PHRD5985 Pharmacotherapy Lecture 8 - Airway & Lung Diseases

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daynuhmay
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269714
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PHRD5985 Pharmacotherapy Lecture 8 - Airway & Lung Diseases
Updated:
2014-04-08 05:08:14
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Airway Lung Diseases
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Airway Lung Diseases
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  1. cells that distinguishes asthma from other airway diseases
    eosinophils - infiltrate airways
  2. 4 characteristics of asthma
    • 1) chronically inflamed airways
    • 2) airway hyperreactivity
    • 3) airway SM hypertrophy
    • 4) IgE-mediated immune response
  3. resultant immune response in Hygiene Hypothesis
    • dec Th1 response (infection fighting)
    • inc Th2 response (allergic diseases)
  4. how long asthmatic episode hyperreactivity can last for
    several weeks
  5. early response asthmatic episode due to...
    mediator release from mast cells
  6. late response asthmatic episode due to...
    mediator release from inflammatory cells recruited by substances released from mast cells
  7. non-specific stimuli that can inc airway reactivity (3)
    • 1) cold air
    • 2) inhaled irritants
    • 3) exercise
  8. key clinical (immunological) feature of asthma
    immediate hypersensitivity (type I) response (allergic reaction) -> IgE mediated
  9. used in bronchial provocation test
    methacholine
  10. syndrome of progressive non-reversible airflow limitation caused by chronic inflammation of small airways & alveoli 
    COPD
  11. COPD is an umbrella term that encompasses what 3 diseases?
    • 1) chronic bronchitis
    • 2) emphysema
    • 3) small airways disease
  12. cells involved in chronically inflamed airways of COPD pts
    • macrophages
    • CD8+ lymphocytes
    • neutrophils
  13. 4 features of COPD
    • 1) chronically inflamed airways
    • 2) imbalance between protease & antiprotease activity
    • 3) airway remodeling
    • 4) pulmonary vascular changes
  14. list 2 proteases
    • 1) MMPs
    • 2) neutrophil elastase
  15. list 2 protease inhibitors
    • 1) TIMPs
    • 2) 1-antitrypsin (AAT)
  16. cause irreversible expiratory flow limitation
    airway narrowing + peripheral airway destruction
  17. what is wrong with the immune cells involved in COPD?
    macrophages & neutrophils have a reduce capacity to phagocytize bacteria & are less responsive to effects of CCS's
  18. why might an undiagnosed pt w/ COPD only show up to the clinic when their disease is very severe?
    pulmonary function can deteriorate BEFORE symptoms manifest
  19. main inflammatory cells involved in COPD
    • macrophages
    • neutrophils
    • CD8+ lymphocytes
  20. main inflammatory cells involved in asthma
    • eosinophils
    • mast cells
    • CD4+ (Th2) lymphocytes
  21. airways involved in asthma vs COPD
    • asthma: central
    • COPD: small/peripheral
  22. majority of pts w/ CF have this mutation
    Phe508del
  23. what happens when Phe508 is deleted?
    failure of channel to be expressed in cell membrane leads to decreased Cl- secretion
  24. 4 effects of defective chloride channels
    • 1) inc Na+ reabsorption
    • 2) inc H2O reabsorption
    • 3) hyperviscous mucus 
    • 4) dec sol fluid
  25. how inflammatory cells cause tissue damage
    ROS & protease release
  26. diagnostic test for CFTR mutation
    sweat chloride testing
  27. pulmonary therapeutic objectives for treatment of CF
    • 1) relieve mucus obstruction/make it easier to breathe
    • 2) treat lung infection

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