COPD 2

Question 1

Do B2 agonists have limited or substantial effect in COPD?

Answer 1

Limited

Question 2

Which muscarinic antagonists are used in COPD?

Answer 2

Ipratropium
Tiotropium
Aclindinium

Question 3

What is ipratropium?

Answer 3

Non-specific muscarinic antagonist

Question 4

What is tiotropium?

Answer 4

M3 selective antagonist

Question 5

When are IV corticosteroids used in COPD?

Answer 5

Acute exacerbations

Question 6

Inhibition of PDEIII and IV in airway smooth muscle leads to what?

Answer 6

Bronchodilation

Question 7

What do PDE inhibitors do?

Answer 7

Increase intracellular cAMP.
Inhibit chemotaxis, granule release, respiratory burst,
Inhibits TNFa release

Question 8

What is theophylline?

Answer 8

A weak, non-selective phosphodiesterase inhibitor

Question 9

What is Roflulimast?

Answer 9

PDE IV selective inhibitor

Question 10

What are the organisms tht infect up to 50% of stable COPD patients?

Answer 10

Haemophilus influenzae

Streptococcus pneumoniae

Question 11

What are the viral infections associated with acute exacerbation of COPD?

Answer 11

Rhinovirus
Influenza
Parainfluenza
Coronavirus

Question 12

What is alondronate?

Answer 12

Bisphosphonate used in osteoporosis

Question 13

What is alondronates mechanisms of action?

Answer 13

Apoptosis of bone-resorbing osteoclasts.

Inhibiton of osteoclast activation

Question 14

What are the supposed mechanisms of action of statins in COPD?

Answer 14

Improved vascular function.
Reduced pulmonary hypertension.
Immunomodulation?
Decreased Systemic inflammation
Decreased Th1 activation

Question 15

What are the other treatments for COPD?

Answer 15

O2
Physiotherapy
Mucolytics

Question 16

Why don’t bronchodilators work very well in COPD?

Answer 16

Occlusion is not due to bronchoconstriction

Question 17

Why dont glucocorticoids work very well in COPD?

Answer 17

Oxidative stress results in decreased steroid sensitivity.

Neutrophil apoptosis inhibited by glucocorticoids

Question 18

Histone acetylase = ?

Answer 18

Increased binding of transcription factors.
NFkB AP-1 CREB
DNA not constrained by the histone

Question 19

Histone deacetylase = ?

Answer 19

Transcriptional suprression.

DNA wrapped tightly on nucelosome surface

Question 20

HDAC or HAC represses inflammatory gene expression?

Answer 20

HDAC

Histone deacetylase

Question 21

What does increased HAT and decreased HDAC cause?

Answer 21

Increased inflammation