Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IRM > L08 - Drugs influencing airway resistance (flipped) > Flashcards

L08 - Drugs influencing airway resistance (flipped) Flashcards

1
Q

What are the different physiological controls of airway diameter?

A
  1. NANC innvervation
  2. Parasympathetic innervation
  3. Mechanical receptors
  4. No sympathetic innervation but beta2 adrenoceptors (another flashcard discuss)
  5. CO2
  6. Mast cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe how NANC innervation can control airway diameter

A

BronchoDILATION

  • Transmitters: VIP and NO
  • In asthma, substance P may cause bronchoconstriction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe how parasympathetic innervation can control airway diameter

A

BronchoCONSTRICTION

- ACh stimulates M3 receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe how sympathetic innervation can control airway diameter

A

NO sympathetic innervation but:

  • Beta 2 adrenoceptors present on airway smooth muscle
  • Circulating adrenaline causes bronchoDILATION
  • Beta 2 receptors on mast cells –> inhibit activity
  • Beta 2 stimulation promotes muco-ciliary escalator activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe how CO2 can control airway diameter

A

BronchoDILATION

- Important for ventilation-perfusion matching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe how mast cells can control airway diameter

A
  • Present in airway walls
  • Mediators released on degranulation cause bronchoCONSTRICTION
  • Histamine, leukotrienes, platelet activating factor
  • Contribute to asthma pathology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe how mechanical receptors can control airway diameter

A
  • Rapidly adapting receptors (RAR) cause bronchoCONSTRICTION
  • Slowly adapting pulmonary stretch receptors (PSR) cause bronchoDILATION
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is radial traction?

??????????????

A
  • Airways embedded into lung parenchyma
  • Parenchyma splints airways open
  • Inflation increases radial traction and REDUCES airway resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is alveolar interdependence?

????????????????

A
  • Neighbouring alveoli share walls
  • Mechanical tethering keeps conducting airways open
  • Loss of radial traction and alveolar interdependence INCREASES airway resistance in COPD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the different possible pharmacological controls of airway DIAMETER in asthma?

A

With bronchodilators

  1. Anti-cholinergic/ muscarini antagonists
  2. Beta 2 agonists
  3. Methylxanthines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is asthma?

A
  • Bronchial hypersensitivity –> airway mucosa inflammation: infiltration of immune cells and thickening
  • Increased airway secretions (mucus)
  • Pharmacological treatment can target bronchoconstrictor or inflammatory components
  • Episodes of bronchoconstriction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the action of anti-cholinergic/ muscarinic antagonists in the treatment of airway diameter (asthma) and give examples

A
  • Block the bronchoconstricting action of ACh
  • IPRATROPIUM (inhaled) - quarternary nitrogen in structure prevents systemic abs and reduces side effects (dry mouth/ cough)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the action of beta 2 agonists in the treatment of airway diameter (asthma) and give examples

A
  • Stimulate the AC/ cAMP/ PKA pathway to cause bronchodilation and red inflammation =
  • SALBUTAMOL (inhaled); short acting
  • SALMETEROL/ TURBUTALINE; slow onset/ long acting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the action of methylxanthines in the treatment of airway diameter (asthma) and give examples

A
  • PDE inhibitors: inc cAMP and cause bronchodilation and reduce inflammation
  • THEOPHYLLINE/ AMINOPHYLLINE (oral); they have a NARROW THERAPEUTIC WINDOW
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the possible side effects of theophylline/ aminophylline

A
  • Headache
  • Restlessness
  • Abdominal symptoms
  • Arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the possible side effects of salbutamol?

A
  • Tachycardia
  • Tremor
  • Airway hyper-responsiveness
17
Q

What are the different possible pharmacological controls of airway INFLAMMATION in asthma?

A
  1. Monoclonal anti-IgE antibodies
  2. Sodium cromoglicate cromolyn
  3. Histamine receptor antagonists
  4. Targeting the leukotriene pathway
  5. Corticosteroids
18
Q

Describe the action of monoclonal anti-IgE antibodies in the treatment of airway inflammation (asthma) and give examples

A
  • OMALIZUMAB - requires subcutaneous injection every 2-4 weeks
  • Reduces circulating IgE antibodies and therefore reduces mast cell degranulation and inflammation
  • Used in severe allergic asthma
  • In rare instance, can cause anaphylaxis
19
Q

Describe the action of histamine receptor antagonists in the treatment of airway inflammation (asthma) and give examples

A
  • KETOTIFEN (oral) - H1 receptor antagonist, anti-inflammatory after 6-12 weeks of treatment
  • Reduced reliance on steroids and bronchodilators
  • Few side effects; 10-15% patients experience drowsiness
20
Q

Describe the action of targeting the leukotriene pathway in the treatment of airway inflammation (asthma) and give examples

A
  • Leukotriene formation antagonists
  • ZILEUTON (oral); inhibits 5-lipoxygenase, short half life
  • Leukotriene receptor antagonist (oral)
  • Single daily dose, used in severe chronic and exercise-induced asthma. bronchodilates, decreases mucus secretion and reduces inflammation
21
Q

Describe the action corticosteroids in the treatment of airway inflammation (asthma) and give examples

A
  • Reduce airway inflammation and hyper-responsiveness
  • Prevents rather than relieves
  • BECLAMETHASONE (inhaled)
  • Metabolised to active form in lung, reducing systemic side effects
22
Q

Describe the action of sodium cromoglicate/ cromolyn in the treatment of airway inflammation (asthma) and give examples

A
  • CROMOLYN (inhaled): a mast cell stabiliser
  • Prophylactic treatment
  • Mechanism of action not fully understood
  • Inhibits release of inflammatory mediators from mast cells and RAR axon reflexes
  • Takes 4 weeks to become effective
  • Mild side effects such as coughing, wheezing, dry throat
23
Q

What is aspirin induced asthma?

A
  • Development of asthma following ingestion of aspirin
  • Sensitivity develops in adulthood; women> men
  • Prevalence approx 21%
  • Symptoms include rinhorrhea, nasal congestion, sinusitis
  • 5-lipoxygenase upregulated
  • MONTELUKAST used as a treatment adjust

IRM (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions