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Overview of Pre-hospital Pharmacology

Mechanism of Airway Hyperactivity. Decrease in baseline airway caliberAlterations in bronchial smooth muscle (hypertrophy, hyperplasia)Increased number of mast cellsIncreased synthesis of mediatorsLowered receptor thresholdDamage to airway epithelial cellsAlterations in ANS regulation:Increased parasympathetic activityDecreased b adrenergic responsivenessIncreased a adrenergic responsivenessDecreased responsiveness of nonadrenergic inhibitory system.

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Overview of Pre-hospital Pharmacology

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    1. Overview of Pre-hospital Pharmacology Lynn K. Wittwer, MD, MPD Clark County EMS

    2. Mechanism of Airway Hyperactivity Decrease in baseline airway caliber Alterations in bronchial smooth muscle (hypertrophy, hyperplasia) Increased number of mast cells Increased synthesis of mediators Lowered receptor threshold Damage to airway epithelial cells Alterations in ANS regulation: Increased parasympathetic activity Decreased b adrenergic responsiveness Increased a adrenergic responsiveness Decreased responsiveness of nonadrenergic inhibitory system

    3. Cholinergic System Vagus (Ach) bronchoconstriction at rest cholinergic stimulation predominates Asthma muscle mass bronchial tone Histamines (H1) bronchoconstriction Bronchoconstriction requires intracellular Ca

    5. Immunology

    6. Immunology

    12. Cellular Metabolism

    14. Respiratory

    17. Cardiac

    19. Cardiac (Antidysrhythmics)

    21. Cardiac (Antidysrhythmics)

    22. Cardiac (Antidysrhythmics)

    23. Cardiac (Antidysrhythmics)

    24. Cardiac (Antidysrhythmics)

    33. Cardiac (Sympathomimetic)

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