COPD

Question 1

What is COPD characterised by?

Answer 1

Airway reduction

Question 2

What does COPD stand for?

Answer 2

Chronic Obstructive Pulmonary Disease

Question 3

How does smoking cause COPD?

Answer 3

Stimulates resident macrophages leading to cytokine production and activation of neutrophils & CD8 T cells. This causes the release of metalloproteases.

Question 4

What does the release of metalloproteases do?

Answer 4

Causes chronic bronchitis & Emphysema

Question 5

What are the three types of muscarinic acetylcholine receptors?

Answer 5

M1 - ganglia - facilitates fast neurotransmission mediated by acetylcholine
M2 - postganglionic neurone - reduces the release of acetylcholine
M3 - airway smooth muscle - mediates contraction to acetylcholine

Question 6

Give an example of a SAMA and LAMA, how are they administered

Answer 6

SAMA - ipratropium
LAMA - tiotropium
Administered by inhalation

Question 7

State three effects of muscarinic receptor antagonists

Answer 7

1. reduce bronchospasm caused by irritant stimuli
2. block ACh mediated basal tone
3. decrease mucus secretion

Question 8

What does functional selectivity mean?

Answer 8

M3 blockers will not block M2. Blocking M2 is not desirable as the release of ACh from parasympathetic posit ganglionic neurones is increased by auto receptor antagonism.

Question 9

Describe LABA/LAMA combination

Answer 9

The drugs work by different but complementary mechanisms to cause smooth muscle relaxation.

Question 10

Describe an acute exacerbation of COPD

Answer 10

Increased sputum production and purulence.

Question 11

What is the treatment for an acute exacerbation?

Answer 11

Antibiotics, bronchodilator inhalers, short course of steroids, oxygen and rest. Investigations include ABG, CXR .