major therapeutic advancement for asthma in the 2010s?
Which medication class was not used in the 1970s asthma therapy?
Which medication class was not used in the 1970s asthma therapy?
Flashcards
Asthma Triggers
Asthma Triggers
Substances or conditions that trigger asthma symptoms, like coughing, wheezing, and shortness of breath.
Coughing in Asthma
Coughing in Asthma
A common asthma symptom where someone coughs forcefully, often to the point of vomitting.
Bronchodilator Reversibility Test
Bronchodilator Reversibility Test
A test used to diagnose asthma, where a person's lung function is measured before and after taking a bronchodilator.
Steroid-o-phobia
Steroid-o-phobia
A common misconception about asthma, suggesting that using corticosteroids causes addiction.
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Asthma as an Acute Illness
Asthma as an Acute Illness
A misconception about asthma, believing that it's a temporary illness that goes away.
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What is Asthma?
What is Asthma?
A long-term condition causing airway narrowing that comes and goes, making breathing difficult.
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What is the main aim of Asthma treatment?
What is the main aim of Asthma treatment?
The goal is to achieve normal lung function and minimize symptoms, as asthma can be unpredictable.
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Why is Asthma treatment important?
Why is Asthma treatment important?
Ignoring asthma treatment can lead to more severe attacks, poor lung function, and even death.
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What are the ideal outcomes of Asthma treatment?
What are the ideal outcomes of Asthma treatment?
Asthma treatment aims for minimal symptoms, infrequent attacks, no emergency visits, and no limitations on daily activities.
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What happens in the early asthmatic response?
What happens in the early asthmatic response?
An allergic reaction triggered by substances like pollen or dust mites causes the body to release chemicals, leading to airway narrowing.
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What happens in the late asthmatic response?
What happens in the late asthmatic response?
This stage occurs hours after the initial allergic reaction and involves inflammation and increased sensitivity to triggers.
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What are the key players in the inflammatory response in asthma?
What are the key players in the inflammatory response in asthma?
Inflammation in asthma involves immune cells that release substances like cytokines, leading to airway narrowing and mucus buildup.
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How does asthma treatment target the inflammatory process?
How does asthma treatment target the inflammatory process?
Asthma treatment aims to control inflammation and prevent airway narrowing, reducing the severity and frequency of attacks.
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Asthma treatment in the 1960s
Asthma treatment in the 1960s
Theophylline, Ephedrine, and Aminophylline were some of the primary medications used for asthma treatment in the 1960s.
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Asthma treatment in the 1970s
Asthma treatment in the 1970s
Beta-agonists, Theophyllines, Beclomethasone, Cromolyn, and Ipratropium were key medications used for asthma relief in the 1970s. This decade saw a shift towards inhaled medications.
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Asthma treatment in the 1980s
Asthma treatment in the 1980s
Inhaled Corticosteroids, Beta-agonists, Cromolyn, and Ipratropium were prominent treatments for asthma in the 1980s.
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Asthma treatment in the 1990s
Asthma treatment in the 1990s
Inhaled Corticosteroids, Beta-agonists, Theophylline, and Leukotriene Inhibitors were key medication categories used in the 1990s for managing asthma.
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Asthma treatment in the 2000s
Asthma treatment in the 2000s
Corticosteroids + LABA, LTRAs, Theophylline, Cromolyn, Ipratropium, and Tiotropium were the primary medications used for treating asthma in the 2000s.
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Asthma treatment in the 2010s
Asthma treatment in the 2010s
This decade, along with preventative measures like preventative therapy and gene therapy, medications like inhaled corticosteroids, LABAs, and LTRAs are frequently used for asthma treatment.
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Relievers vs. Controllers in Asthma Treatment
Relievers vs. Controllers in Asthma Treatment
Relievers are medications that provide quick relief from asthma symptoms, while controllers aim for managing asthma symptoms over the long term.
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Relievers in Asthma
Relievers in Asthma
Inhaled Short-acting Beta-2 Agonists, Inhaled Anticholinergics, and Systemic Corticosteroids are used to provide quick relief from asthma symptoms.
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Bronchial Asthma Treatment
- Asthma is a chronic inflammatory disorder with intermittent airway narrowing. It's also characterized by wide variations in airflow resistance over short periods.
- Asthma treatment aims for normal function. However, the condition varies in cause, bronchoconstriction extent, and inflammation degree. This makes the treatment course unpredictable, requiring individualized therapy.
- Failure to treat asthma leads to poor or no control, accelerated lung function decline, increased asthma attacks, reduced response to treatment if started late, and increased mortality.
- Treatment goals include minimal symptoms (even during sleep), infrequent acute episodes, no missed school/work days due to asthma, rare need for beta-agonist inhalers, unrestricted activities (including sports), peak flow variability below 20%, and minimal drug side effects.
Asthma Pathogenesis
- Early Asthmatic Response: Allergens trigger IgE production, a genetically determined trait. Allergen re-exposure creates antigen-antibody interactions on mast cells, leading to stored mediator release. Activation of neural pathways also occurs, preventable by bronchodilators.
- Late Asthmatic Response (4-5 hours later): This phase involves sustained bronchoconstriction, increased inflammatory cell influx, and enhanced bronchial responsiveness. Cytokines (especially interleukins 5, 9, and 13) produced by TH2 lymphocytes drive IgE production and stimulate mucus production. This phase is managed with corticosteroids.
Risk Factors of Untreated Asthma
- Poor or lack of control of asthma
- Accelerated lung function decline
- Increased number of attacks
- Poorer treatment response if treatment is started late
- Increased mortality
Diagnosis of Asthma (Subjective)
- A persistent cough, often occurring in spasms, and worsening at night is common. A cough may follow exposure to irritants, like cold air or allergens.
- Shortness of breath (dyspnea) develops along with coughing and wheezing, followed by sputum production.
- Previous bronchiolitis history as a child is relevant.
- A family history of asthma is common.
Diagnosis of Asthma (Objective)
- Reduced peak expiratory flow rate (PEFR).
- Reduced forced expiratory flow rates (FEFR).
- Reversibility with bronchodilator use.
- Increased response to methacholine testing.
- Increased levels of exhaled nitric oxide.
- Elevated inflammatory mediators and their byproducts in bodily fluids.
Asthma Myths & Misconceptions
- Patient and physician "steroid-o-phobia."
- Asthma is not an emotional illness.
- Asthma is not an acute disease.
- Asthma medications are not typically addictive.
- Asthma medications generally do not lose effectiveness with regular use.
- Asthma is not usually a fatal illness.
Survey of Asthma Therapy Changes Over Decades
- 1960s: Aminophylline, Epinephrine, Ephedrine
- 1970s: Beta-agonists, Theophyllines, Beclomethasone, Cromolyn, Ipratropium
- 1980s: Beta-agonists, Inhaled corticosteroids, Cromolyn, Ipratropium
- 1990s: Inhaled corticosteroids, Beta-agonists, Theophylline, Leukotriene Inhibitors
- 2000s: Corticosteroids + LABA, LTRAs, Theophylline, Cromolyn, Ipratropium, Tiotropium
- 2010s: Prevention strategies, including gene therapy
Asthma Medications (Quick Relief)
- Inhaled short-acting beta-2 agonists
- Inhaled anticholinergics
- Systemic corticosteroids
Asthma Medications (Long-Term Control)
- Topical (inhaled) corticosteroids
- Inhaled cromolyn Na and nedocromil
- Methylxanthines (Theophyllines)
- Inhaled long-acting beta-2 agonists (LABAs)
- Oral leukotriene modifiers (LTRAs)
Asthma Triggers
- Exercise/cold air
- Cigarette smoke
- Stress/anxiety
- Animal dander (cats, dogs)
- Allergens (grass, trees, molds, cockroaches)
- Air pollutants (sulfur dioxide, ozone)
- Fumes/toxic substances
- Medications (ASA, NSAIDs)
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