Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DRUGS > Anti-Asthma Drugs > Flashcards

Anti-Asthma Drugs Flashcards

1
Q

what do chemokine do in mast cells

A

attract inflammatory mediators to the area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the types of bronchodilators

A

beta2 adrenergic receptor agonists
theophylline
muscarinic receptor antagonists
leukotriene receptor antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

where are beta2 receptor also found apart from on smooth muscle cells

A

mucous glands in the bronchiole wall and on ciliated epithelial cells that line the lumen of the bronchioles - stimulates mucus secretion and increases the beat frequency of cilia which together increases mucucillary clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what kind of receptors are beta2 adrenergic receptors

A

G protein coupled receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are G protein coupled receptors mediated by

A

signalling cascades that are activated downstream of aGTP binding protein (G protein)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the G protein involved in the beta2 adrenergic receptor mechanism

A

the Gs protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what enzyme does the Gs protein activate

A

adenylate cyclase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the natural agonists of the beta2 receptors

A

noradrenaline released from sympathetic nerve terminals or adrenaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does the endogenous agonist binding to the receptor site cause

A

a conformational change in the receptor protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what does adenylate cyclase catalyse

A

the conversion of ATP into the second messenger, cAMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what does cAMP bind to

A

protein kinase A causing it to be activated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does protein kinase A do

A

phosphorylates several proteins that promote the relaxation of smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the enzyme that metabolises cAMP called

A

phosphodiesterase which hydrolyses phosphodiester bonds to generate cAMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how can the activity of phosphodiester be blocked

A

drugs known as phospohodiester inhibitors, resulting in an elevation of cAMP levels and stimulation of downstream events in the pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is an example of a phosphodiesterase inhibitor

A

theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how does a beta2 adrenergic antagonist work

A

when the beta blocker is bound to the receptor it does not interact with the Gs protein and stimulate the signalling cascade. compete with the beta2 agonist for binding to the receptor site and when they are bound they prevent the agonist from binding and having an effect.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

examples of SABA

A

salbutamol and terbutaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how long do SABA drugs work for

A

3-5 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how often do you use SABA

A

as needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

examples of LABA

A

salmeterol and formoterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how long do LABA work for

A

8-12 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how often are LABA given

A

twice daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

examples of Ultra LABA

A

vilanterol and indacaterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how long to ultraLABA work for

A

around 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how often are ultraALABA used for

A

once daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what drugs can be combined with a corticosteroid

A

ultra LABAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

side effects of beta2 agonists

A

tremor caused by activation of the skeletal muscles
rise to headaches
lowers blood pressure and triggers a reflex tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is aminophylline made by

A

combining theophylline with ethylene diamine and is more water soluble and used when the drug is given intravenously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is theophylline

A

a phosphodiesterase inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is adenosine

A

produced in all cells as the final product of ATP
extracellular conc is highly regulated but can be increased dramatically when the energy demand of a cell increases in cases such as inflammation
In the long term thought to contribute to athsma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

where are adenosine receptors found

A

airway smooth muscle and they evoke bronchocontriction and on inflammatory cells including mast cells that regulate degranulation

32
Q

what is aminophylline used to treat

A

status asthaticus and given by slow intravenous infusion

33
Q

what are the unwanted effects of theophylline

A

tremor
vasodilation
cardiac stimulation
GI tract stimulation

34
Q

what do muscarinic receptor antagonists do

A

bind to muscarinic receptors on bronchiole smooth muscle and prevent the binding of acetylcholine and that is released from parasymthpathetic nerves

35
Q

what is the neurotransmitter for parasympathetic neurones

A

acetylcholine

36
Q

what kind of receptors are muscarinic receptors

A

G protein coupled receptors so agonist binding to the receptor results in the activation of a G protein

37
Q

how do muscarinic receptor antagonists work

A

they bind to the receptor but also only reduce the level of bronchoconstriction as still allow some receptors to bind as normal

38
Q

what is main muscarinic antagonist drug

A

ipratropium because it is hydrophilic and poorly absorbed from the airways into the systemic circulation

39
Q

what is the side effect of ipratropium - muscarinic antagonist

A

dry mouth

40
Q

how long to ipratropium last

A

3-5 hours and act quickly

41
Q

where are leukotrienes derived from

A

part of the plasma membrane of cells

42
Q

what are leukotrienes generated by

A

cytosolic enzyme

43
Q

lipoxygenase pathway

A
44
Q

mechanism of the cysteinyl leukotriene receptor anatagonists

A
45
Q

what are leukotriene receptor antagonists used with

A

an anti-inflammatory corticosteroid

46
Q

when are leukotriene receptor antagonists used

A

as an add on for uncontrolled mild-moderate asthma - additive with beta2 receptor agonists

47
Q

what kind of asthma are leukotriene receptor antagonists more effective against

A

asthma induced by exercise or sensitive to aspirin

48
Q

what are the examples of leukotriene receptor antagonist drugs and how often are they taken

A

montelukast - x1 daily

zafirlukast - x2 daily

49
Q

what do glucocorticoids reduce the production of

A

cytokines
spasmogens
leukocytes chemotaxis

50
Q

where do glucocorticoids bind to their receptor

A

in the cytosol

51
Q

what is the main anti-inflammatory protein

A

lipocortin

52
Q

what are the two effects of glucocorticoids

A

increase the transcription of anti-inflammatory proteins and reduce the transcription of pro-inflammatory proteins

53
Q

what is the target of lipcortin

A

phospholipase A2 which it inhibits

54
Q

what is the consequence of lipocortin inhibiting phospholipase A2

A

stops cleavage of phospholipid to generate arachidonic acid. it inhibits all of the downstream pathways that employ arachidonic acid as the precursor, including all the lipoxygenase and xcyxlo-oxygenase pathways. much more effective than leukotriene antagonists as anti-inflammatory drugs.

55
Q

examples of glucocorticoids and when they are given

A 
beclometasone - 2x daily 
fluticasone - 2x daily 
budesonide - 1x daily 
mometasone - 1x daily 
ciclesonide - 1x daily
56
Q

how are glucocorticoids given

A

by inhaler

57
Q

what can be given by intravenous injection to treat patients with acute exacerbations of asthma

A

prednisolone may be given orally and hydrocortisone by injection

58
Q

what drugs are anti-inflammatory but weaker than glucocorticoids

A

cromoglicate and nedocromil

59
Q

what are the beneficial effects of cromoglicate and nedocromil

A

mast cell stabilisation
reduction of neuronal reflexes
inhibition of cytokine release from T cells
inhibition of inflammatory cells and mediators

60
Q

who are C and N most effective in

A

children

61
Q

what are the unwanted effects of C and N

A

mainly irritation to the upper respiratory tract

hypersensitivity reactions

62
Q

what does omalizumab target

A

targets IgE

63
Q

what does mepolizumab target

A

targets IL5

64
Q

what does reslizumab target

A

IL5

65
Q

what does benralizumab target

A

IL5 receptor

66
Q

what is IL5

A

one of the cytokines released from mast cells; activates and recruits eosinophils in the Airways

67
Q

what do mepolizumab and reslizumab do

A

bind to IL5 and prevent it from binding to its receptor on eosinophils

68
Q

what is the mechanism for benralizumab

A

acts downstream of these drugs by binding to the IL5 receptor and preventing it from being activated by endogenous IL5

69
Q

what asthma are IL5 activity inhibitors good at treating

A

severse asthma known as eosinphilic asthma

70
Q

route and frequency of biological drugs

A

they are proteins and usually delivered by subcutaneous injection.
drug is slowly released into circulation to reach a peak plasma concentration after a few days

71
Q

what drugs are used in a mild asthmatic with rare attacks

A

inhaled beta2 agonist

72
Q

mild asthma with more frequent attacks

A

glucocorticoid for prophylaxis (prevention) and beta 2 agonist when needed for acute attack

73
Q

moderate to severe asthmatic

A

long acting beta 2 agonist with glucocorticoid combined inhaler

74
Q

what does a blue inhaler contain

A

salbutamol

75
Q

what does a brown inhaler include

A

beclometasone dipropionate. low strength steroid

corticosteroid

76
Q

theophylline mode of action

A

Theophylline relaxes the smooth muscle of the bronchial airways and pulmonary blood vessels and reduces airway responsiveness to histamine, methacholine, adenosine, and allergen. Theophylline competitively inhibits type III and type IV phosphodiesterase (PDE), the enzyme responsible for breaking down cyclic AMP in smooth muscle cells, possibly resulting in bronchodilation. Theophylline also binds to the adenosine A2B receptor and blocks adenosine mediated bronchoconstriction. In inflammatory states, theophylline activates histone deacetylase to prevent transcription of inflammatory genes that require the acetylation of histones for transcription to begin.

DRUGS (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions