Cough

Question 1

What are anti - tussive agents? Give examples

Answer 1

Anti - coughing (often very little effect)
Codeine and Dextromethorphan - act in cough centre, marginally better than placebo
Levodropropizine - may inhibit release of sensory neuropeptides, comparable to codeine and dextromethorphan

Question 2

What is cystic fibrosis?

Answer 2

Inherited disorder of ion transport in epithelial cells

Defect in chloride transporter (CFTR) = reduced NA+ and H2O transport

Question 3

Pathophysiology of cystic fibrosis?

Answer 3

Thicker secretions with obstruction and destruction of exocrine glandular ducts (physio therapy to remove from lungs)
Recurrent infections - bacteria trapped in lungs

Question 4

What are cystic fibrosis disease characteristics

Answer 4

Pancreatic exocrine insufficiency

- reduced or absent secretions –> pancreatic ( inactivated by gastric acid therefore given with food

Question 5

What complications can arise as a result of CF patients living longer?

Answer 5

Diabetes
Liver Disease
Osteoporosis

Question 6

Management of CF - what are the aims?

Answer 6

Aim to clear viscous mucus from airways, treat respiratory infection and improve respiratory function.

Question 7

What is Dornase Alfa / how is it administered?

Answer 7

Administered using a nebuliser
Synthetic version of enzyme that cleaves extra cellular DNA
- dead neutrophils in the mucus
- DNA (That is released from the dead neutrophils) makes the mucus more viscous therefore drug targets this by breaking down the DNA

Question 8

What is a cough / what is its purpose?

Answer 8

Protective mechanism
Cough reflex = sensory nerves in upper airways (diaphragm, abdominal muscles and intercostal muscles)
Triggered by irritants