Bronchoconstriction can be caused by what normal physiological actions?
Parasympathetic innervation of muscarinic 1 and 3 receptors
Bronchodilation can be caused by what normal physiological actions?
Adrenal Medulla releases epinephrine into the blood and interacts with B2 adrenergic receptors
Are airways in humans innervated by the sympathetic nervous system?
No
Muscarinic cholinergic receptors are agonized or antagonized by atropine?
Antagonized
Alpha-adrenergic receptors are agonized or antagonized by Phentolamine and Prazosin?
Antagonized
Beta-adrenergic receptors are agonized or antagonized by Propranolol?
Antagonized
What are the ways that inhaled materials may cause bronchoconstriction?
Trigger releases of mediators from mast cells, Stimulate afferent receptors to initiate constriction or release Substance P
What mediates allergen caused mast cell degranulation?
IgE antibodies
What are the mast cell chemical mediators of anaphylaxis/bronchoconstriction?
Histamine, Tryptase, Prostaglandin D4, Leukotriene C4 and Platelet activating factor
Mast cell degranulation in the airways promotes what major things to happen?
FEV1 to fall and bronchoconstriction
Re-exposure to an allergen may cause the synthesis of what by mast and T cells?
Interleukins 4 and 5, Granulocyte Macrophage colony stimulating factor, Tumor Necrosis factor and Tissue growth factor
Cytokines (like TNF and GM-CSF) produced by T and Mast cells in response to re-exposure to an allergen cause what to happen?
Activate Eosinophils and Neutrophils
Activation of Eosinophils and Neutrophils by Cytokines, cause them to produce what chemical mediators?
Eosinophil cationic Protein (ECP), Major basic protein (MBP), proteases and platelet activating factor
Eosinophil cationic Protein (ECP), Major basic protein (MBP), proteases and platelet activating factor produced by activated eosinophils and neutrophils cause what physiological changes?
Edema, Mucus hypersecretion, smooth muscle contraction and increase in bronchial reactivity
The increase in what mediators is associated with “Late asthmatic Response”?
Eosinophil cationic Protein (ECP), Major basic protein (MBP), proteases and platelet activating factor
The “late asthmatic response” is associated with a fall in what?
FEV1
How long does the “late asthmatic response” happen after allergen exposure?
2-8 hours
What are the three approaches to managing asthma?
Reverse acute bronchospasm, prevent recurrent episodes, and Treat hyper-responsiveness cause by inflammation
What are the short acting B2 agonists used to reverse acute bronchospasm?
Albuterol, Pirbuterol and Terbutaline/Epinephrine
Terbutaline/Epinephrine shows a distinct advantage in reversing acute bronchospasm over either component alone (True/False)
False
What receptors would Terbutaline/Epinephrine interact with?
Interacts with B2, B1, a1 and a2
What are the adverse effects of Terbutaline/Epinephrine or other B2 agonists?
Arrhythmias, tremors, muscle cramps, metabolic disturbances and loss of effectiveness with chronic use
Is Ipratropium a first line therapy for acute bronchoconstriction?
No
What is the MOA of Ipratropium for treatment of bronchospasm?
Muscarinic antagonist
Ipratropium is usually used alone or in combination?
In combination with B-2 agonists
What is the MOA for Prednisone, Methylprednisone and Prednisolone?
Anti-inflammatory steroids/Corticosteroids
What is the most effective available therapy to prevent recurrent episodes of asthma?
Daily prophylactic steroid anti-inflammatories
What are the daily prophylactic steroid anti-inflammatories used to prevent recurrent asthma?
Beclomethasone, Budesonide, Flunisolide, Fluticasone and Triamcinolone
What are nasal preparations of Steroid anti-inflammatories used to treat?
