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2 types of Ashtma
1. Extrinsic: Allergic or Atopic specific allergies
2. Intrinsic: Nonallergic or non-atopic situational allergies
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2 types of Immune Response
1. Cellular Immunity: Sensitiezed Lyrmphocytes, transplant rejects
2. Humoral: Circulatory Antibody allergic asthma protects against mumps, measles, & rubella.
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What is an antibody?
Serum Globulin protein that reacts with a pecific antigen. IgE, IgA, IgD, IgG, IgM.
A- protects from respiratory
G- protects against common diseases
E- reacts to different allergies
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Antigen-Antibody Reaction
1. 1st exposure to Antigen
2. IgE produced specific to Antigen
3. Re-exposure
4. Antigen-Antibody Reaction
5. Inflammation, Elimination of antigen
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Mediators of inlammation
Histamine- Promotes edema formation, vasodilation causes increase blood flwo bring more leukocytes heparin.
NCF-A- Neutrophil chemotactic factor of anaphylaxis
PAF- Platelet activating factor
ECF-A- Eosinophilic chemotactic factor of anaphylaxis
Causes: 1. Increase in vascular permeability- edema
2. Smooth muscle contraction
3. Increase mucus secretion
4. Vasodilation
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Mast Cell Stablizers
Antiasthmatic, can't really stop an asthma attack in progress more of prophylactic preventative agent.
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Aarane/Intal
Cromolyn Sodium
Indi: Prophylaxis of intrinsic & extrinsic asthma
Contra: Sensitivity to the drug
Side: pweder may cause cough or bronchospashm
Action: Inhibits degranulation of the mast cell stabilizes the mast cell wall.
- Dose: 20 mg qid in sphinhaler
- Aerosol: 20 mg in 2 ml sterile H2O qid
- MDI 2 mg or .8 mg/puff 2 puffs
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Tilade
Nedocromil
Indi: Maintenance therapy for pts. with mild to moderate brochial asthma.
Contra: Sensitivity to drug
Side: minimal
Action: anti-inflammatory agent, inhibits actication and mediator release from inflammatory cell types.
Dose: MDI 1.75 mg per puff 2 puffs qid
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Zoditen
Ketotifen
Oral admin some side effects.
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Leukotine inhibitors
- Montelukast (Singulair)
- Pobilukast
- Pranlukast (Ultair)
- Tomelukast
- Verlukast
- Zafirlukast (Accolate)
- Zileuton (Zyflo)
- Kitafin
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Antihistamines
H1: in the lung and airways
H2: primarily gastric mucosa
H3: Agents may be effective as a preventative in treating allergic rhinitis.
Action: Prevent histamine from reaching site of action through receptor competition.
Side Effects: drowsiness, dizziness, nausea, may cause some drying of secretions.
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Omalizumb
Xolair
Designed to specifically target IgE used to treat asthma and allergic rhinitis.
IgE triggers the release of histamine, prostaglandins, & Leukotrienes, causing symptoms associated with allergic reactions.
Prevents IgE from binding to mast cells.
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