CVR30 Pulmonary pharmacology 1 Flashcards
Things that cause episodic airway obstruction?
bronchospasm
cholinergic nerve over activity
Increase mucus secretion
Pulmonary inflammation
Symtoms of asthma?
dyspnoea
wheezing
cough
In the ANS the parasympathetic _____ nerve uses ____ receptors by Ach causing ______ and increased mucous secretion.
In the sympathetic there is no direct supply of _____ muscle. Circulating _____ acts on the ___ receptors on airways smooth muscles inhibiting bronchoconstriction.
10th bronchocontriction smooth adrenaline beta 2 adreno
Name the big 3 bronchodilators
Beta 2 adrenoreceptor agonist
Muscarinic antagonist
Xanthines
Beta 2 agonists MOA and examples and SE
relaxation of smooth muscle by increasing cAMP via G protein activation of adenylate cyclase. Inhibit release of mast cells.
Short acting - salbutamol (ventolin)
Long acting - bind to exoreceptor beside B2 causing repeated activation (salmetrerol) EROL
SE - tremor, arryhtmia, hypokalemia, cramps
Muscarinic antagonist MOA, example?
Ipratropium bromide (IUM Bromide)
MOA - inhibition of acetyl choline action at M1 M2 M3 thus prodicing bronchodilation and reducing mucous secretion.
Slower than B2 agonists
Tiotropium is selective for M1 and M3
Examples of xanthines with MOA
PDE4 inhibitors inhibit mast cells, eosoniphils, T cells, macrophages, neutrophils, airway smooth, eithelial, cholinergic nerves
What drugs do interactions with other drugs matter the most?
theophillines with low therapeutic index.
Cyto P450 like erythromyacin
In asthma, within minutes bronchocontriction is caused by ____, ____, and _____. Hourse later you get ____. Days later you get _____ and ______ and _____.
histamine
PGD2
LTC4 and D4 and E4
mucosal oedema
neutrolphil and eosoniphil adhesion and migration and maturation
Name the anti-inflammatory drugs used asthma?
glucocorticoids
cromones
leukotrienes synth inhibitors
What are the major effects of corticosteroids in asthma
inhibition of transcription of genes coding cytokines involved in inflammation
Name some corticosteroids
prednisilone oral
beclomethasone
hydrocortisone IV
What are the SE of corticosteroids
Thrush
hypertension
fluid retention
electrolyte imbalance
dysphonia - myopathy of laryngeal
Examples, MOA and SE of cromones
anti inflammatory - mast cell stabilation, reduced IgE, inhibit eosoniphil.
Nedocromil
cough wheeze transiently post administration
Good for children as it has less SE even though its less affective than steroids
In the stopping of leukotrienes glucocorticoids stop the _______ and ________. Zileuton (inhibiotr so 5 lipooxygenase inhibit ______. Receptor Antagonist Zafirlukast inhibit
COX converting to PGG
Phospholipase converting to arichadonic acid
5 lipoexygenase
All of the steps after LT4
