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Respiratory physiology > COPD and Rhinitis Treatment > Flashcards

COPD and Rhinitis Treatment Flashcards

1
Q

M1 location

A

Ganglia

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2
Q

M2 location

A

Post-ganglionic neurone terminals

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3
Q

M3 location

A

Smooth muscle

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4
Q

M1 muscarinic ACh receptor function

A

Enhance cholingeric reflex

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5
Q

M2 muscarinic ACh receptor function

A

Inhibit ACh release

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6
Q

M3 muscarinic ACh receptor function

A

Mediate bronchoconstriction and mucus secretion (increase secretion)

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7
Q

SAMA

A

ipatropium and oxitropium

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8
Q

LAMA

A

tiotropium and aclidium

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9
Q

SAMA and LAMA given by

A

Inhalation

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10
Q

How are side effects avoided in SAMA and LAMA

A

Quaternary ammonium group reduces absorption and systemic exposure

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11
Q

SAMA and LAMA effect

A

Decrease mucus secretion

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12
Q

Mainly palliative effect?

A

Yes

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13
Q

Non-selective SAMA

A

Ipatropium

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14
Q

Selective LAMA

A

Tiotropium - selective for M3, achieved by longer half life.
Aclindium also selective for M3.

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15
Q

ultra LABA

A

Indacaterol

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16
Q

LABA and LAMA combination

A

Best at increasing FEV1

Recommended for moderate COPD

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17
Q

MABA

A

LABA and LAMA in the same molecule.

Batefenterol

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18
Q

PDE4 inhibitor

A

Rofimulast

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19
Q

Rofimulast action

A

Anti-inflammatory, also suppresses emphysema

Add on to LABA/LAMA

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20
Q

Rofimulast side effects

A

Nausea, diarrhoea, headache, weight loss

21
Q

Glucocorticoid unresponsiveness cause in COPD

A

oxidative/nitrative stress

HDAC2 is reduced in COPD

22
Q

Rhinitis definition

A

Acute/chronic inflammation of the nasal mucosa

23
Q

Rhinorrhoea definition

A

Runny nose

24
Q

allergic rhinorrhoea types

A

seasonal, perennial and episodic

25
Q

in rhinits, inhalation of allergen causes

A

Increase of specific IgE levels, IgE binds to receptors on mast cells and basophils.
Re-exposure to allergen causes mast cell and basophil degranulation, and release of mediators, causing acute symptoms.
Delayed response caused by recruitment of lymphocytes and eosinophils to nasal mucosa contributes to congestion and obstruction.

26
Q

Mediators released in rhinitis

A

histamine, cysLTs, tryptase, prostaglandins

27
Q

non-allergic rhinitis

A

doesn’t involve IgE

28
Q

occupational rhinitis

A

may have allergic and non-allergic components

29
Q

both rhinitis and rhinorrhoea involve

A

Increased mucosal blood flow and/or increased blood vessel permeability - increase volume of nasal mucosa causing difficulty in breathing.

30
Q

Glucocorticoids in rhinitis mechanism

A

Reduce vascular permeability, recruitment and activity of inflammatory cells and release of cytokines and mediators.

31
Q

Glucocorticoids in rhinitis examples

A

Beclometasone
Fluticasone
Prednisolone

32
Q

Glucocorticoids in rhinitis

A

mono therapy suitable
Reduce all symptoms
Can be combined with antihistamines

33
Q

Glucocorticoids in rhinitis administration

A

Intranasal

34
Q

Anti-histamines (H1 receptor antagonists) in rhinitis mechanism

A

Competitive antagonists of H1 receptors reduce effects of mast cell derived histamine that include:

  • vasodilation and increased capillary permeability
  • increased mucus secretion
  • activation of sensory nerves
35
Q

Anti-histamines (H1 receptor antagonists) in rhinitis examples

A

Second generation examples:

  • Loratadine
  • Fexofenadine
  • Cetirizine
36
Q

Anti-histamines (H1 receptor antagonists) in rhinitis administration

A

Orally

Intranasal spray - azelastine

37
Q

Anti-histamines (H1 receptor antagonists) in rhinitis

A

Mono therapy suitable
Less effect on congestion than others
Effective in allergic rhinitis

38
Q

Anti-cholingeric drugs (muscarinic receptor antagonists) in rhinitis mechanism

A

Stops ACh activating M3 muscarinic receptor.

39
Q

Anti-cholingeric drugs (muscarinic receptor antagonists) in rhinitis administration

A

Nasal

40
Q

Anti-cholingeric drugs (muscarinic receptor antagonists) in rhinitis examples

A

Ipatropium

41
Q

Anti-cholingeric drugs (muscarinic receptor antagonists) in rhinitis

A

Reduce rhinorrhoea in PAR and SAR.

No effect on itching, sneezing, coughing

42
Q

Sodium Cromoglicate in rhinitis mechanism

A

Mast cell stabilisation?

Anti-allergic

43
Q

Sodium Cromoglicate in rhinitis adminsitation

A

Nasal

44
Q

Sodium Cromoglicate in rhinitis

A

Less effective than corticosteroids

45
Q

CysLT receptor antagonists in rhinitis mechanism

A

Reduce the effect of CysLTs on the nasal mucosa

46
Q

CysLT receptor antagonists in rhinitis

A

Equi-Effective with H1 receptor antagonists - additive effect

47
Q

CysLT receptor antagonists in rhinitis example

A

Montelukast

48
Q

Vasoconstrictors in rhinitis mechanism

A

Mimic effect of noradrenaline - vasoconstriction via activation of alpha1-adrenoreceptors to decrease swelling in nasal mucosa.
Help nasal blood flow

49
Q

Vasoconstrictors in rhinitis examples

A

Oxymetazoline

  • intranasal
  • reduce congestion in allergic rhinitis
  • after a few days - rebound increase in nasal congestion (rhinitis medicamentosa) due to receptor desensitisation etc.

Respiratory physiology (2 decks)

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