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Questions and Answers
What is the primary characteristic of asthma?
What is the primary characteristic of asthma?
What type of cells are activated in asthma?
What type of cells are activated in asthma?
What is the result of mast cell activation in asthma?
What is the result of mast cell activation in asthma?
What contributes to airflow obstruction in asthma?
What contributes to airflow obstruction in asthma?
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What is a trigger for asthma attacks?
What is a trigger for asthma attacks?
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What is a complication of untreated asthma?
What is a complication of untreated asthma?
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What is the goal of asthma therapy?
What is the goal of asthma therapy?
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What type of medication is used to treat acute asthma symptoms?
What type of medication is used to treat acute asthma symptoms?
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What is the primary effect of sympathomimetic agents on the bronchi?
What is the primary effect of sympathomimetic agents on the bronchi?
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Which of the following is a characteristic of non-selective sympathomimetics?
Which of the following is a characteristic of non-selective sympathomimetics?
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What is the primary indication for the use of epinephrine in asthma?
What is the primary indication for the use of epinephrine in asthma?
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What is the advantage of ephedrine compared to epinephrine?
What is the advantage of ephedrine compared to epinephrine?
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What is a characteristic of isoproterenol?
What is a characteristic of isoproterenol?
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What is the main reason for the limited use of isoproterenol in treating asthma?
What is the main reason for the limited use of isoproterenol in treating asthma?
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What is the classification of albuterol (salbutamol)?
What is the classification of albuterol (salbutamol)?
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What is the effect of sympathomimetic agents on the release of bronchoconstricting mediators from mast cells?
What is the effect of sympathomimetic agents on the release of bronchoconstricting mediators from mast cells?
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What is the recommended dose of Aminophylline?
What is the recommended dose of Aminophylline?
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What is the therapeutic use of Theophedrine tablet?
What is the therapeutic use of Theophedrine tablet?
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What is a contraindication for the use of Theophylline?
What is a contraindication for the use of Theophylline?
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What is the effect of Muscarinic Antagonists on bronchospasm?
What is the effect of Muscarinic Antagonists on bronchospasm?
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What is the advantage of Ipratropium bromide?
What is the advantage of Ipratropium bromide?
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What is the duration of action of Tiotropium?
What is the duration of action of Tiotropium?
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What is the receptor binding affinity of Tiotropium?
What is the receptor binding affinity of Tiotropium?
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What is the approved indication for Tiotropium?
What is the approved indication for Tiotropium?
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What is the primary mechanism of action of corticosteroids?
What is the primary mechanism of action of corticosteroids?
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Which of the following is a common side effect of corticosteroids?
Which of the following is a common side effect of corticosteroids?
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What is the primary route of administration for corticosteroids in chronic asthma?
What is the primary route of administration for corticosteroids in chronic asthma?
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Which of the following corticosteroids is commonly used in emergency cases?
Which of the following corticosteroids is commonly used in emergency cases?
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What is a potential consequence of long-term corticosteroid use?
What is a potential consequence of long-term corticosteroid use?
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Corticosteroids can cause which of the following eye problems?
Corticosteroids can cause which of the following eye problems?
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What is a potential consequence of corticosteroid use in children?
What is a potential consequence of corticosteroid use in children?
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Which of the following is a potential consequence of long-term corticosteroid use?
Which of the following is a potential consequence of long-term corticosteroid use?
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What is a common side effect of glucocorticoids on the muscles?
What is a common side effect of glucocorticoids on the muscles?
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What is a potential complication of long-term glucocorticoid use in the eyes?
What is a potential complication of long-term glucocorticoid use in the eyes?
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What is the recommended treatment for severe bronchial asthma and COPD?
What is the recommended treatment for severe bronchial asthma and COPD?
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What is the characteristic of status asthmaticus?
What is the characteristic of status asthmaticus?
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What is the recommended medication combination for treatment of asthma?
What is the recommended medication combination for treatment of asthma?
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What is a potential side effect of glucocorticoids on bone health?
What is a potential side effect of glucocorticoids on bone health?
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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.
