CPP 2

• Asthma is a chronic respiratory condition characterized by airway inflammation and hyper-responsiveness. It affects over 300 million people worldwide.
• Asthma


  • Reversible
  • Causes airway inflammation and hyper-responsiveness
• Causes of asthma attacks

  • Allergens (pollen, dust mites, pet dander)
  • Irritants (smoke, air pollution, strong chemical odors)
  • Respiratory infections (common cold, flu)
  • Exercise
  • Cold air
  • Emotional stress
• Types of asthma


  • Childhood-onset asthma
  • Adult-onset asthma
  • Exercise-induced asthma (EIA)
  • Nighttime asthma
• What happens during asthma?

  1. Inflamed airway

  2. Constricted airway
• Medications used to treat asthma

  • Inhaled corticosteroids (ICS)
  • Long-acting beta2-agonists (LABAs)
  • Short-acting beta2-agonists (SABAs)
  • Leukotriene receptor antagonists (LTRAs)
• Inhaled corticosteroids (ICS)


  Inhibit phopholipase A2 and exhibit COX 2 expression, reducing inflammatory cytokines including prostaglandines and leukotrienes, and reducing thickness of respiratory mucosa
• Inhaled corticosteroids (ICS)


  • Administered directly into the lungs through an inhaler or nebulizer
  • Suppress inflammatory genes
  • Reduce immune cell activity
  • Promote airway healing
• Inhaled corticosteroids (ICS) do not work immediately to relieve symptoms like a sudden asthma attack. They typically take several days to weeks to show their full effects and are most effective when used regularly as prescribed for long-term control of asthma.
• Inhaled corticosteroids (ICS) are generally well-tolerated with minimal side effects when used at recommended doses. However, it is crucial to follow the proper inhalation technique to ensure the medication reaches the target site in the lungs and minimize potential side effects.
• Inhaled corticosteroids (ICS) are prescription medications and should only be used under the supervision of a healthcare professional.
• Bronchodilators


  Bind to B2 receptor, stimulate cAMP in smooth muscle cells, leading to smooth muscle relaxation in bronchial muscle and dilation of bronchioles
• Types of bronchodilators


  • Short-acting (<6 hours): salbutamol and terbutaline
  • Long-acting (12-24 hours): salmeterol and formoterol
• Indacaterol is only approved for COPD, not asthma.
• Leukotriene receptor antagonists (LTRAs)


  Bind competitively to leukotriene receptors on the surface of various cells, particularly in the airways, blocking the action of leukotrienes and inhibiting the inflammatory cascade
• Leukotriene receptor antagonists (LTRAs)


  • Reduce mucus production in the airways
  • Relax airway smooth muscle, leading to bronchodilation and improved airflow
  • Decrease inflammation and swelling in the airways, easing symptoms
• Leukotriene receptor antagonists (LTRAs) are not as effective as inhaled corticosteroids (ICS) and are not recommended for acute asthma.
• Leukotriene receptor antagonists (LTRAs) are effective in exercise-induced bronchospasm, antigen-induced bronchospasm, aspirin allergy, and aspirin-induced bronchospasm.
• Examples of leukotriene receptor antagonists (LTRAs) include Montelukast and Zafirlukast. Zileuton is a 5-lipooxygenase inhibitor.
• COPD is a progressive lung disease that includes chronic bronchitis and emphysema. Treatment focuses on symptom control and prevention of exacerbations.
• COPD


  • Irreversible
• Causes of COPD


  • Smoking
  • Exposure to other irritants (air pollution, occupational dusts and fumes, secondhand smoke)
  • Alpha-1 antitrypsin deficiency
• Symptoms of COPD


  • Shortness of breath
  • Chronic cough
  • Wheezing
  • Chest tightness
  • Fatigue
  • Frequent respiratory infections
• Types of COPD


  • Emphysema
  • Chronic bronchitis
• Treatments for COPD


  • Bronchodilators
  • Inhaled corticosteroids
  • Pulmonary rehabilitation
  • Oxygen therapy
  • Vaccinations
• Allergic rhinitis, often referred to as hay fever, is an inflammatory response in the nose triggered by exposure to allergens.
• Types of allergic rhinitis

  • Seasonal allergic rhinitis (hay fever)
  • Perennial allergic rhinitis
  • Occupational allergic rhinitis
• Causes of allergic rhinitis include exposure to allergens like pollen, dust mites, pet dander, or mold spores.
• Getting vaccinated against influenza and pneumonia is crucial for people with COPD to prevent respiratory infections that can worsen symptoms
• Allergic rhinitis


  An inflammatory response in the nose triggered by exposure to allergens
• Types of allergic rhinitis

  • Seasonal allergic rhinitis (hay fever)
  • Perennial allergic rhinitis
  • Occupational allergic rhinitis
• Causes of allergic rhinitis

  • Genetics
  • Exposure to allergens
  • Environmental factors
• Symptoms of allergic rhinitis

  • Runny or stuffy nose
  • Sneezing
  • Itchy nose and eyes
  • Watery and red eyes
  • Postnasal drip
  • Facial pressure or pain
• Pharmacological treatment for allergic rhinitis

  • Antihistamines
  • Nasal corticosteroids
  • Decongestants
• Antihistamines


  Medications that block the effects of histamine, a chemical released during an allergic reaction
• First-generation antihistamines


  • Chlorpheniramine
  • Diphenhydramine
  • Doxylamine
• Second-generation antihistamines


  • Cetirizine
  • Desloratadine
  • Fexofenadine
  • Loratadine
• Nasal corticosteroids


  Medications that reduce inflammation in the nasal passages, providing long-term control of symptoms
• Examples of nasal corticosteroids

  • Budesonide
  • Beclomethasone
  • Fluticasone
  • Mometasone
• Decongestants


  Medications that relieve congestion in the nasal passages and sinuses by narrowing the blood vessels