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Questions and Answers
What is a key contributor to bronchial narrowing in asthma?
What is a key contributor to bronchial narrowing in asthma?
Which category of drugs is primarily used for immediate relief during an asthmatic attack?
Which category of drugs is primarily used for immediate relief during an asthmatic attack?
What is the mechanism of action for beta-2 selective agonists?
What is the mechanism of action for beta-2 selective agonists?
Which of the following agents is used to control inflammation in asthma?
Which of the following agents is used to control inflammation in asthma?
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What symptom is associated with the inflammatory response in asthma?
What symptom is associated with the inflammatory response in asthma?
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Which class of drugs is considered a preventer for recurrent asthmatic attacks?
Which class of drugs is considered a preventer for recurrent asthmatic attacks?
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What effect do leukotrienes have in the context of asthma?
What effect do leukotrienes have in the context of asthma?
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Which bronchodilator is used for long-term asthma management?
Which bronchodilator is used for long-term asthma management?
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Which type of hypersensitivity response is involved in the pathophysiology of asthma?
Which type of hypersensitivity response is involved in the pathophysiology of asthma?
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Which of the following mediators is primarily involved in the early phase response of asthma?
Which of the following mediators is primarily involved in the early phase response of asthma?
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What is the primary action of leukotriene inhibitors in the treatment of asthma?
What is the primary action of leukotriene inhibitors in the treatment of asthma?
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Which of the following statements best describes the mechanism of action of beta-agonist bronchodilators?
Which of the following statements best describes the mechanism of action of beta-agonist bronchodilators?
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Which pharmacological agents are responsible for the late phase response in asthma?
Which pharmacological agents are responsible for the late phase response in asthma?
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What primary effect do the pro-inflammatory primary mediators released from mast cells have in asthma?
What primary effect do the pro-inflammatory primary mediators released from mast cells have in asthma?
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Which of the following medications specifically targets interleukin-5 (IL-5) in the treatment of asthma?
Which of the following medications specifically targets interleukin-5 (IL-5) in the treatment of asthma?
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Which combination of drugs is most commonly used for long-term management of asthma?
Which combination of drugs is most commonly used for long-term management of asthma?
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What is a primary mechanism of action of anti-inflammatory monoclonal antibodies in asthma management?
What is a primary mechanism of action of anti-inflammatory monoclonal antibodies in asthma management?
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What characterizes status asthmaticus in patients with asthma?
What characterizes status asthmaticus in patients with asthma?
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Which of the following is NOT a recognized treatment to manage status asthmaticus?
Which of the following is NOT a recognized treatment to manage status asthmaticus?
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Which of the following statements about leukotriene receptor antagonists is true?
Which of the following statements about leukotriene receptor antagonists is true?
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What pharmacological effect do calcium channel blockers have concerning asthma?
What pharmacological effect do calcium channel blockers have concerning asthma?
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What is the primary goal of pharmacological therapy in bronchial asthma?
What is the primary goal of pharmacological therapy in bronchial asthma?
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Study Notes
Overview of Asthma
- Asthma characterized by recurrent cough, breathing difficulties, chest tightness, and wheezing.
- Airway hypereactivity triggered by allergens leads to widespread airway narrowing.
Pathophysiology of Asthma
- Type 1 hypersensitivity response occurs on allergen exposure.
- Initial allergen exposure results in production of reaginic IgE antibodies, which bind to mast cells in the airway mucosa.
- Upon re-exposure, Ag-IgE complex formation activates mast cells, releasing inflammatory mediators.
Inflammatory Mediators
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Primary Mediators: Histamine, tryptase, proteases, leukotrienes C4&D4, prostaglandins (PG).
- Cause bronchial smooth muscle contraction and increased vascular permeability.
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Secondary Mediators: Interleukins 4 & 5, GM-CSF, and cytokines contribute to late-phase response.
- Mepolizumab, reslizumab, benralizumab, and dupilumab target IL-5.
Pharmacological Basis of Therapy
- Targets bronchial smooth muscle contraction and inflammatory activity.
- Bronchodilators used to relieve airway narrowing caused by muscle contraction.
- Anti-inflammatory agents control inflammation-related airway narrowing.
Pharmacological Agents Categories
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Relievers: Immediate acting bronchodilators, such as:
- Short-Acting Beta Agonists (SABAs): Albuterol, terbutaline, metaproterenol, among others.
- Preventers: Long-term injectable agents controlling inflammation, such as corticosteroids combined with Long-Acting Beta Agonists (LABAs).
Bronchodilators
- β2 Selective Agonists act by binding to β2 adrenoceptors, stimulating adenylyl cyclase, increasing cAMP, relaxing smooth muscle, and inhibiting inflammatory cell functions.
- SABAs include salbutamol, albuterol.
- LABAs such as salmeterol and formoterol used in combination with steroids for long-term control.
Other Therapeutic Agents
- Anti-IgE Monoclonal Antibodies: Omalizumab; used to prevent IgE interaction with receptors.
- Other Agents: K+ channel openers like cromakalim, calcium channel blockers, nitric oxide donors.
Combination Therapy
- Utilizes inhalation drugs that combine LABAs with inhaled steroids for long-term management.
- Examples include:
- Salmeterol + fluticasone dipropionate
- Formoterol + budesonide
Status Asthmaticus
- Represents severe, acute exacerbation of asthma episodes, resistant to treatment.
- Requires immediate medical intervention and hospitalization.
- Management includes systemic and inhalational anti-asthmatic drugs, oxygen therapy, intravenous fluids, and assisted ventilation if necessary.
Conclusion
- Effective pharmacological treatment for bronchial asthma focuses on mitigating bronchoconstriction and inflammation.
- A comprehensive understanding of asthmatic pathophysiology informs therapeutic strategies.
Sample MCQ Key Points
- Adrenoceptor agonists have various effects and potential applications beyond asthma, such as in glaucoma and cardiogenic shock.
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Description
This quiz explores the pharmacological aspects related to pro-inflammatory cells and their effects, such as sustained bronchoconstriction, mucus hyper-secretion, and IgE production. Test your understanding of the pathophysiology and treatment options for bronchial hypereactivity.
