PHRM 514 - Asthma - Fall 2012 (1)

Global strategy for asthma management and prevention

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Global Strategy for Asthma Management and Prevention. Global Initiative for Asthma. http://www.ginasthma.org/. Updated 2011. Accessed October 10, 2012. 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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Epithelial Cells n Participate in inflammation by the release of eicosanoids, peptidases, matrix proteins, cytokines, and nitric oxide n Activated by IgE dependent mechanisms, viruses, pollutants, or histamine n Epithelial shedding occurs n Integrity of airway epithelium may influence sensitivity of the airways to various stimuli 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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Eosinophils n Increased numbers in airways of those with asthma n Release inflammatory mediators such as leukotrienes and granule proteins to injure airway tissue 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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T-Lymphocytes n Express surface markers of inflammation n T-helper CD4+ cells ¡ TH1: used for cellular defense mechanisms ¡ TH2: mediate allergic inflammation 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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Mast Cells n Located throughout the walls of the respiratory tractincreased numbers found in patients with asthma with an allergic component n Allergens bind to IgE on the membranes of mast cells leading to the release of inflammatory mediators 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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Alveolar Macrophages n Found in large and small airways n When activated by allergens may release inflammatory mediators and cytokines n Also produce neutrophil chemotactic factor and eosinophil chemotactic factoramplify the inflammatory process 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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Neutrophils n Unclear role n High numbers of neutrophils have been reported in airways of patients who died from sudden onset fatal asthma and in those with severe disease n May play a role in patients with long standing or corticosteroid dependent asthma n Also a source of platelet activating factor, prostaglandins, thromboxanes, and leukotrienes Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds.
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