B2 W2 - Pharmacology of Airway Disease Flashcards
What is the immediate phase of asthma characterised by, and what causes it?
The immediate phase of asthma is characterised by episodes of bronchospasm, brought on by allergen triggers.
How can drugs target the immediate phase of asthma?
Drugs can alleviate the immediate phase by affecting lung smooth muscle function and targeting receptors on mast cells involved in allergen responses.
What characterises the late phase of asthma?
The late phase of asthma involves a more profound involvement of immune cells recruited to the lung due to chronic inflammation.
What types of drugs can alleviate the late phase of asthma?
Drugs that target the immediate phase can also help with the late phase, along with corticosteroids, which can modify immune system responses to reduce inflammation and bronchospasm.
What are the three main pharmacological strategies for managing chronic airway diseases?
The strategies involve
targeting
* nervous system control of airway constriction
* airway hyper-responsiveness,
* chronic inflammation in the lung.
What is the primary mechanism for promoting bronchodilation directly?
Bronchodilation can be directly promoted by targeting the smooth muscle cells that control airway diameter.
What are three ways drugs can target smooth muscle cells to promote bronchodilation?
- Activate beta-two adrenergic receptors (β2-Adrenergic Agonists)
- Target acetylcholine responses (Anti-muscarinic drugs)
- Affect adrenergic responses (Methylxanthines.)
How can drugs target the immunological aspects of airway diseases?
Drugs like corticosteroids and leukotriene receptor antagonists can reduce tissue inflammation and modulate inflammatory responses.
What acronym is useful for remembering the steps in emergency asthma care?
“OMG SHIT”
What does the “O” in “OMG SHIT” represent, and what is its purpose?
“O” stands for oxygen, which is the first step in emergency asthma care to address the patient’s immediate need for oxygen.
What does the “S” in “OMG SHIT” represent, and how is it administered?
“S” stands for salbutamol, a beta-two agonist drug often administered intravenously in emergencies to promote bronchodilation.
What does the “H” in “OMG SHIT” represent, and what is its function?
“H” stands for hydrocortisone, a corticosteroid drug used to reduce inflammation and help restore airway function.
What does the “I” in “OMG SHIT” represent, and what type of drug is it?
“I” stands for ipratropium, an anti-muscarinic drug that helps to relax the airways.
What does the “T” in “OMG SHIT” represent, and how is it considered in treatment?
“T” stands for theophylline, a methylxanthine drug that is a potent but last resort treatment for severe cases.
What additional treatment, not included in the acronym, can be used in emergency respiratory care?
Magnesium sulphate (Mg) can also be used, and its abbreviation conveniently fits into the acronym.
What distinguishes the different phases of asthma?
The severity of the pathology
What is the immediate phase of asthma characterised by?
The immediate phase involves episodes of bronchospasm caused by allergen triggers.
What types of drugs can target the immediate phase of asthma?
Drugs that affect lung smooth muscle function and target receptors on mast cells involved in allergen responses can target the immediate phase.
How is the late phase of asthma different from the immediate phase?
The late phase involves a more significant influx of immune cells to the lungs due to chronic inflammation and progressive lung changes.
What drugs can alleviate the late phase of asthma?
Drugs used for the immediate phase and corticosteroids, which modify immune system responses, can alleviate the late phase.
What is the role of glucocorticoids in treating airway diseases?
To modify immune system responses to reduce inflammation and bronchospasm in the lungs.
Often used interchangeably with corticosteroids
How do leukotriene receptor antagonists function in treating airway diseases?
Leukotriene receptor antagonists work by modulating some of the immunological and inflammatory responses in the lungs.
What does the acronym ‘SABA’ stand for, and what is an example of this drug class?
- SABA stands for short-acting beta-agonist
- E.g Salbutamol.
What is the mechanism of action of a SABA?
SABAs promote bronchodilation by activating beta-two adrenergic receptors on airway smooth muscle cells.
What is a potential side effect of SABAs?
Tremor
What does the acronym ‘LABA’ stand for?
LABA stands for** Long-Acting Beta-Agonist.**
Provide an example of a LABA.
Salmeterol
What is the mechanism of action of an anti-muscarinic drug for airway disease?
Anti-muscarinic drugs block acetylcholine receptors on airway smooth muscle, preventing bronchoconstriction.
What is a common example of an anti-muscarinic used for airway disease?
Ipratropium bromide
What is a potential side effect of ipratropium bromide?
Dry mouth.
What is the mechanism of action of methylxanthines in treating airway disease?
Methylxanthines affect the adrenergic responses in bronchial smooth muscle cells, leading to bronchodilation.
What is the main methylxanthine used in treating airway disease?
Theophylline
What are two potential side effects of theophylline?
Nausea and tachycardia.
What is the mechanism of action of corticosteroids in treating airway disease?
Reduce tissue inflammation in the airways.
Provide an example of a commonly used corticosteroid in airway disease.
Beclomethasone
What is a potential side effect of inhaled corticosteroids?
Oral thrush
What is the mechanism of action of leukotriene receptor antagonists?
Leukotriene receptor antagonists **block **the action of leukotrienes, which are inflammatory mediators.
Provide an example of a leukotriene receptor antagonist.
Montelukast
Which branch of the nervous system predominantly influences smooth muscle function in the lungs?
Sympathetic nervous system.
What is another name for the sympathetic nervous system?
The sympathetic nervous system is also known as the **“fight or flight” **system.
What are the nerve fibres associated with the sympathetic nervous system called?
Adrenergic nerve fibres.
What is the primary neurotransmitter involved in the sympathetic nervous system’s influence on the lungs?
Noradrenaline.
What is the primary effect of sympathetic responses in the lungs?
Sympathetic responses primarily cause bronchodilation, widening the airways to enhance airflow into the lungs.
What is the parasympathetic nervous system often associated with?
It is associated with “rest and digest” responses.
What is the primary neurotransmitter of the parasympathetic nervous system?
Acetylcholine is the primary neurotransmitter, acting through cholinergic nerve fibres.
What is the typical effect of parasympathetic responses on the airways?
Parasympathetic responses generally lead to bronchoconstriction, narrowing the airways.
Which neurotransmitter and type of nerve fibre primarily mediate parasympathetic responses in the lungs?
The parasympathetic nervous system primarily uses **acetylcholine **and cholinergic nerve fibres.
How do the sympathetic and parasympathetic nervous systems interact in regulating airway diameter?
The parasympathetic nervous system often works alongside and in opposition to the sympathetic nervous system, reversing the bronchodilation effect after a predominant sympathetic response.
What is the key component of Beta 2 agonist action in the lungs?
The key component is the Beta 2 adrenergic receptor found on lung smooth muscle cells.
What is the role of Beta 2 agonists in relation to the Beta 2 adrenergic receptor?
Beta 2 agonists, such as salbutamol or salmeterol, act as stimulants, activating the Beta 2 adrenergic receptor.
What are the natural agonists for the Beta 2 adrenergic receptor?
Noradrenaline and adrenaline
What is the purpose of introducing a pharmacological agent like salbutamol?
Introducing salbutamol enhances and drives the adrenergic response in the lungs.
What intracellular change occurs upon salbutamol binding to the Beta 2 adrenergic receptor?
It leads to an increase in the concentration of cyclic AMP (cAMP) inside the cell.