L17 - drug treatment of respiratory disease Flashcards
symptoms of asthma
bronchoconstriction
oedema
mucus secretion
inflammation
what drug types are used to treat asthma
bronchodilators
anti-inflammatory
what type of bronchodilators are used to treat asthma
B2 agonists (salbutamol ST/salmeterol LT) muscarinic antagonists
what types of anti-inflammatory drugs are used to treat asthma
glucocorticosteroids xanthines cromones leukotriene antagonists anti - IgE
describe the process of a B2 agonist causing vasodilation
- binds to B2 receptors
- induce cAMP release
- cAMP activates PKA to phosphorylate MLCK
- relaxation
how do muscarinic antagonists (M3) cause vasodilation
and give an example of one
decrease PNS activation
ipratropium bromide
why do muscarinic antagonists have few side effects
they are inhaled and polar so unlikely to become systemic
give example of a direct bronchodilator and indirect bronchodilation
direct - salbutamol
indirect - ipratropium bromide (acts on M)
describe the process of glucocorticosteroids causing anti inflammation
- form receptor complex inside cell which enters nucleus
- leads to repression of TFs involved in inflammatory protein synthesis
- decrease in cytokines, chemokines, inflammatory enzymes
list the proteins involved in inflammation that are inhibited by glucocorticosteroids
cytokines
chemokines
inflammatory enyzmes
what anti-inflammatory pathways do steroids activate
annexin synthesis which is involved in -ve feedback of inflammation pathways
what does annexin do and what stimulates it
steroids
involved in -ve feedback inflammation pathways
what are side effects of glucocorticosteroids taken orally for asthma
- immunosuppression
- osteoporosis
- cushings syndrome
- hypertension
what do leukotrines cause?
vasoconstriction
oedema
mucus production
how do xanthines treat asthma
they inhibit PDE3 (phosphodiesterase) leading to increased [cAMP] available to activate PKA
what does phosphodiesterase do
breaks down cAMP to CMP
side effects of xanthines?
nausea arrhythmias hypokalaemia hypotension seizures
weakness of xanthines?
small therapeutic window
so often involves side effects
name 2 cromones
sodium cromoglicate
nedocromil sodium
what are cromones and how do they work
anti inflammatory drugs that reduce inflammatory cell activation & recruitment
what does IgE antibody do?
bind to mast cells stimulating inflammatory mediator release
what does the anti - IgE antibody do
binds to the IgE antibody before it can bind to mast cells and stimulate inflammatory response
what is emphysema
alveolar collapse
what is COPD
chronic obstructive pulmonary disease
chronic airway inflammation
what drug is the anti -IgE antibody
omalizumab
causes of COPD?
smoking
pollution
what type of drugs treat COPD
B2 agonists muscarinic receptor antagonists glucocorticosteroid PDE4 inhibitors codeine dextromethorphan
how do codeine and dextromethorphan help treat COPD
anti tussives - anti cough
example of a PDE4 inhibitor
rofumilast
