Objectives
- Assist your preparation for the following pharmacological lectures on preventers and relievers
- To help you identify the may managemnet targets involved in the inflammatory process vs those involved in bronchoconstriction
What is asthma
Chronic airway inflammation characterised by:
- inflammatory cell infiltration/airway wall thickening
- with increased mucous production aiding obstruction
- with airway hyperresposiveness leading to excessive bronchial smooth muscle constriction in response to numerous stimuli
Key points of management
Asthma is a variable disease and so medication needs to be able to be adjusted
often patient will self monitor symptoms and adjust/administer medication as needed as per set treatment
therapy goals is to provide effective antiinflammatory and bronchodilatory control Reduce symptoms with minimum medication!
Example Asthma classification system
SABA = short acting B2 agonist (not advocated for monotherapy)
Asthma should be viewed primarily as an inflammatory illnees with bronchial hyperreactivity, spasm and mucous over production
Asthma as an inflammatory diseaese
Naive T cells → IL-12 to Tcells which makes interfereon gamma what stops atopic resopnse Th-1 response
atopic patients CD4 activated CD4 B cells whcih activate eosinophils, mast cells, plasma cells, increased mucous and smooth muscle contraction. Th-2 response
mediators of inflammation are histamine prostaglandins leukotrienes and enxzymes
IL-4,-5,-13 initiate B cells response
Arachadonic acid is the main substrate which leukotrienes and prostaglandins are made from
NSAIDS lead to increased lipoxygenase enzyme action