L17: Drugs & the Respiratory System

Question 1

Location of asthma in the lungs

Answer 1

Trachea

Question 2

Location of bronchitis

Answer 2

Bronchi- Bronchioles

Question 3

2 zones in the lungs

Answer 3

1) Conducting Zone
2) Transitional & Respiratory Zones

Question 4

Location of COPD

Answer 4

Respiratory bronchioles

Question 5

Location of small airways disease

Answer 5

Respiratory bronchioles- alveolar ducts

Question 6

Location of emphysema

Answer 6

Alveolar sacs

Question 7

Where does tuberculosis tend to occur in?

Answer 7

Upper lung lobes

Question 8

How does the body respond to allergens into the body?

Answer 8

Releasing an antibody called immunoglobin, too much IgE can cause inflammation of lungs

Question 9

3 phases in lung function after allergen exposure

Answer 9

1) Immediate asthmatic phase
2) Delayed phase
3) Airway/bronchial hyperresponsiveness

Question 10

What is the immediate phase after allergen exposure?

Answer 10

Due to bronchospasm released from allergen-triggered mast cells acting on bronchiolar smooth muscle

Question 11

What is the delayed phase after allergen exposure?

Answer 11

Airway narrowing due mainly to mucosal swelling as a result of mediators released from inflammatory cells

Question 12

What is the AHR phase after allergen exposure?

Answer 12

Combined effects of bronchospasm on an inflamed aiway sensitive to any inhaled irritant

Question 13

Drugs used in a pharmacological treatment of asthma 1

Answer 13

1) bronchodilators
2) anti-inflammatory agens

Question 14

2 agonists in current treatment of symptoms

Answer 14

1) short acting beta-2 agonists
2) long acting beta-2 agonists
3) theorphylline

Question 15

What do muscarinic antagonists prevent?

Answer 15

Prevent smooth muscle contraction & mucus secretion induced by activation of parasympathetic nerves

Question 16

What are muscarinic antagonists used in the treatment of?

Answer 16

COPD

Question 17

What bromides are bronchoconstriction inhibited by?

Answer 17

1) ipratropium bromide
2) tiotropium bromide

Question 18

Actions of glucocorticosteroids in asthma

Answer 18

• Inhibition of leukotriene & cytokine synthesis/release
• Inhibition recruitment of inflammatory cells
• Increases beta-adrenoceptor function

Question 19

Role of inhaled corticosteroids in asthma therapy

Answer 19

• Prevents infiltration & activation of inflammatory cells
• Improves airflow
• Decrease airway
• Reduce symptoms

Question 20

Side effects of glucocorticosteroids

Answer 20

Inhaled route
Oral/prolonged high dose

Question 21

What do xanthines inhibit?

Answer 21

phosphodiesterase (PDE)

Question 22

Treatment options for COPD

Answer 22

quit smoking
anti-inflammatory drugs

Question 23

Mechanism of action of muscarinic antagonists

Answer 23

Blocks M3 receptors on aiway smooth muscle- preventing bronchoconstriction & reduce mucus secretion

Question 24

One type of steroids used in anti-inflammatory therapy

Answer 24

Glucocorticosteroids

Question 25

How does glucocorticosteroids work on asthma ?

Answer 25

Suppress multiple inflammation by: 1) Suppressing cytokine production 2) Reducing leukotriene & prostaglandin synthesis 3) Block recruitment of inflammatory cells 4) Increase b-adrenoceptor function

Question 26

Role of inhaled corticosteroids (ICS) in asthma therapy

Answer 26

1) Prevents infiltration 2) Reduce mucosal oedema 3) Improves airflow

Question 27

Role of PLA2 in the action of inhaled GCS

Answer 27

Convert membrane bound phospholipids into arachidonic acid

Question 28

What does leukotriene antagonists inhibit?

Answer 28

Bronchoconstriction, oedema, mucus production

Question 29

Mechanisms of xanthines

Answer 29

Inhibit phosphodiesterase (PDE), enzyme that degrades cAMP, causing bronchodilation- leading to relaxation

Question 30

Function of cromones

Answer 30

Prevents mast cell degranulation, reducing inflammation

Question 31

Mechanism of Anti-IgE therapy

Answer 31

Binds free IgE, preventing mast cell activation

Question 32

Pathophysiology of chronic obstructive pulmonary disease

Answer 32

1) chronic inflammation of drugs 2) progressive breathlessness

Question 33

Treatments of chronic obstructive pulmonary disease

Answer 33

1) bronchodilators- muscarinic antagonists & beta-2 antagonists 2) anti-inflammatory drugs- ICS 3) Anti-tussives (cough)

Question 34

What does pro-inflammatory ligands bind to whcih activates G-protein signalling & adenylyl cyclase?

Answer 34

Pro-inflammatory receptors

Question 35

What is PDE4?

Answer 35

Phosphodiesterase

Question 36

What does PDE4 break down in the cAMP signalling pathway?

Answer 36

cAMP into AMP, reducing signalling effects

Question 37

What do PDE4 inhibitors prevent?

Answer 37

cAMP breakdown

Question 38

What does cAMP activate to influence downstream signalling?

Answer 38

pKa, Epac 1/2

Question 39

Effects of Epac 1/2,

Answer 39

Inhibits Rap1 to decrease cell proliferation

Question 40

What does pKa activate & inhibit?

Answer 40

Activate: Creb, increasing anti-inflammatory cytokine production Inhibit: NF-kB & Bcl6, decrease pro-inflammatory cytokines & cell proliferation