PHRM 514 - Asthma - Fall 2012 (1)

Accessed hygiene hypothesis n allergic immunologic

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Accessed October 10, 2012.
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Hygiene Hypothesis n Allergic immunologic system develops (TH2 lymphocytes) instead of the immunologic system used to fight infections (TH1 lymphocytes) n First two years of life most important for the exposures to produce an alteration to the immune system response n Lower risk of asthma in children who: ¡ Exposed to higher levels of bacteria or endotoxin ¡ Live on farms ¡ Have large numbers of older siblings ¡ Enroll early in child care ¡ Are exposed to fewer antibiotics Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Hygiene Hypothesis Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. National Institutes of Health, National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. http://www.nhlbi.nih.gov/guidelines/asthma/ asthgdln.pdf. Published August 28, 2007. Accessed October 16, 2011.
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Factors Influencing Asthma n Environmental factors ¡ Allergen exposure ¡ Socioeconomic status ¡ Urbanization ¡ Family size ¡ Decreased exposure to childhood infectious agents ¡ Occupational stimuli ¡ Active smoking and secondhand smoking ¡ Air pollution Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448. Global Strategy for Asthma Management and Prevention. Global Initiative for Asthma. http://www.ginasthma.org/. Updated 2011. Accessed October 10, 2012.
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Agents and Events Triggering Asthma n Respiratory infections n Allergens n Occupational stimuli n Environment n Emotions n Exercise n Drugs/preservatives Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Which of the following is/are the most significant precipitant(s) of severe asthma exacerbations in adults? 1. Drugs 2. Exercise 3. Environmental exposures 4. Viral respiratory infections 5. Emotions
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Which of the following is/are the most significant precipitant(s) of severe asthma in children? 1. Drugs 2. Exercise 3. Environmental exposures 4. Viral respiratory infections 5. Emotions
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Viral Respiratory Infections n Particularly in children < 10 years old n Rhinovirus most common cause n Other viruses include: ¡ Respiratory syncytial virus ¡ Parainfluenza virus ¡ Coronavirus ¡ Influenza n Inflammatory response associated with BHR n Increase in asthma symptoms may last for days or weeks after resolution of virus symptoms Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Environmental and Occupational Factors n General mechanisms unknown n Thought to be a result of epithelial damage and inflammation in the airway mucosa
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Accessed Hygiene Hypothesis n Allergic immunologic system

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