Pathophysiology of Asthma
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Questions and Answers

What is the primary characteristic of asthma?

  • A viral infection
  • An autoimmune disease
  • A genetic disorder
  • A chronic inflammatory disease of the airways
  • What type of cells are activated in asthma?

  • Neutrophils
  • T helper 1 (TH1) lymphocytes
  • Eosinophils
  • Mast cells (correct)
  • What is the result of mast cell activation in asthma?

  • Mucus production
  • Bronchodilation
  • Bronchoconstriction (correct)
  • Airway relaxation
  • What contributes to airflow obstruction in asthma?

    <p>Contraction of bronchial smooth muscle</p> Signup and view all the answers

    What is a trigger for asthma attacks?

    <p>All of the above</p> Signup and view all the answers

    What is a complication of untreated asthma?

    <p>Airway remodeling</p> Signup and view all the answers

    What is the goal of asthma therapy?

    <p>To decrease the intensity and frequency of asthma symptoms</p> Signup and view all the answers

    What type of medication is used to treat acute asthma symptoms?

    <p>Quick-relief medication</p> Signup and view all the answers

    What is the primary effect of sympathomimetic agents on the bronchi?

    <p>Dilate the bronchi</p> Signup and view all the answers

    Which of the following is a characteristic of non-selective sympathomimetics?

    <p>They also act in cardiac muscle</p> Signup and view all the answers

    What is the primary indication for the use of epinephrine in asthma?

    <p>Anaphylactic shock</p> Signup and view all the answers

    What is the advantage of ephedrine compared to epinephrine?

    <p>Longer duration of action</p> Signup and view all the answers

    What is a characteristic of isoproterenol?

    <p>It is a potent bronchodilator</p> Signup and view all the answers

    What is the main reason for the limited use of isoproterenol in treating asthma?

    <p>It is associated with cardiac arrhythmias</p> Signup and view all the answers

    What is the classification of albuterol (salbutamol)?

    <p>Short-acting beta2 agonist</p> Signup and view all the answers

    What is the effect of sympathomimetic agents on the release of bronchoconstricting mediators from mast cells?

    <p>They inhibit the release</p> Signup and view all the answers

    What is the recommended dose of Aminophylline?

    <p>5mg/kg by slow IV push over 5 mins</p> Signup and view all the answers

    What is the therapeutic use of Theophedrine tablet?

    <p>Acute and chronic asthma</p> Signup and view all the answers

    What is a contraindication for the use of Theophylline?

    <p>History of PUD</p> Signup and view all the answers

    What is the effect of Muscarinic Antagonists on bronchospasm?

    <p>They control only a portion of bronchospasm produced by parasympathetic stimulation</p> Signup and view all the answers

    What is the advantage of Ipratropium bromide?

    <p>It can be given at higher doses via inhalation</p> Signup and view all the answers

    What is the duration of action of Tiotropium?

    <p>24 hours</p> Signup and view all the answers

    What is the receptor binding affinity of Tiotropium?

    <p>It binds to M1, M2, and M3 receptors with equal affinity</p> Signup and view all the answers

    What is the approved indication for Tiotropium?

    <p>COPD only</p> Signup and view all the answers

    What is the primary mechanism of action of corticosteroids?

    <p>Inhibition of phospholipase A2</p> Signup and view all the answers

    Which of the following is a common side effect of corticosteroids?

    <p>Hyperglycemia</p> Signup and view all the answers

    What is the primary route of administration for corticosteroids in chronic asthma?

    <p>Inhaled</p> Signup and view all the answers

    Which of the following corticosteroids is commonly used in emergency cases?

    <p>Betamethasone</p> Signup and view all the answers

    What is a potential consequence of long-term corticosteroid use?

    <p>Hypokalemic alkalosis</p> Signup and view all the answers

    Corticosteroids can cause which of the following eye problems?

    <p>Both A and B</p> Signup and view all the answers

    What is a potential consequence of corticosteroid use in children?

    <p>Slow growth</p> Signup and view all the answers

    Which of the following is a potential consequence of long-term corticosteroid use?

    <p>Increased susceptibility to infection</p> Signup and view all the answers

    What is a common side effect of glucocorticoids on the muscles?

    <p>Weakness of proximal limb and respiratory muscles</p> Signup and view all the answers

    What is a potential complication of long-term glucocorticoid use in the eyes?

    <p>Cataract</p> Signup and view all the answers

    What is the recommended treatment for severe bronchial asthma and COPD?

    <p>IV 60 to 120 mg of methylprednisolone /6 h followed by daily oral doses of prednisone</p> Signup and view all the answers

    What is the characteristic of status asthmaticus?

    <p>A very severe and sustained attack of asthma that fails to respond to usual treatment</p> Signup and view all the answers

    What is the recommended medication combination for treatment of asthma?

    <p>CS + LABAs</p> Signup and view all the answers

    What is a potential side effect of glucocorticoids on bone health?

    <p>Osteoporosis</p> Signup and view all the answers

    Study Notes

    Pathophysiology of Asthma

    • Asthma is a chronic inflammatory disease characterized by activation of mast cells, infiltration of eosinophils, and T helper 2 (TH2) lymphocytes.
    • Mast cell activation by allergens and physical stimuli releases bronchoconstrictor mediators, such as histamine, leukotriene D4, and prostaglandin D2, causing bronchoconstriction, microvascular leakage, and plasma exudation.
    • Airflow obstruction in asthma is due to bronchoconstriction resulting from contraction of bronchial smooth muscle, inflammation of the bronchial wall, and increased secretion of mucous.
    • Underlying inflammation of the airways contributes to airway hyperresponsiveness, airflow limitation, respiratory symptoms, and disease chronicity.
    • Asthma attacks may be triggered by exposure to allergens, exercise, stress, and respiratory infections.

    Treatment of Asthma

    • The goals of asthma therapy are to decrease the intensity and frequency of asthma symptoms and the degree of airflow limitation.
    • All patients need to have a “quick-relief” medication to treat acute asthma symptoms.
    • Drug therapy for long-term control of asthma is designed to reverse and prevent airway inflammation.

    Bronchodilators

    • Sympathomimetic agents (epinephrine, ephedrine, isoproterenol, and β2-agonists) are used to dilate the bronchi, inhibit the release of bronchoconstricting mediators from mast cells, and stimulate adenylyl cyclase to increase the formation of intracellular cAMP.
    • Non-selective sympathomimetics (epinephrine, ephedrine, and isoproterenol) are not selective for bronchial smooth muscle and can cause adverse effects such as tachycardia, arrhythmias, and skeletal muscle tremor.
    • β2-selective agonists (albuterol and terbutaline) are used to treat acute and chronic asthma.

    Muscarinic Antagonists

    • Ipratropium bromide and tiotropium are used to control only a portion of bronchospasm produced by parasympathetic stimulation.

    Anti-Inflammatory Agents

    • Corticosteroids (beclomethasone, budesonide, fluticasone, mometasone, triamcinolone, prednisone, and methylprednisolone) are used to lower the production and release of inflammatory substances, reduce mucus and edema, and may be inhaled or taken orally, as well as IV.
    • Corticosteroids have anti-inflammatory activity, lowering and inhibiting peripheral lymphocytes and macrophages, and blocking the release of arachidonic acid.

    Status Asthmaticus

    • Characterized by very severe and sustained attack of asthma that fails to respond to usual treatment.
    • Management includes administration of oxygen, frequent administration of β-agonists, systemic corticosteroids, IV fluid to avoid dehydration, antibiotics if there is an infection, and combination medications.

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    Description

    Learn about the chronic inflammatory disease of the airways, characterized by mast cell activation, eosinophil infiltration, and T helper 2 lymphocytes. Understand the release of bronchoconstrictor mediators such as histamine and leukotriene D4.

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