ASTHMA

Question 1

Differentiates between parasympathetic and sympathetic innervation of the lungs, in relation to the lung.

Autonomic innnervation of the lungs

Answer 1

During parasympathetic the M3 receptors become stimulated resulting to bronchoconstriction (constrict in bronchioles smooth muscles)
During sympathetic the B2 receptors become stimulated resulting to bronchodilation (bronchioles smooth muscles relaxes.

Question 2

1. Common symptoms of pulmonary dieases
2. Treatment focuses on what?
3. name types of obstructive diseaseses
4. Respiratory diseases maybe due to what?

Answer 2

1. Wheeze, shortness of breath, cough with or without suputum, and chest pains
2. focuses on underlying diseases or symptoms
3. COPD and Asthma
4. Infection or malignancy

Question 3

1. Define asthma
2. how do asthma attacks occur
3. symptoms of Asthma
4. Common in children with what?

Answer 3

1. Inflammatory condition recurrent reversible airway obstruction in response to irritant stimuli
2. Intermittent
3. Wheezing, shortness of breath, difficult in breathing out (worse at night)
4. Atopy=allergic asthama

Question 4

Common triggers of asthma

Answer 4

Pets, mould, cleaning materials, tobacco smoke, air pollution

Question 5

Asthma is characterized by what?

Answer 5

1. Inflamation of the airways
2. Bronchial hyperectivity
3. reversible airway obstruction

Question 6

Name Eliciting agents of immediate phase of asthma

Answer 6

1. Allergens
2. Non-specific stimulus

Question 7

Names of cells involved in immediate asthma phase

Answer 7

Mast cells and monuclear cells

Question 8

During immediate phase of asthma the cells secretes which substances

Answer 8

1. Chemokines and chemotaxins
2. Spasiminogens Histamine, PGD2, CysTL

Question 9

Chemicals releasesed during immediate phase of asthma result to which physiological change

Answer 9

Bronchospams

Question 10

Bronchospams is usually reversed by which drugs?

Answer 10

1. Theophylline
2. B2 adrenoceptor agonists
3. CysTL Receptor antagonists

Question 11

Explain what happens during late phase of asthma

Answer 11

Infiltration of cytokines realising Th2 cells and monocytes and activation of inflammatory cells particulary easinophils

Question 12

Name four mediators released in late phase of asthma attacks

Answer 12

1. NO
2. Adenosine
3. Neuropetides
4. CysTLs

Question 13

Name proteins that are released in late phase of asthma

Answer 13

1. Eosinophilic Cationic Protein
2. Eosinophil major basic Proteins

Question 14

The proteins that are released in late phase of asthma causes what?

Answer 14

Epithelial damage

Question 15

what happens to the airways late phase of astma

Answer 15

Airway inflammationa and airway hyperactivity

Question 16

Late phase of asthma is inhibited by what?

Answer 16

Glucocorticoids

Question 17

PEFR is the indicator of what?

Answer 17

1. ventilate adequacy
2. airway obstruction

Question 18

List examples of B2 agonists drugs use to treat asthma and classify them according to SABA and LABA

Answer 18

1. SABA: Salbutamol, fenoterol and terbutaline
2. LABA: Salmeterol and formoterol

Question 19

List Glucorcoticoids drugs

Answer 19

Beclomethasone
Budesonide
Fluticasone
All inhlaled

Question 20

M3 receptor antagonist for asthma

Answer 20

Ipatropium bromide (inhaled)

Question 21

Xanthines drugs for asthma

Answer 21

Theophylline and aminophylline
IV/ORAL

Question 22

drug that antagonise leukotrines

Answer 22

Montelukast

Question 23

Explain the mechanism of action of B2 adrenoceptor agonist

Answer 23

1. B2 activation causes relaxation of bronchial smooth muscles
2. Clearing of mucus using cilia

Question 24

SABAs
1. Clinical use/ indication
2. Route of administration
3. Onset
4. Duration of action
5. Maximum effect
6. Salbutamol dosage

Answer 24

1. Acute bronchospasm
2. Inhaled
3. 5-15 min
4. 4-6 hours
5. 30 minutes
6. 1-2 puffs prn

Question 25

1. Instruction usage of SABAs 2. What to note when comes to SABAs

Answer 25

1. As needed for acute bronchospasm 2. tolerance may develop to bronchodilator effects with continous use or inappropriate

Question 26

Clinical usage of LABA

Answer 26

COPD, Uncontrolled persistent asthma attack combination with steroids, never use alone for asthma

Question 26

Route of administration for LABA and onset of action

Answer 26

Inhaled, Onset of action longer than of SABA.

Question 27

which drugs fall under LABA that you should not use for acute attack?

Answer 27

Salmeterol

Question 28

Duration of LABA and when to admister LABA

Answer 28

8-12 HOURS Administer twoce daily consistently

Question 29

List the adverse effects of B2 adrenoceptor agonists

Answer 29

1. discolouration of teeths, mouth dryness, taste alteration 2. Nervousness ( B2 stimulation results to increases of catecholimines in nerve terminals 3. dizzness, headache, muscle tremor, tachycardia and palpitation (dose related)

Question 30

Caution for B2 adrennoceptor agonists

Answer 30

1. Cardiac arrythmias, IHD, HCF and uncontrolled HT 2. Pregnancy: delay labour pain, asthma need to be well controlled, inhalled preparation prefered

Question 31

DI of B2 adrenoceptor agonists

Answer 31

Non-selective B blockers