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PHA 3112 Study Guide - Final Guide: Wheeze, Shortness Of Breath, Mast Cell

Course Code
PHA 3112
Frank Feiner
Study Guide

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Respiratory & Gastrointestinal Disorders
Chapter 76: Asthma & COPD
Chronic widespread disorder of children & adults
o 1/11 children, 1/12 adults: 2.6 million ill (Canada)
15% increase since ~ 2000
o 350 deaths/yr
Signs & symptoms:
o Breathlessness
o Chest tightness / pressure/ pain
o Wheezing
o Cough
o Dyspnea (difficulty breathing)
Underlying cause: Immune attack on & resulting inflammation of airways
Drug therapy highly effective
o Most patients lead full lives w/ no limitation
Chronic widespread disorder of adults who smoke cigarettes
o 2.4 million affected (Canada)
Third leading cause of death
Signs & symptoms:
o Chronic bronchitis
Cough/ excessive sputum
Poor exercise tolerance
Pathophysiology: airflow restrictions & inflammation
Chronic, progressive, largely irreversible
Drug therapy benefits minimal Doest slo progressio, redue hospitalizatio
or prolong life
Mostly preventable-stop cigarette smoking
Asthma Pathophysiology
Allergen binds via igE to mast cell & activates it
Inflammatory mediators (histamine, leukotrienes, prostaglandins, interleukins) released
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Result: airway bronchoconstriction & inflammation
o Edema
o Mucus plug
o Muscle hypertrophy
o Bronchial hyperreactivity to mild trigger factors (cold air, cigarette smoke, exercise)
o Rx: bronchodilators + antiinflammatory drugs
o Allergen known in 50% children/some adults
In other, unknown or may not be allergen that triggers
COPD Pathophysiology
Exaggerated reaction to cigarette smoke inflammatory response in airways:
o Hypertrophy of mucus- secreting glands in epithelium of larger airways increased
mucus secretion chronic bronchitis
o Enlargement of air space in bronchioles/ alveoli from deterioration of walls
emphysema (---not seen w/ asthma)
o Leukocytes/ inflammatory mediators bronchial edema airways narrow
Also: production of protective protease inhibitors inhibited
o Protease enzyme break down elastin alveolar wall destruction
Rx: (FWIW): bronchodilators + anti-inflammatory drugs
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Administering Drugs by Inhalation
1. Direct lung delivery enhances therapeutic effects
2. Systemic effects minimized
3. Rapid relief
Metered-Dose Inhalers (MDIs):
o Hand-held, pressurized devices
o Measured dose
o User activates after inhaling
o Difficulty to use properly
10% reaches lungs/ 80% swallowed/ 10% left in or exhaled
o Similar to MDIs, fine mist delivers more drug to lung
Dry-Powder Inhalers:
o Breath activated: use much easier
o Deliver 20% to lungs
o Hea ahie: drug solutio fine mist
o Face mask
o Delivery over min, not sec
o May be more effective than an inhaler
Drugs for Asthma & COPD
Some taken daily to establish long-term control (not used during attack)
o Attack frequency/severity decreases
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