Respiratory therapeutics

• What is asthma defined as in the study material?

  An inflammatory disease of the airways
• What are the main characteristics of asthma?

  Recurrent reversible airways obstruction
• What causes hypersecretion of mucus in asthma?

  Bronchial epithelial cell activity
• What cells infiltrate the airways in asthma?

  Mast-cells and eosinophils
• What causes bronchial smooth muscle cells hyperplasia in asthma?

  Airway hyper-responsiveness and bronchospasm
• What is a major issue in asthma management worldwide?

  Underuse of anti-inflammatory inhalers
• What contributes to high asthma death rates in low-middle-income countries?

  Lack of availability of inhaled medicines
• What factors increase the chances of developing asthma?

  Family history of asthma or allergies
• What are common symptoms of asthma?

  Wheeze, breathlessness, and cough
• What tests are used for asthma diagnosis?

  Lung function tests and airway inflammation measurement
• What are the non-pharmacological management strategies for chronic asthma?

  • Avoiding triggers
  • Education on asthma management
  • Regular monitoring of symptoms
  • Use of peak flow meters
• What are the two main types of pharmacological treatments for asthma?

  Bronchodilators and anti-inflammatory agents
• What is the mechanism of action of β2 adrenoceptor agonists?

  Activate β2 AR in airway smooth muscle
• What do β2 adrenoceptor agonists cause in the airways?

  Airway smooth muscle relaxation
• What are the two types of β2 adrenoceptor agonists?

  Short-acting and long-acting
• What are the advantages of long-acting β2 adrenoceptor agonists?

  Reduction of corticosteroid dose and symptoms
• What are the disadvantages of long-acting β2 adrenoceptor agonists?

  Increased risk of asthma exacerbation
• What are some adverse effects of β2 adrenoceptor agonists?

  Arrhythmias and tachycardia
• What is the mechanism of action of glucocorticoids?

  Bind to NR3C1 glucocorticoid nuclear receptor
• What are the two main actions of glucocorticoids?

  Transrepression and transactivation
• What do glucocorticoids decrease through transrepression?

  Transcription of inflammatory genes
• What do glucocorticoids increase through transactivation?

  Anti-inflammatory gene expression
• What are some adverse effects of long-term glucocorticoid use?

  Osteoporosis and glaucoma
• What do nonsteroidal selective glucocorticoid receptor modulators do?

  Bind to GR and induce nuclear translocation
• What is the mechanism of action of leukotriene receptor antagonists?

  Block cysteinyl-leukotrienes receptors
• What do leukotriene receptor antagonists reduce?

  Bronchoconstriction and mucus secretion
• What are the key components of asthma pathogenesis?

  • Inflammatory response in airways
  • Hypersecretion of mucus
  • Airway hyper-responsiveness
  • Bronchospasm and wheezing
• What are the strengths and weaknesses of β2 adrenoceptor agonists?

  Strengths:

  • Quick relief of symptoms
  • Improved lung function

  
  

  Weaknesses:

  • Risk of exacerbation
  • Potential adverse effects
• What are the strengths and weaknesses of glucocorticoids?

  Strengths:

  • Effective anti-inflammatory action
  • Reduces asthma symptoms

  
  

  Weaknesses:

  • Long-term adverse effects
  • Risk of systemic side effects
• What are the strengths and weaknesses of leukotriene receptor antagonists?

  Strengths:

  • Reduces bronchoconstriction
  • Decreases mucus secretion

  
  

  Weaknesses:

  • Variable response among patients
  • Potential for liver enzyme elevation
• What are the adverse effects of long-term glucocorticoid use?

  Glaucoma, muscle atrophy, peptic ulceration
• What syndrome is associated with long-term glucocorticoid use?

  Cushing syndrome
• What is a potential effect of glucocorticoids on growth?

  Retardation of growth
• How do glucocorticoids affect skin condition?

  They cause thinning of skin
• What is the impact of glucocorticoids on wound healing?

  Impaired wound healing
• What metabolic condition can be caused by glucocorticoids?

  Diabetes mellitus
• What axis is suppressed by glucocorticoids?

  Hypothalamic-pituitary-adrenal axis
• What is the mechanism of action of nonsteroidal selective glucocorticoid receptor modulators?

  Bind to GR and induce nuclear translocation
• What is the benefit of selective glucocorticoid receptor modulators?

  Dissociate anti-inflammatory efficacy from adverse effects
• How do leukotriene receptor antagonists work in asthma?

  Block cysteinyl-leukotriene receptors