Inflammation 4

inflammatory bowel disease

IBD

IBD

a group of chronic inflammatory conditions that affect the digestive tract, including Crohn's disease and ulcerative colitis

risk factors of crohns disease

family history

- environmental and bacterial tiggers

autoimmune disorders

crohns and ulcerative colitis

systemic sighns and symptoms

fever

anemia

fatigue

weight loss and rash

autoimmune effect

GI cells targeted by an atypical immune response

anemia

symptom of low oxygenation in the blood

Crohn's disease

anywhere within the GI tract

UC

large intestine

treatment drug classes

- glucocorticoids

- aminosalicylates

- DMARDs

- stem cell research

glucocorticoids

1st line for Crohn's

DMARDs

methotrexate

methotrexate

suppress immune system ability but not damaging it

stem cell research

mesenchymal stem cells

rectal treatment

if disease starts at the anus (common in ulcerative colitis)

Crohn's disease characteristics

skip patchy lesions with point of contact between disease intestines that create communication tunnels if there is perforation

fistulas

point of contact between. disease intestines that create communication tunnels if there is perforation

colonoscopy

scope inserted into lower GI from imaging

- see that precludes nutrients from being absorbed

drug class

aminosalicylates

amionosalicylates

sulfasalazine

sulfasalazine

azulfidine, salazopyrin

administration of aminosalicylates

PO administered

metabolization of aminosalicylates

metabolized in the colon = active metabolites

first line for US

5-ASA: salicylate

5-ASA; salicylate

NSAID

asthma aka

bronchial asthma

asthma incidence

up to 10% of Canadians

risk. factors for asthma

- family history

- atopy

Etiology

cause of disease

asthma ethology

- noxious stimuli trigger

- chronic hypersensitivity

- epithelial injury

- high gobble activity

noxious stimuli for asthma examples

allergens, particles, infection, stress

chronic hypersensitivity

reactivity of the airways to stimuli

epithelial injury

chronic inflammatory changes

high goblet cell activity

production of mucous blocks airways

presentation of asthma

- bronchial inflammation

- bronchoconstriction

- mucous production.

challenges of asthma

- chronic bronchial inflammation

- risk of acute attacks

acute attacks

sudden extreme inflammatory response

treatment focus of asthma

controllers

anti-inflammatory drugs inhaled

first line maintenance treatment prophylaxis against attacks

drug class of prophylactic asthma medication

- pulmicort

- Qvar

- Flovent

pulmicort

budenoside

Qvar

beclomethasone

Flovent

fluticasone

adjunct asthma treatment

- mast cell stabilizers

mast cell stabilizers

cromolyn

cromolyn

cromoglicic acid

cromolyn mechanism

decreases degranulation

leukotriene modifiers

Singulair

singulair

montelukast

what do leukotriene modifiers

They work by reducing swelling and mucus in the airways, and relaxing the muscles around them.

leukotrienes

chemicals that cause inflammation and are released by the body in response to allergens or other stimuli

long term asthma maintenance

biologics (antibodies)

asthma antibody

Xolair

xolair

omalizumab

Xolair administration

subcutaneous

mechanism of Xolair

- high affinity for free IgE which decreases expression of mast cell-bound IgE and reaction in mast cell response reducing allergic inflammation

gas exchanges

vital for survival

in asthma

patient is moving air but into the anatomical dead space

asthma attack signs and symptoms

- wheezing

- shortness of breath

- decreased/no air entry into. lung lobes

- therefore pain

- tachycardia

fatigue

patho of asthma

limited inspiration and longer expiration lead to trapping air in alveoli

trapping air in alveoli

- hyper inflated lungs with low gas exchange

- ventilation-perfusion mismatch

- hypoxia

- hypercarbia

high pulmonary pressure

ventilation perfusion mismatch

occurs when the ratio of ventilation (airflow) to perfusion (blood flow) in the lungs is abnormal

hypoxemia

deficient amount of oxygen in the blood

hypercarbia

Increased carbon dioxide level in the bloodstream.

high pulmonary pressures

increases RVED causing low CO

RVED

right ventricular end-diastolic dimension (RVED)

increased RVED

deceased pulmonary artery flow in pulmonary bed increases pressure in ventricles the right ventricle is affected first but eventually the left the product is complete failure of CO and complete lung and heart failure

asthma rescue treatment

inhaled bronchodilator drugs

bronchodilator drug class

beta 2 adrenergic agonists

beta 2 adrenergic agonist characteristics

- potent

- high receptor affinty

- stimulate SNS;s B2

- fast acting

beta 2 adrenergic agonist

a class of drugs that cause smooth muscle relaxation and are used to treat breathing conditions like asthma and COPD:

beta 2 adrenergic agonist drugs

- salbutamol

- albuterol

- formoterol

salbutamol

Ventolin

albuterol

Ventolin

formoterol

oxeye, turbohaler

other asthma drug class

anticholinergics

anticholinergics characteristics

- less potent

- antagonize PNS

- slower onset of action

- synergy with beta. 2 adrenergic agonists

anticholinergics

substances that block acetylcholine, a chemical messenger in the brain and body that sends messages to muscles and nerves. causes bronchodilator

anticholinergic

atrovent

atrovent

ipratropium

drug class for treatment of UC

aminosalicylates

aminosalicylate drug

sulfasalazine

sulfasalazine brand names

azulfidine, salazopyrin

sulfasalazine administration

PO administrated

sulfasalazine metabolization

happens in the colon and breaks into 5-ASA; salicylate, and sulfapyridine

what types of drug is salicylate

NSAID

what type of drug is sulfapyridine

DMARD immunomodulary activity

5-ASA administration

can be PO and rectal

5-ASA:

Asacol, Teva, Mesalamine

anaphylaxis

systemic vasodilation

bronchoconstriction

tx anaphylaxis

ABCs

asthma

airway/breathing

can epinephrine treat asthma attack and anaphylaxis

yes

IV asthma treatment

Magnesium sulfate

mechanism of magnesium sulfate

inhibition of Ca channels in smooth. muscle and reduced cellular excitability causing bronchodilator

no calcium influx

smooth muscle cell relax

drug classes of magnesium sulfate

enzymatic activatory

calcium channel blocker

electrolyte

other meangeniusm sulfate mechanism

stabilization of mast cells and T cells due to decreased pro inflammatory mediators

magnesium sulfate causes enhanced release of

nitric oxide

nitric oxide causes

vasodilation, pulmonary vasodilation and improved gas exchanges