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Questions and Answers
What is a characteristic feature of asthma pathophysiology?
What is a characteristic feature of asthma pathophysiology?
Which of the following diseases falls under the category of Chronic Obstructive Pulmonary Disease (COPD)?
Which of the following diseases falls under the category of Chronic Obstructive Pulmonary Disease (COPD)?
What happens to the alveoli in emphysema?
What happens to the alveoli in emphysema?
What primarily causes the persistent cough in chronic bronchitis?
What primarily causes the persistent cough in chronic bronchitis?
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Which of the following can trigger asthma symptoms?
Which of the following can trigger asthma symptoms?
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What type of asthma occurs without a history of allergies?
What type of asthma occurs without a history of allergies?
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Which of the following medications can potentially induce asthma symptoms?
Which of the following medications can potentially induce asthma symptoms?
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Which of the following is NOT typically considered an asthma trigger?
Which of the following is NOT typically considered an asthma trigger?
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What is the primary mechanism of action of leukotriene receptor antagonists (LTRAs) in asthma treatment?
What is the primary mechanism of action of leukotriene receptor antagonists (LTRAs) in asthma treatment?
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Which of the following is a contraindication for the use of leukotriene receptor antagonists?
Which of the following is a contraindication for the use of leukotriene receptor antagonists?
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What is one of the key indications for prescribing leukotriene receptor antagonists?
What is one of the key indications for prescribing leukotriene receptor antagonists?
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Which symptom is NOT directly relieved by leukotriene receptor antagonists?
Which symptom is NOT directly relieved by leukotriene receptor antagonists?
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What is a potential serious side effect associated with montelukast?
What is a potential serious side effect associated with montelukast?
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In patients with asthma, what role do leukotrienes play in the pathophysiology of an asthma attack?
In patients with asthma, what role do leukotrienes play in the pathophysiology of an asthma attack?
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What is one of the roles of leukotriene receptor antagonists in managing asthma symptoms?
What is one of the roles of leukotriene receptor antagonists in managing asthma symptoms?
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Which of the following triggers might lead to the release of leukotrienes in the body?
Which of the following triggers might lead to the release of leukotrienes in the body?
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Which inhaled corticosteroid is indicated for both asthma and allergic rhinitis?
Which inhaled corticosteroid is indicated for both asthma and allergic rhinitis?
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Inhaled corticosteroids are primarily used for what purpose in asthma management?
Inhaled corticosteroids are primarily used for what purpose in asthma management?
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What is a common indication for prescribing inhaled corticosteroids?
What is a common indication for prescribing inhaled corticosteroids?
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Which of the following inhaled corticosteroids has a longer duration of action?
Which of the following inhaled corticosteroids has a longer duration of action?
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Which inhaled corticosteroid is specifically mentioned as new among the listed options?
Which inhaled corticosteroid is specifically mentioned as new among the listed options?
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Inhaled corticosteroids are inappropriate for which of the following situations?
Inhaled corticosteroids are inappropriate for which of the following situations?
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What class of medication are inhaled corticosteroids often combined with for enhanced asthma control?
What class of medication are inhaled corticosteroids often combined with for enhanced asthma control?
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Which inhaled corticosteroid is used solely for the treatment of asthma in children and adults?
Which inhaled corticosteroid is used solely for the treatment of asthma in children and adults?
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Study Notes
Respiratory Diseases
- Chronic Obstructive Pulmonary Disease (COPD): A group of chronic lung diseases, including chronic bronchitis and emphysema, that cause airflow obstruction.
- Asthma: A chronic inflammatory disease of the airways that causes recurrent episodes of wheezing, breathlessness, chest tightness, and coughing.
- Emphysema: A lung condition where the tiny air sacs in the lungs (alveoli) lose their elasticity and ability to expand and contract.
- Chronic Bronchitis: Condition where the airways become inflamed and swollen, causing persistent cough and excessive mucus production.
Bronchial Asthma
- Definition: A chronic inflammatory disorder of the airways that causes recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. Symptoms are triggered by various stimuli, including allergens, irritants, exercise, or infections.
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Pathophysiology: Characterized by airway inflammation, bronchospasm, and mucus hypersecretion, leading to airway obstruction.
- Inflammation: Involves the recruitment of inflammatory cells, such as eosinophils, mast cells, and lymphocytes, into the airway walls.
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Categories:
- Intrinsic: Occurs in individuals with no history of allergies or specific triggers.
- Extrinsic: Develops in individuals exposed to known allergens, such as pollen, dust mites, or animal dander.
- Exercise-induced: Triggered by physical exertion, often in individuals with a history of asthma.
- Drug-induced: Caused by exposure to certain medications, such as aspirin or beta-blockers.
Leukotriene Receptor Antagonists (LTRAs)
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Mechanism of Action: Prevent leukotrienes from attaching to their receptors, reducing inflammation, bronchoconstriction, and mucus production.
- Prevent Leukotriene Binding: LTRAs block the binding of leukotrienes to their receptors.
- Reduced Inflammation: Inflammation in the lungs is reduced.
- Asthma Symptom Relief: Asthma symptoms are relieved.
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Drug Effects:
- Bronchial Airways: LTRAs block leukotrienes, preventing smooth muscle contraction in the bronchi and decreasing airway constriction.
- Mucus Secretion: LTRAs reduce the secretion of mucus, which can contribute to airway obstruction.
- Inflammation: By blocking leukotrienes, LTRAs decrease inflammation in the lungs, reducing neutrophil and leukocyte infiltration.
- Black Box Warning: Montelukast, an LTRA, carries a black box warning for serious mood changes and behaviors.
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Indications:
- Prophylaxis & Treatment: LTRAs are used to prevent and treat asthma in adults and children 12 years or older.
- Long-Term Management: LTRAs provide long-term control of asthma symptoms and reduce the frequency of attacks.
- Not for Acute Attacks: LTRAs are not meant for immediate relief of acute asthma exacerbations.
- Allergic Rhinitis: Montelukast is also approved for treating allergic rhinitis symptoms.
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Contraindications:
- Known Drug Allergy: Patients with a known drug allergy to leukotriene receptor antagonists should not receive these medications.
- Previous Adverse Drug Reaction: If a patient has experienced a previous adverse drug reaction, they should not receive LTRAs.
- Inactive Ingredients: It is important to note allergies to inactive ingredients such as povidone, lactose, titanium.
Inhaled Corticosteroids
- Beclomethasone dipropionate (Beclovent): Used for long-term control of asthma.
- Budesonide (Pulmicort Turbuhaler): Used for long-term asthma management and reducing exacerbations.
- Ciclesonide (Omnaris): Newer inhaled corticosteroid for asthma, with a longer duration of action than some other options.
- Flunisolide (AeroBid): Indicated for the treatment of asthma in adults and children.
- Fluticasone: Available in inhaled (Flovent) and intranasal (Flonase) forms, used for asthma and allergic rhinitis respectively.
- Mometasone (Asmanex): Used for long-term control of asthma in adults and children.
- Triamcinolone acetonide (Azmacort): Used for the treatment of asthma.
Inhaled Corticosteroids: Indications
- Asthma Management: Primarily used to control inflammation in the airways, which is a key factor in asthma.
- Persistent Asthma: Often prescribed for persistent asthma, which requires ongoing management to prevent symptoms.
- Combined Therapy: Frequently used alongside beta-adrenergic agonists for comprehensive asthma control.
Inhaled Corticosteroids: Contraindications
- Drug Allergy: Not suitable for patients who have a known allergy to these drugs.
- Acute Asthma Attacks: Not a primary treatment for acute asthma attacks; other treatments are used for this purpose.
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