Shared Flashcard Set

Details

PTherapeutics I T3 Asthma
Asthma
44
Pharmacology
Professional
04/25/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
In spiromtery, a normal value is ____ of expected.
Definition
70-80%
Term
In spirometry, how do indications of obstructive and restrictive dysfunction differ?
Definition
The percentage of obstructive decreases, where as in restrictive, FEV1 and FVC decline at the same rate, thus the percentage may change and even increase.
Term
Peak Flow Meters are useful for evaluating ______
Definition
Asthma severity, progress & adjustments in tx of chronic asthma, worsening lung fxn, and peak flow variability
Term
What is used to definitively diagnose asthma?
Definition
Spirometry - Pulmonary function testing (PFT)
Term
What are the major environmental factors that contribute to asthma?
Definition
Airborne allergens and Viral Respiratory infections
Term
What sort of disorder is asthma?
Definition
chronic inflammatory
Term
Which cells are often linked to sudden onset, fatal asthma exacerbations; as well as with occupational asthma and smokers?
Definition
Neutrophils.
Term
Which cells are the lymphocytes of concern?
Definition
Th1 and Th2
Term
IL 4-5, released by _____, are ______
Definition
Th2, cytokines.
Term
Inhaled antigens activate_______
Definition
lymphocytes and mast cells
Term
Which cells degranulate?
Definition
Mast Cells
Term
Mast cells release what inflammatory mediators and cytokines?
Definition
histamines, leukotrienes, IL 4-5, and GM-CSF (Granulocyte Macrophage-colony Stimulating Factor)
Term
Exercise induced bronchospasm may activate _______ by _______
Definition
Mast cells, osmotic stimuli
Term
Eosinophils release which mediators?
Definition
Leukotriene and granule proteins
Term
What prolongs the lifespan of Eosinophils?
Definition
IL-4,5 and GM-CSF
Term
Eosinophils respond to ____
Definition
corticosteroids
Term
_____are increased in severe asthma, acute exacerbations and smokers. Their role is_______
Definition
neutrophils; unclear
Term
Epithelial cells are activated by ______
Definition
IgE dependent mechanisms, or precipitating virii, pollutants or histamine
Term
Epithelial cell inflammation contributes to asthma by ______
Definition
increasing airway responsiveness, altering permeability of the airway mucosa, reducing epithelial-derived relaxant factors, and reducing proinflammatory degrading enzymes
Term
What are the inflammatory mediators?
Definition
Cytokines, leukotrienes, histamine and IgE
Term
Which inflammatory mediator is likely to determine the severity and modify the inflammatory response?
Definition
cytokines
Term
Which inflammatory mediator effect mucous secretion, airway edema, microvascular permeability and bronchoconstriction?
Definition
Leukotrienes
Term
Which inflammatory mediator contributes smooth muslce constriction and bronchospasm?
Definition
Histamine
Term
Which inflammatory mediator is responsible for the activations of allergic reactions?
Definition
IgE
Term
What activates IgE? IgE activates which cells? What is the result?
Definition
Allergens activate IgE.
Lymphocytes, eosinophils and mast cells are activated by IgE.
The result is further release of inflammatory mediators by these activated cells
Term
Persistent inflammation leads to edema. The structural changes resulting from airway edema are _____
Definition
airway remodeling, leading to less elastic airways.
Term
The degree of hypperresponsiveness is determined by _____
Definition
inflammation
Term
Affected tissues during airway remodeling involve the Subbasement membrane, the subepithelium, smooth muscle, blood vessels, and mucous glands. How are each affected?
Definition
Sub basement membrane thickens
subepithelium fibrosis
smooth muscle hypertrophy and hyperplasia
BV proliferation and dilation
Mucous glands hyperplasia and hypersecretion
Term
early phase inflammation of asthma is initiated by ____ and activates_____. It takes place over a matter
Definition
initiated by IgE. Activates Mast Cells. Takes place over minutes.
Term
Late phase inflammation occurs ___after initial provocation and can last up to ____. Cells activated include______. In addition to secretion, ______ takes place during this period.
Definition
occurs 6-9 hours after initial provocation and can last up to 24 hrs. Cells activated are eosinophils, T-cells, basophils, neutrophils, and macrophages. Edema and hypersecretion takes place as well
Term
During the chronic inflammatory phase of inflammation, ______airways are inflamed. The process of _____ is initiated by ______
Definition
central and peripheral airways are inflamed
remodeling is initiated by cytokines and growth factors
Term
IL-2 and INF gamma are produced by ___ and are ____
IL-4,5,6,9,13 are _____ produced by ____
Definition
cellular defense mechanisms, from Th1
Allergic mechanism cytokines from Th2
Term
______are factors that enhance Th1 over Th2
Definition
Infection with mycobacterium tuberculosis, measles and Hep A; exposure to other kids, LESS FREQUENT use of abx.
Term
Majore enivironmental factors contributing to asthma are ______
Definition
airborne allergens and respiratory viruses incl rhinovirus, respiratory syncytial virus and influenza
Term
What are the more unusual environmental factors that can contribute to asthma?
Definition
Food additives/preservatives, Stress, GERD, Medications (ASA, NSAIDs, BBs), PMS
Term
Classic asthma symptoms are____
Definition
episodic dyspnea, wheezing, chest tightness, SoB, coughing (esp nocturnal), and difficulty breathing
Term
in the physical exam of asthma, the pulse may be____
Definition
increased
Term
during the PE to diagnose asthma, breath sounds may be_____
Definition
decreased
Term
During the PE exam of asthma, what characteristics may be seen in the shoulder, muscle use and chest?
Definition
shoulders hunched, use of accessory muscles, deformed chest (due to trapped air)
Term
In diagnosing asthma, FEV1 will be_____ relative to predicted limit
Definition
<80%
Term
In diagnosing asthma, FEV1/FVC will be_____ of the normal lower limit
Definition
<65%
Term
Peak flow is for (management/diagnosis/both)
Definition
management
Term
Asthma may be diagnosed if FEV1 increases by _____ after a administration of _____ or a short course of _____
Definition
>12%; SABA or ORAL ccs (2-3wks)
Term
What is the key to determining obstructive vs restrictive disease?
Definition
An FEV1/FVC of ≤65% of normal lower limit
Supporting users have an ad free experience!