6. Physiology and pharmacology of airway smooth muscle Flashcards by idhil Unknown

Q

bronchoconstriction

of Airway smooth muscle

A

M3

ach

Parasympathetic innervation- vagus

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Q

bronchodilation of Airway smooth muscle

A

β2

Adrenaline

Sympathetic/adrenergic tone

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Q

main site of airway resistance

A

Bronchioles

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Q

Reflex activation of bronchoconstriction

A

Dust

Irritant gases

Smoke

Cold air

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Q

Asthma is characterised by

A

Reversible airways obstruction

Inflammation of airways

Bronchial hyper-reactivity

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Q

Relievers of asthma:

A

β2 adrenoceptor agonists

Methylxanthines

Anticholinergics

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Q

Preventers/controllers of asthma:

A

corticosteroids

anti-inflammatory agents

leukotriene receptor antagonists

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Q

Short-acting β2 agonists – physiological antagonists

A

max effect within 30 min

Duration 3-5 h

muscle tremor at high doses

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Q

Longer-acting β2 agonists

A

8-12 h duration

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Q

Theophylline (Methylxanthines)

A

used as bronchodilator

Acts as a phosphodiesterase inhibitor

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Q

Theophylline Therapeutic effects

A

30-100 µmol/L

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Q

Theophylline Unwanted side effects

A

at 110 µmol/L

dysrhythmias

seizures

tremor

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Q

Ipratropium (Antimuscarinic)

A

bronchodilation

Administered by inhalation

Poorly absorbed

May increase mucociliary clearance

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Q

Ipratropium side effects

A

dry mouth

gastrointestinal motility disorder

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Q

Inhaled corticosteroids side effects

A

adrenal suppression

reduced bone mineral density

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Q

Mechanism of corticosteroids

A

Decrease formation of cytokines

Th2 cytokines reduce activation of eosinophils

IgE production decreases

Leukotrienes and PAF production decreases

β2 receptor expression upregulated

Q

Leukotriene receptor antagonists

A

Bind to cysLT1

reduces response to: exercise-induced asthma

Given orally (tablets) 1-2 times daily

Side effects include abdominal pain, thirst and headache

Q

Severe Acute Asthma

A

Status asthmaticus

Medical emergency

Treatment Oxygen (> 60%)

Nebulised salbutamol

IV hydrocortisone

followed by oral prednisolone