L17: Drugs & the Respiratory System Flashcards
Location of asthma in the lungs
Trachea
Location of bronchitis
Bronchi- Bronchioles
2 zones in the lungs
1) Conducting Zone
2) Transitional & Respiratory Zones
Location of COPD
Respiratory bronchioles
Location of small airways disease
Respiratory bronchioles- alveolar ducts
Location of emphysema
Alveolar sacs
Where does tuberculosis tend to occur in?
Upper lung lobes
How does the body respond to allergens into the body?
Releasing an antibody called immunoglobin, too much IgE can cause inflammation of lungs
3 phases in lung function after allergen exposure
1) Immediate asthmatic phase
2) Delayed phase
3) Airway/bronchial hyperresponsiveness
What is the immediate phase after allergen exposure?
Due to bronchospasm released from allergen-triggered mast cells acting on bronchiolar smooth muscle
What is the delayed phase after allergen exposure?
Airway narrowing due mainly to mucosal swelling as a result of mediators released from inflammatory cells
What is the AHR phase after allergen exposure?
Combined effects of bronchospasm on an inflamed aiway sensitive to any inhaled irritant
Drugs used in a pharmacological treatment of asthma 1
1) bronchodilators
2) anti-inflammatory agens
2 agonists in current treatment of symptoms
1) short acting beta-2 agonists
2) long acting beta-2 agonists
3) theorphylline
What do muscarinic antagonists prevent?
Prevent smooth muscle contraction & mucus secretion induced by activation of parasympathetic nerves
What are muscarinic antagonists used in the treatment of?
COPD
What bromides are bronchoconstriction inhibited by?
1) ipratropium bromide
2) tiotropium bromide
Actions of glucocorticosteroids in asthma
- Inhibition of leukotriene & cytokine synthesis/release
- Inhibition recruitment of inflammatory cells
- Increases beta-adrenoceptor function
Role of inhaled corticosteroids in asthma therapy
- Prevents infiltration & activation of inflammatory cells
- Improves airflow
- Decrease airway
- Reduce symptoms
Side effects of glucocorticosteroids
Inhaled route
Oral/prolonged high dose
What do xanthines inhibit?
phosphodiesterase (PDE)
Treatment options for COPD
quit smoking
anti-inflammatory drugs
Mechanism of action of muscarinic antagonists
Blocks M3 receptors on aiway smooth muscle- preventing bronchoconstriction & reduce mucus secretion
One type of steroids used in anti-inflammatory therapy
Glucocorticosteroids
How does glucocorticosteroids work on asthma ?
Suppress multiple inflammation by:
1) Suppressing cytokine production
2) Reducing leukotriene & prostaglandin synthesis
3) Block recruitment of inflammatory cells
4) Increase b-adrenoceptor function
Role of inhaled corticosteroids (ICS) in asthma therapy
1) Prevents infiltration
2) Reduce mucosal oedema
3) Improves airflow
Role of PLA2 in the action of inhaled GCS
Convert membrane bound phospholipids into arachidonic acid
What does leukotriene antagonists inhibit?
Bronchoconstriction, oedema, mucus production
Mechanisms of xanthines
Inhibit phosphodiesterase (PDE), enzyme that degrades cAMP, causing bronchodilation- leading to relaxation
Function of cromones
Prevents mast cell degranulation, reducing inflammation
Mechanism of Anti-IgE therapy
Binds free IgE, preventing mast cell activation
Pathophysiology of chronic obstructive pulmonary disease
1) chronic inflammation of drugs
2) progressive breathlessness
Treatments of chronic obstructive pulmonary disease
1) bronchodilators- muscarinic antagonists & beta-2 antagonists
2) anti-inflammatory drugs- ICS
3) Anti-tussives (cough)
What does pro-inflammatory ligands bind to whcih activates G-protein signalling & adenylyl cyclase?
Pro-inflammatory receptors
What is PDE4?
Phosphodiesterase
What does PDE4 break down in the cAMP signalling pathway?
cAMP into AMP, reducing signalling effects
What do PDE4 inhibitors prevent?
cAMP breakdown
What does cAMP activate to influence downstream signalling?
pKa, Epac 1/2
Effects of Epac 1/2,
Inhibits Rap1 to decrease cell proliferation
What does pKa activate & inhibit?
Activate: Creb, increasing anti-inflammatory cytokine production
Inhibit: NF-kB & Bcl6, decrease pro-inflammatory cytokines & cell proliferation
