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Respiratory Block > Drugs Used in the Treatment of Chronic Obstructive Pulmonary Disease (COPD) > Flashcards

Drugs Used in the Treatment of Chronic Obstructive Pulmonary Disease (COPD) Flashcards

1
Q

What largely causes COPD?

A

Smoking

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2
Q

What is COPD characterized?

A

increased resistance to air flow during expiration (harder to breath out - inspiration is almost normal)

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3
Q

Is COPD reversible?

A

Partially reversible in some patients but progressively worsens

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4
Q

What can partially reverse COPD in some patients?

A

Bronchodilators

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5
Q

What are the two COPD categorizes

A

Bronchitis and Emphysema

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6
Q

What is the pathway of getting COPD in smoking?

A

Stimulation of Resident Alveolar Macrophages.
Cytokine production.
Activation of neutrophils, CD8+ T cells, increased macrophage numbers.
Release of matrix metalloproteinases, and free radicals

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7
Q

What symptoms does chronicbronchitis cause?

A 
Inflammation of bronchi and bronchioles. 
Cough.
Clear Mucoid Sputum.
Infections with purulent sputum. 
Increased breathlessness.
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8
Q

What symptoms does Emphysema cause?

A

Distension and discharge to alveoli.
Destruction of acinial puching in alveolar sacs.
Loss of elastic recoil.

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9
Q

What is the resistance pressure of severe COPD compared to normal in expiration?

A

Much lower!

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10
Q

What does the muscarinic receptors agonists do?

A

Reduces parasympathetic neuroeffector transmission. .

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11
Q

What type of antagonist does muscarinic receptor antagonists?

A

Pharmacological antagonist.

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12
Q

What does muscarinic receptors antagonists cause?

A

prevents bronchoconstriction caused by smooth muscle M3 receptor activation. (blocks Aceylcholine)

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13
Q

What types of Muscarinic acetylcholine receptors are there?

A

M1, M2 and M3

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14
Q

What is the location and function of M1?

A

Ganglia - facilitates fast neurotransmission mediated by Ach acting on nicotinic receptors (increase action potential)

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15
Q

What is the location and function of M2?

A

Postganglionic neurone terminals - acts as inhibitor on autorecptors which reduce the release of Ach (cause they cause negative feedback control of Ach).

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16
Q

What is the location and function of M3?

A

Airways smooth muscle - mediate contraction to Ach and present on mucus secreting cells to increase secretion.

17
Q

Competitive short acting muscarinic receptors (SAMA) antagonists currently licensed are?

A

Ipratropium (they all end in ium)

18
Q

Competitive long acting muscarinic antagonists currently licenced are?

A

Tiotropium
Glycopyrronium
Aclidinium
Umeclidinium (all end in ium)

19
Q

How are all competitive muscarinic receptors administered?

A

Inhalation

20
Q

What group on these competitive muscarinic receptor antagonists reduces absorption and systematic exposure which avoid adverse effects?

A

Quaternary ammonium (its why they all have ium on the end)

21
Q

How fast action are muscarinic receptor antagonists?

A

Relative to SAMA

22
Q

What do Muscarinic receptors antagonists do?

A

They reduce bronchospasm causes by irritant stimuli. They also block Ahc-mediated basic tone.
They also decrease mucus secretion.

23
Q

What effect does muscarinic receptors have on the progression of COPD?

A

Very little - Their main effect is palliative (reducing pain)

24
Q

how many adverse effects of the muscarinic receptor antagonists?

A

Very few adverse effects - they have a Quaternary ammonium group!

25
Q

Ipratropium is selective or non selective type of blocker? and for what?

A

Non selective blocker for M1, M2 and M3 receptors.

26
Q

What is B-receptor agonist administered by combinations of what?

A

SABA and LABA

27
Q

What are Ultra-LABA not recommended for?

A

relief of acute bronchospasm - once daily dosing is effective.

28
Q

What type of B2 antagonists/ muscarinic antagonists work well together?

A

LABA and LAMA

29
Q

When is LABA and LAMA combinations effective?

A

When both are deposited in the same location in the airways.

30
Q

What does LABA nd LAMA combinations do?

A

They work in complementary with different mechanism to cause smooth muscle relaxation.

31
Q

Whats the difference in effect of LABA and LAMA?

A

LABA - Prevent contraction

LAMA - Cause relaxation

Respiratory Block (12 decks)

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