L17 - drug treatment of respiratory disease

Question 1

symptoms of asthma

Answer 1

bronchoconstriction
oedema
mucus secretion
inflammation

Question 2

what drug types are used to treat asthma

Answer 2

bronchodilators

anti-inflammatory

Question 3

what type of bronchodilators are used to treat asthma

Answer 3

B2 agonists (salbutamol ST/salmeterol LT)
muscarinic antagonists

Question 4

what types of anti-inflammatory drugs are used to treat asthma

Answer 4

glucocorticosteroids 
xanthines 
cromones
leukotriene antagonists 
anti - IgE

Question 5

describe the process of a B2 agonist causing vasodilation

Answer 5

1. binds to B2 receptors
2. induce cAMP release
3. cAMP activates PKA to phosphorylate MLCK
4. relaxation

Question 6

how do muscarinic antagonists (M3) cause vasodilation

and give an example of one

Answer 6

decrease PNS activation

ipratropium bromide

Question 7

why do muscarinic antagonists have few side effects

Answer 7

they are inhaled and polar so unlikely to become systemic

Question 8

give example of a direct bronchodilator and indirect bronchodilation

Answer 8

direct - salbutamol

indirect - ipratropium bromide (acts on M)

Question 9

describe the process of glucocorticosteroids causing anti inflammation

Answer 9

1. form receptor complex inside cell which enters nucleus
2. leads to repression of TFs involved in inflammatory protein synthesis
3. decrease in cytokines, chemokines, inflammatory enzymes

Question 10

list the proteins involved in inflammation that are inhibited by glucocorticosteroids

Answer 10

cytokines
chemokines
inflammatory enyzmes

Question 11

what anti-inflammatory pathways do steroids activate

Answer 11

annexin synthesis which is involved in -ve feedback of inflammation pathways

Question 12

what does annexin do and what stimulates it

Answer 12

steroids

involved in -ve feedback inflammation pathways

Question 13

what are side effects of glucocorticosteroids taken orally for asthma

Answer 13

1. immunosuppression
2. osteoporosis
3. cushings syndrome
4. hypertension

Question 14

what do leukotrines cause?

Answer 14

vasoconstriction
oedema
mucus production

Question 15

how do xanthines treat asthma

Answer 15

they inhibit PDE3 (phosphodiesterase) leading to increased [cAMP] available to activate PKA

Question 16

what does phosphodiesterase do

Answer 16

breaks down cAMP to CMP

Question 17

side effects of xanthines?

Answer 17

nausea 
arrhythmias 
hypokalaemia 
hypotension 
seizures

Question 18

weakness of xanthines?

Answer 18

small therapeutic window

so often involves side effects

Question 19

name 2 cromones

Answer 19

sodium cromoglicate

nedocromil sodium

Question 20

what are cromones and how do they work

Answer 20

anti inflammatory drugs that reduce inflammatory cell activation & recruitment

Question 21

what does IgE antibody do?

Answer 21

bind to mast cells stimulating inflammatory mediator release

Question 22

what does the anti - IgE antibody do

Answer 22

binds to the IgE antibody before it can bind to mast cells and stimulate inflammatory response

Question 23

what is emphysema

Answer 23

alveolar collapse

Question 24

what is COPD

Answer 24

chronic obstructive pulmonary disease

chronic airway inflammation

Question 25

what drug is the anti -IgE antibody

Answer 25

omalizumab

Question 26

causes of COPD?

Answer 26

smoking

pollution

Question 27

what type of drugs treat COPD

Answer 27

B2 agonists
muscarinic receptor antagonists
glucocorticosteroid 
PDE4 inhibitors
codeine 
dextromethorphan

Question 28

how do codeine and dextromethorphan help treat COPD

Answer 28

anti tussives - anti cough

Question 29

example of a PDE4 inhibitor

Answer 29

rofumilast