Drugs used in the treatment of COPD and Rhinitis

Question 1

What are the two branches of COPD and describe each one

Answer 1

Chronic bronchitis - inflammation of bronchi and bronchioles, cough, clear mucoid sputum, infection with purulent sputum, increasing breathlessness
Emphysema - distention and damage to alveoli, destruction of acinial pouching in alveolar sacs

Question 2

What do the three M muscarinic receptors do in the airways?

Answer 2

M1 - gagnlia - facilitate transmission mediated by ACh acting on nicotine receptors
M2 - postganglionic neurone terminals - act as inhibitory auto receptors reducing release of ACh
M3 - smooth muscle - mediate contraction to ACh

Question 3

Give examples of SAMAs and LAMAs

Answer 3

SAMAs - ipratropium, oxitropium

LAMAs - tiotropium, aclidinium

Question 4

What do both the SAMAs and LAMAs do?

Answer 4

Relax bronchospasm and decrease mucus production

Question 5

Combinations of LABAs and LAMAs

Answer 5

A combination of both is superior to either drug alone -recommended in moderate COPD
A combination is more logical and effective

Question 6

what is rhinitis?

Answer 6

Common and often debilitating disease involving acute or chronic inflammation of the nasal mucosa which is characterised by
-rhinorrohea (‘runny nose’ - watery mucus accumulation in nasal cavity)
-sneezing
-itching
-nasal congestion and obstruction (swelling of the nasal mucosa largely due to dilated blood vessels - particularly in cavernous sinusoids)
Rhinitis may be allergic, non allergic or mixed

Question 7

allergic rhinitis

Answer 7

Very similar to allergic asthma

there are 3 types SAR (seasonal), PAR (perennial) and episodic

Question 8

non allergic rhinitis

Answer 8

this is any rhinitis cute or chronic that does not involve IgE, there are many diverse causes

• infection - infectious rhinitis (largely viral)
• hormonal imbalance - hormonal rhinitis (e.g. pregnancy)
• vasomotor disturbances - vasomotor rhinitis (idiopathic)
• nonallergic rhinitis with easophilia syndrome (NARES)
• medications - drug induced rhinitis

Question 9

Treatment of rhinitis and rhinorrhoea

Answer 9

Anti inflammatory - glucocoticoids
mediator receptor blocker - H1 receptor antagonist
nasal blood flow - vast constrictors
antiallergic - sodium chromoglicate

Question 10

glucocorticoids

Answer 10

over several weeks reduce al of the symptoms of rhinitis including nasal congestion
may be combined with anti-histamines in moderate to severe rhinitis

Question 11

what are antihistamines and what do they do?

Answer 11

competatic antagonists og H1 receptors reduce effects of mast cells derived histamine that include vasodilation and increase capillary permeability, activation of sensory nerves and mucus secretion from submucosal glands

Question 12

give examples of anti histamines

Answer 12

loratidine
fexofenadine
cetirizine